Melissa Jackson from Bridlington is calling for all pregnant women to be better informed about group B Strep (also known as GBS or Strep B) bacteria, which almost killed her newborn baby, Matilda.
After a straightforward pregnancy and extremely fast labour, Matilda was born in Scarborough Hospital on 24 April 2017, but Melissa, quickly sensed that all was not well. The ward doctor found that Matilda’s oxygen levels were alarmingly low and she was rushed to the special care unit.
History was repeating itself for the Jacksons. Their eldest daughter, Annabelle, who is now five, was also in special care for 13 days at birth with suspected sepsis.
Melissa Jackson said: “To be going through this horrendous experience again was almost too much to bear. I couldn’t even stay with Matilda on the first night as there were no beds in the special care unit, so I ended up back on the maternity ward with no baby. At midnight, I heard a doctor asking which bed Melissa Jackson was in. My heart was pounding as I feared the worst with them coming in the middle of the night, however, they had come to say that thankfully the lumbar puncture results were clear for meningitis and they wanted to let me know as soon as possible.”
Testing for Group Strep B
As well as testing Matilda, Melissa Jackson had a swab test and was found to be carrying group B Strep. The bacteria was passed to Matilda around labour, and caused a group B Strep infection. During Matilda’s eight-day stay in hospital, her oxygen saturations gradually improved and she was moved from an incubator into a hot cot but stayed on antibiotics during her stay.
“Once Matilda was diagnosed, the hospital gave us leaflets about group B Strep,” said Melissa Jackson, “and it was then that I realised that this was only the start of a long journey. It was frightening to read that although the treatment was working well, we wouldn’t be able to relax once we got home as there was the possibility that Matilda could relapse.”
The UK does not routinely test pregnant women for group B Strep, unlike the United States, Canada, Germany, France, Spain and many other developed countries where all mothers-to-be are tested. Each week in the UK, one baby dies and another is left with a long-term disability, like cerebral palsy or hearing or vision loss, as a result of group B Strep infection. The bacteria can be passed unknowingly from a mother to her baby around birth. Rarely harmful to adults, it is the UK’s most common cause of severe infection in newborn babies, causing sepsis, pneumonia, and meningitis.
Most group B Strep infections in newborn babies can be prevented by testing the mother late in pregnancy and providing intravenous antibiotics during labour to those who test positive. This reduces the risk of a baby developing a group B Strep infection by up to 90 per cent. The test would cost the NHS just £11 and private tests can also be purchased online. Pregnant women can take this simple, safe test between 35 and 37 weeks of pregnancy.
Matilda was closely monitored during her first 12 months, and she successfully reached all her developmental milestones and is now a happy and healthy three-year-old.
“New mums need to be made aware of group B Strep and the fact that they can take a test privately, if the NHS doesn’t offer one to them. I would have had the test if I’d known about it,” said Melissa Jackson.
Jane Plumb MBE, founder and chief executive of the Group B Strep Support charity, said: “We’re so sorry that Melissa and Sam and baby Matilda had to go through this frightening experience. The UK’s rate of group B Strep has been rising in recent years, showing that the current prevention is failing. We’re fighting for the UK to adopt a national policy of testing and prevention and until then, it’s essential that we spread the word to pregnant women and their family and friends.”
Since late 2017 the Royal College of Obstetricians and Gynaecologists guideline on group B Strep has recommended that all pregnant women should be provided with a leaflet on group B Strep during pregnancy. (This leaflet can be downloaded from the Group B Strep Support charity’s website).
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Key facts about group B Strep
- Group B Streptococcus (also known as group B Strep, GBS or Strep B) is the most common cause of life-threatening infection in newborn babies.
- It causes a range of serious infections including sepsis, pneumonia and meningitis – it is the most common cause of severe infection in newborn babies and of meningitis in babies under 3 months of age.
- If left untreated, a GBS infection can kill a newborn baby within hours.
- On average, two babies each day in the UK develop a GBS infection and each week, one baby dies from a GBS infection and another is left with a life-changing disability.
- Most GBS infections in newborn babies can be prevented by testing late in pregnancy and providing intravenous antibiotics during labour to women whose test results are positive.
- The UK does not routinely test for GBS, unlike the United States, Canada, Germany, France and Spain.
- Even Bangladesh, Iran, Lithuania and Trinidad and Tobago routinely test pregnant women for GBS.
- The test would cost the NHS just £11, and costs from £35 privately.
What is group B Strep?
- GBS is a bacterium carried by many adults, commonly in the gut or in the vagina. Carriage is not infection or illness, rarely causes any symptoms, and does not need to be treated. Carriage is normal.
- GBS can cause infection in young babies. Most GBS infection in babies develop within the first 6 days of life, after the bacteria are transmitted to the baby around labour and birth.
- GBS infection in babies is very rare after age 3 months, though it also can cause infection in the elderly, those with compromised immune system, and women during or shortly after pregnancy.
Testing for group B Strep carriage
- Pregnant women can take a simple, safe test for group B Strep carriage, ideally in the last 5 weeks of pregnancy (usually at 35- 37 weeks’ gestation).
- The most effective test for group B strep is an enriched culture medium test (ECM test) which is available from some NHS trusts, plus several home testing services and private clinics (see gbss.org.uk/test).
- Since 2017 the Royal College of Obstetricians and Gynaecologists has recommended that women who tested positive in their previous pregnancy should be offered the option of ECM testing for GBS in their next pregnancy.
- The ECM test is highly sensitive – it will detect almost twice as many women carrying GBS than the all-purpose swab test used in the NHS to investigate vaginal discharge.
Preventative medicine in labour
- Most GBS infections in newborn babies could be prevented by identifying women who are carrying GBS late in pregnancy and offering them intravenous antibiotics during labour.
- Giving women antibiotics (usually penicillin) in labour reduces the risk of a baby developing a group B Strep infection by up to 90%.
UK prevention approach
- The UK does not routinely offer antenatal testing for group B Strep, unlike most high-income countries, including the United States, Canada, Germany, France and Spain.
- Currently in the UK health professionals consider a range of risk factors to decide whether a woman should be offered antibiotics in labour, rather than testing for GBS carriage. The latest RCOG guidelines.
- The rate of early-onset GBS infection in newborn babies in the UK is currently two and half times (2.5x) that of the United States, where the rate dropped by over 80% following the introduction of routine testing.
- If the rate in the UK reduced in the same way, we could prevent GBS infection in 350 babies every year, saving 15 babies’ lives and protecting another 15 from life-changing disability.
- Depending on where she lives, a woman may not have access to the ECM test or be offered antibiotics in labour- it’s a postcode lottery.
- On 14 May 2019, the UK’s Department of Health & Social Care announced a major clinical trial for group B Strep prevention. The new trial will test the effectiveness of two types of testing compared against risk-based screening in 80 hospitals in England, Wales and Scotland and the results will inform future pregnancy policy in the UK.
Who are Group B Strep Support?
- Group B Strep Support is the group B Strep charity, working to stop GBS infection in babies.
- Set up in 1996 by Jane and Robert Plumb after their newborn son, Theo, died from GBS infection aged 17 hours.
- GBSS works with families affected by GBS and campaigns for better prevention against GBS infection to be introduced in the UK.
- gbss.org.uk: provides information about GBS, testing and treatment. All information is approved by an expert medical advisory panel.
- Helpline: provides one to one support and information. Call 0330 120 0796 or email firstname.lastname@example.org.
- Community support: where families share experiences and support others, including a Facebook community of over 35,000 people.
- Campaigns: to stop GBS infection in babies through the introduction of better prevention in the UK, including making ECM testing routinely available on the NHS
- Education and education: working with health professionals to improve education, awareness and knowledge about group B Strep among new and expectant parents and their health professionals.
Story by Melissa Jackson
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