Within hours of birth, baby Ralf Jones was showing signs of life-threatening infection. He stopped breathing twice and had two seizures. Ralf had developed meningitis caused by group B Strep infection; he has recovered, but GBS has left its legacy
Ralf’s infection and resulting disabilities could have been prevented. Group B Streptococcus (group B Strep/GBS) is a common bacterium carried by approximately 25% of women and is the leading cause of sepsis and meningitis in newborn babies. Without preventative medicine, GBS infects up to 700 babies a year in the UK, of whom 10% will die and 5% will suffer long-term physical or mental consequences.
Carrying GBS during pregnancy is recognised as an important risk factor for GBS infection in newborn babies and yet women are rarely told about GBS by their health professionals and even more rarely offered testing.
A simple, GBS test – the ‘gold standard’ ECM (Enriched Culture Medium) sensitive test – taken at between 35 to 37 weeks of pregnancy best predicts GBS carriage in labour. Those women where GBS is identified, and others known to be a higher risk, can then be offered antibiotics in labour to minimise the risk of GBS infection in their newborn babies. The use of antibiotics at this stage reduces the risk of GBS infection in the newborns from around a one in 300 risk to less than one in 6,000.
Ralf was born in September, 2009, at 37 weeks in Huddersfield, “It was an easy pregnancy,” says his Mum, Sally, “with no suggestion of testing for GBS throughout. I did not have any risk-factors and Ralf’s delivery was fine, albeit a little early.” Shortly after his birth, however, Ralf was struggling to feed and was crying. “A couple of midwives looked at him and asked a doctor to check him because he was showing three signs of GBS, which I didn’t realise as I had never heard of it,” says Sally. The next day, Ralf was still struggling to feed. By that evening, he had become lethargic, his jaundice levels were unchanged and he was finding it hard to breathe. “The midwives transferred him to intensive care where he was administered antibiotics and was put on a ‘respirator’. That afternoon, we were told he had contracted meningitis from GBS infection.”
Ralf required hospital care for over four weeks. “He had brain scans including MRI, which showed changes to the brain, cysts and a loss of white matter.” The family was told that he would develop problems as a result of his infection. Ralf made good progress during his early years, reaching his developmental milestones. However, at three years of age, things were not right. “Ralf has now undergone a multitude of tests and occupational therapy and has been diagnosed with dyspraxia which has been linked to changes found in the movment section of his brain.”
Sonny is Ralf’s younger brother, who was born in May 2011. Sally was given intravenous antibiotics during labour as a result of having previously carried GBS and Sonny did not develop GBS.
National charity Group B Strep Support relentlessly campaigns for greater awareness and better prevention, including for the simple and safe ‘Gold Standard’ ECM test to be offered to every pregnant mum. During July Awareness Month – A Simple Test to Save A Life – Group B Strep Support will be urging pregnant women to get informed about GBS and consider testing. Sir Bob Russell MP has just tabled a Parliamentary Early Day Motion (EDM) supporting GBS Awareness month.
Jane Plumb MBE, chief executive of Group B Strep Support, lost her middle child to GBS infection and is calling on the government to inform all pregnant women, “Every mother-to-be should be informed about GBS during routine antenatal care and if she wants to be tested for it in pregnancy, the ‘gold standard’ test should be readily available on the NHS. The Government should act now to ensure women get the very best advice and support during their pregnancy.”
Testing:
The ‘gold standard’ ECM testing for GBS carriage requires swabs to be taken from the mum- to-be at 35 to 37 weeks of pregnancy, then cultured using enriched media. Not all NHS hospitals offer the ECM test; fortunately there are some private medical laboratories that offer home-testing packs for approximately £35. For hospitals and labs which offer ECM testing, visitGBSS Test
Discount testing
For the month of July, The Doctors Laboratory is offering a 17 % discount on their private testing kit which will be priced at £29. You can contact them on tel: 0207 307 7373 or visit TDL Pathology
Group B Strep Support is asking that:
• Information about GBS should be routinely given to all women as part of their antenatal care
• Sensitive testing for GBS should be made freely available within the NHS and offered to every pregnant woman whose baby is at low risk of developing GBS infection
• Antibiotics should be offered intravenously in labour to all mums whose babies are known to be at higher risk of developing GBS infection
• The use of the ‘standard’ test within the NHS for the detection of GBS carriage in pregnancy should cease and vaginal swabs from pregnant women should always be tested using a method that offers good sensitivity for GBS detection
Sarah Jane Chapman has created a petition, ending on 31 December 2013, asking The Department of Health to ensure women are routinely offered testing for group B Strep in every pregnancy. Please read it at http://epetitions.direct.gov.uk/petitions/43712 and consider signing it, and sharing it with your friends and family.
