Watch this space for the latest news about the activities of GBSS, and for other announcements and news about Group B Strep.

If you have some news that you think might be appropriate for this page, please contact us.

GBS Symposium - 17 June 2010 in London

The Prime Minister's Commission on the future of nursing & midwifery - your views sought

Petition to the Prime Minister March 2009

GBS Infection on the Increase

Experiences of Legal Action

National Screening Committee GBS Meeting

Research into preterm labour and preterm membrane rupture

New petition to the Prime Minister asking for testing for GBS to be offered to pregnant women

DEVANI Research Project into developing a vaccine against GBS

New book release

Reception at Stormont

WI Resolution

GBS Petition to 10 Downing Street 2008

The private laboratories offering Enriched Culture Medium (ECM) testing for GBS carriage during pregnancy

Royal College of Obstetricians & Gynaecologists – audit on GBS disease January 2007

GBS Survey by Pregnancy and Birth Magazine

2006 Information made available on NHS Direct on GBS

Royal College of Obstetricians &Gynaecologists – patient information on GBS – February 2006

Online GBS Learning Package Launched

GBS Petition Presented to Downing Street 2005

Health Protection Agency Standard Operating Procedure now available on testing for GBS carriage

Royal College of Obstetricians & Gynaecologists Summary of Guidelines

Parliamentary Early Day Motion 538 Group B Streptococcus – Summer/Autumn 2005

Parliamentary Early Day Motion 973 Group B Streptococcus

UK Research into the incidence of GBS infection

Royal College of Obstetricians & Gynaecologists issue GBS guidelines

National Screening Committee – workshop on GBS prevention

Adjournment Debate on GBS - 9th July 2003

Higher estimates of incidence of early-onset group B streptococcal (EOGBS) infection - Lancet 7th June 2003

Revised GBS Guidelines from the U.S. Center for Disease Control

Public Health Laboratory Service issued Interim Good Practice Recommendations

Research into the Treatment of GBS with Antibiotics

GBS infections in babies on the increase in the UK and these infections are also increasing in adults.  The Health Protection Agency (and formerly the CDR) reported 470 GBS infections in babies aged 0-90 days in 2008, an increase of 51% since 2003 (when RCOG's guidelines were introduced).  That’s 3 more babies a week ... and this at a time when national prevention guidelines were being implemented.  Click here to view the detail.
 
Experiences of Legal Action

Would you help us help families considering legal action relating to GBS infection?  Please support the Experiences Register – you will be contributing to our work and your experiences will inform what we are doing.  Click here for more details.

National Screening Committee GBS Meeting

The slides and papers from the November 2008 GBS Stakeholders' Meeting are available online -  click here .  To read the comments GBSS submitted to the NSC on the meeting note and the Evaluation of antenatal screening for Group B Streptococcal (GBS) carriage against NSC Handbook Criteria, most of which were not included in the final submission to the NSC policy making meeting on 24 March 2009, please click here .

New Research - Oral Antibiotics and preterm labour / rupture of membranes

Research published in the Lancet on 18 September 2008 suggested that low-dose oral antibiotics given to pregnant women to delay premature birth might cause long-term harm to their babies. 

And how does this study relates to antibiotics prescribed against GBS infection?  It doesn’t.  Antibiotics given to mothers and babies for GBS infection are given intravenously and in large doses so that the infection is properly treated.  The study published in the Lancet related to giving low-does oral antibiotics to mothers who were in threatened preterm labour, or who had preterm prelabour rupture of the membranes.  For more information, click here

New petition for group B Strep testing

Please check out the petition asking the Prime Minister to offer all women the chance to be tested for group B Strep - click here.

DEVANI Research Project into developing a vaccine against GBS

DEVANI (an abbreviation of the title DEvelopment of a Vaccine Against Neonatal Infections) is a European Commission Framework Seven project (HEALTH-F5-2007-200481), which began on 1st January 2008, is to provide useful information for the development of a vaccine against infections in babies caused by GBS.  Public Health Institutes and Universities from Belgium, Bulgaria, Czech Republic, Denmark, Germany, Italy, Spain and the United Kingdom (Health Protection Agency Centre for Infections) are all participating in the project.  The study is coordinated by Novartis Vaccines & Diagnostics, Siena, Italy - click here for more information on the Health Protection Agency website, click here for more information about the project itself and click here for a chart summarising the project.

Just released is a book, Mourning Sarah.  It's a mother's story of the death of her newborn baby from group B Strep infection.  It's a story of grief and recovery - one theme is empowerment.  Women must ask for the healthcare they deserve for themselves and their unborn and newborn babies.  For more information, click here.

Reception at Stormont

On 25 February 25, a reception and information event was held at Stormont for Irish MPs and medical professionals. The event was hosted by Northern Ireland’s new junior minister, Mr Jeffrey Donaldson MP MLA, and Dr Alasdair McDonnell MP MLA. The charity’s founder and chairman, Jane Plumb attended along with Professor Philip Steer, the chairman of the charity’s medical advisory panel. Mr Donaldson said “Northern Ireland has the highest rate of GBS infection in babies in the UK. We in Northern Ireland have the opportunity to lead the way in the UK by raising awareness of GBS and introducing testing to protect our babies from this devastating and preventable infection”. Our very grateful thanks to Susan Kyle a GBSS supporter who organised the event. Read more about it by clicking this link.

WI Resolution

Each year the WI adopts a Resolution put forward by a member. Last year a member tabled a resolution to support offering testing to all pregnant women for GBS. All the resolutions put forward were then debated by the WI groups - the GBS resolution got to the final 6 but unfortunately was not been selected. Thank you to all WI members who voted for and supported the GBS resolution. If any WI members would like to put forward a GBS resolution for the future, we’d love to hear from you - please contact us at info@gbss.org.uk or on 01444 416176.

GBS Petition to 10 Downing Street 2008

On 23 January 2008, we delivered our Petition to No 10 which over 11,000 people had signed. GBSS supporters, representatives from Pregnancy & Birth, MPs Nicholas Soames, Theresa May, Nia Griffith, Philip Hollobone, Jeffrey Donaldson and Alasdair McDonnell and celebrity Doctor Chris Steele from TV’s This Morning all went to Downing Street to present the petition to the Prime Minister. Thanks to everyone who signed the petition and. You can see the responses (two of them!) to the petition on our website by clicking here.

If you’re as disappointed with the response as we are, please do make your views know – please write to your MP and tell them what you believe should be happening, and ask for his/her support. You can find out how to do this by clicking this link.

The private laboratories offering Enriched Culture Medium (ECM) testing for GBS carriage during pregnancy are

The Doctors Laboratory, which is based in London – call 020 7307 7373 or e-mail gbs@tdlpathology.com

Mullhaven Medical Laboratory, which is based in Bedford – call 01234 831115 or e-mail info@mullhaven.co.uk

Each offers a postal service – contact them direct and they will send you a GBS Testing Pack, including the swabs, relevant paperwork (including instructions) and their reply-paid envelope. You pay for the test when you return the swabs.

Royal College of Obstetricians & Gynaecologists – audit on GBS disease January 2007

In January 2007 the RCOG published the findings of their audit of practice in UK obstetric units against the recommendations of their guideline against GBS infection in newborn babies. The audit examined the organisation of testing, the use of intrapartum antibiotic prophylaxis (IAP) and the management of neonates born with increased risk of early-onset GBS disease. The clinical directors of each obstetric unit were contacted and asked to participate in this audit. A senior midwife, consultant obstetrician and consultant neonatologist from each unit were then asked to complete a short questionnaire about their own practice in relation to preventing GBS disease.

The results of the audit have now been published in a RCOG report. A summary version has also been created. Both versions of the report are available in .pdf and paper formats. The .pdf reports can be downloaded from http://www.rcog.org.uk/our-profession/good-practice/audit/prevention-neonatal-group-b-streptoccocal-disease-audit

GBS Survey by Pregnancy and Birth Magazine

Pregnancy & Birth Magazine According surveyed 1,000 pregnant women and new mothers about GBS. The key results are :

• Nine out of 10 have 'never heard of Group B Strep' (87%) and of the few that have heard of it, TWO-THIRDS have 'no idea how dangerous this infection can be' (67%).
• Most of the 13% who had heard about Group B Strep 'found out by chance' on the internet.
• At present, NO test is given on the NHS and the only reliable test costs £32 privately. An overwhelming 92% of pregnant women surveyed say they would pay to have this test if they knew about it, although 40% of these say they 'can't really afford it'
• 100% of survey respondents say the they 'would have the test if it was available on the NHS'

More details can be found in this press release from the magazine.

NHS Direct

NHS Direct publishes information provided by the UK's National Screening Committee's GBS Working Group about group B Strep and pregnancy - click here

Online GBS Learning Package Launched

In May 2006, the UK National Screening Committee launched their GBS online learning package. This learning package has been developed to raise awareness of GBS amongst health care professionals and it provides a comprehensive multidisciplinary interactive teaching resource. Developed by the Women’s Health Specialist Library (part of the National Library for Health), the learning package is based upon the current UK guidelines published by the Royal College of Obstetricians & Gynaecologists. It is divided into three sections - antenatal; delivery; and postnatal. Within each section there is the option to access:

• an introduction to GBS
• different clinical scenarios
• a series of quiz questions to test knowledge
• a FAQs section

Each section is self contained making easy access for busy health care professionals and allowing individuals to work through relevant sections at their preferred pace.

You can access the GBS learning pack- which is primarily aimed at health care professionals - at www.whsl.org.uk/gbs

Royal College of Obstetricians &Gynaecologists – patient information on GBS

In February 2006, the RCOG produced a patient information leaflet on preventing GBS infection in newborn babies. You can find this at http://www.rcog.org.uk/womens-health/clinical-guidance/preventing-group-b-streptococcus-gbs-infection-newborn-babies .

GBS Petition Presented to Downing Street 2005

On Tuesday, 8th November 2005, GBSS delivered a petition of 5060 names to Downing Street. That there were as many signatures as this in the 2 month period the petition was running is testament to the strength of feeling in the country about this issue. This petition called on the Government to ensure sensitive testing for GBS carriage is routinely and freely available for all pregnant women in the UK and that relevant health professionals are fully informed about GBS so they can advise expectant parents in their care.

We asked the Prime Minister to let us know:

1. What steps were being take to ensure that all health professionals involved in maternity care – particularly obstetricians, midwives and GPs – are fully educated and informed about the issues around GBS prevention, so that they can confidently and appropriately advise the expectant parents in their care.

2. When sensitive testing for GBS carriage will be routinely available on the NHS for all women late in pregnancy in the UK; and

3. What steps he will be taking to ensure the recently issued Health Protection Agency guidelines for tests for GBS carriage, recognised as optimal by not only the Royal College of Obstetricians & Gynaecologists, but also by leading experts in the issue of GBS prevention, are used within the National Health Service.

Health Protection Agency Standard Operating Procedure now available on testing for GBS carriage

The Health Protection Agency (HPA) has issued their BSOP (Bacteriology Standard Operating Procedure) No 58 - Screening swabs for Group B Streptococcal Carriage - see www.hpa-standardmethods.org.uk. In order to obtain optimum detection of GBS carriage, this BSOP recommends taking swabs from both the lower vagina AND rectum from pregnant women and recommends they should be processed using enriched culture media. It also states that the results should be reported urgently.

As a BSOP issued by the Health Protection Agency, it's the minimum standard recommended by the HPA for swab testing for group B streptococcal carriage. Indeed, All NHS laboratories accredited by Clinical Pathology Accreditation (UK) must have in place standard operating procedures that are based on, or give equivalent results to, these BSOP Standards.

The Royal College of Obstetricians & Gynaecologists has produced a one-page summary of their Green Top Guidelines Prevention of Early Onset Neonatal Group B Streptococcal Disease (36) November 2003 - see http://www.rcog.org.uk/files/rcog-corp/uploaded-files/GT36SummaryGroupBStrep.pdf .

On 6th July 2005, Mr David Cameron, MP for Witney, tabled another all-party Early Day Motion (EDM) about GBS. You can view the EDM at http://edmi.parliament.uk/EDMi to see who has already signed. MPs can no longer sign this motion, but you could still ask your MP for his/her support for GBSS's campaign for high quality information on GBS to be made available to all expectant parents, together with reliable testing to be offered to all pregnant women between 35 and 37 weeks of pregnancy. For more information about how to do this, go to our help page.

Mr David Cameron, MP for Witney, tabled another all-party Early Day Motion (EDM) about GBS. You can view the EDM at http://edmi.parliament.uk/EDMi/ to see who signed. Although it is no longer possible for MPs to sign this motion, you could still ask your MP for his/her support for GBSS's campaign for high quality information on GBS to be made available to all expectant parents, together with reliable testing to be offered to all pregnant women between 35 and 37 weeks of pregnancy. For more information about how to do this, go to our help page.

A research paper was published in January 2004 which, for the first time, establishes the minimum current burden of GBS disease in UK and Irish infants. The study identified cases of invasive GBS disease in infants younger than 90 days between 1 February 2000 and 28 February 2001 through surveillance involving paediatricians, microbiologists, and parents. 568 cases were identified, equivalent to a total incidence of 0.72 per 1000 live births; the incidence for early-onset disease was 0.48 per 1000, and for late-onset disease was 0.24 per 1000. Risk factors were identifiable for 218 (58%) cases of early-onset disease. 53 infants died (overall 9.7%). However, the study states, “Paediatricians and microbiologists failed to report 44% and 21% of cases respectively. The capture-recapture analysis suggests that the total number of cases for England, Wales & the Channel Islands may actually be 23% (21%-40%) higher than estimated from reports alone."UK research published in June 2003 estimates that the true incidence of GBS infection in newborn babies may be as high as 3.6 in every 1,000 babies born. Lancet. 2003 Jun 7;363(9373):1953-4. Estimated early-onset group B streptococcal neonatal disease. Luck S, Torny M, d'Agapeyeff K, Pitt A, Heath P, Breathnach A, Russell AB. (www.ncbi.nlm.nih.gov/entrez/)So, the figures reported in this study should be looked upon as absolute minimum incidence figures – using them as they are will not only underestimate the true incidence of GBS infection but, inevitably, also underestimate the risks to babies from GBS infection. Group B streptococcal disease in UK and Irish infants younger than 90 days. Heath PT, Balfour G, Weisner AM, Efstratiou A, Lamagni TL, Tighe H, O'Connell LA, Cafferkey M, Verlander NQ, Nicoll A, McCartney AC; PHLS Group B Streptococcus Working Group. Lancet. 2004 Jan 24;363(9405):292-4 (www.ncbi.nlm.nih.gov/).

The Royal College of Obstetricians & Gynaecologists (RCOG) issued their Green Top Guideline No 36 "Prevention of early onset neonatal Group B streptococcal disease" in November 2003 (http://www.rcog.org.uk/womens-health/clinical-guidance/prevention-early-onset-neonatal-group-b-streptococcal-disease-green-). GBSS’s original recommendations for GBS prevention have clearly been vindicated by this guideline – we advocated a similar approach over 7 years ago … but we hope a guideline advocating reliable testing will happen more quickly! The RCOG guideline quotes likely incidences of GBS infection based on the presence of recognised risk factors and recommends intravenous antibiotics in labour for women in higher risk groups. However, the guideline uses the minimum incidence figures quoted in the Heath et al paper and, therefore, not only underestimates the true incidence of GBS infection but, inevitably, also underestimates the risks to babies from GBS infection. GBSS is fully supportive of this guideline which, when fully implemented in the UK, will prevent the majority of lethal cases of GBS infection in newborn babies. The major difference between our position and RCOG’s is that we view their guideline as a key starting position as even more GBS infection in newborn babies could be prevented through adopting a testing approach to GBS prevention. Unfortunately, the tests currently used within the NHS to diagnose GBS colonisation are insufficiently reliable as they give a falsely negative result for up to 50% of carriers - reliable Enriched Culture Media (ECM) tests do exist but are not widely publicised and, at present, we know of only one London laboratory which offers these tests (see Test Now Available For GBS Colonisation below).

The National Screening Committee (NSC) convened a workshop in November 2003 on preventing GBS infection in newborn babies. You can see the presentations from this workship by clicking here. Discussions from this workshop were used to inform the NSC and the key outcomes were:

1. The National electronic Library for Women’s Health will focus on improving the organisation, distribution and management of knowledge about GBS. This will be a priority for next year. NeLH will work with NHS Direct to make this information available to women as well as clinicians.

This is an enormous step forward – good quality information being provided to health professionals and pregnant women is brilliant news!

2. Priority will be given to ensuring that women at increased risk receive consistent advice and appropriate clinical management.

This is fantastic too because, to achieve this, the level of knowledge about GBS prevention needs to rise dramatically amongst health professionals. And it also means that reliable testing should be made available on the NHS for this group of women, for example, so obstetricians can use reliable test to establish whether a woman with prolonged rupture of membranes is carrying GBS. The sooner reliable tests are available on the NHS, the better!

3. The research priorities for GBS will be reviewed and further research commissioned as appropriate.

This is a wonderful opportunity for good quality, useful research to be commissioned – clearly it’s important that money is spent on new research, rather than repeating research already done either here or in other countries. The commitment seems to be there to fund research aimed at GBS prevention, and even though the results may take years to obtain, that’s got to be good news

4. A project group will keep early-onset GBS, prevention, particularly the management of women at medium and low risk, under review and report to the NSC Antenatal Sub-Group.

The women at medium/low risk we believe would also benefit from ECM testing being available to them on the NHS. They could then make an informed decision about their care, based on good quality information about their GBS carriage status. But this seems unlikely to be available for the foreseeable future.

So there’s lots of really encouraging news – and we mustn’t forget that the NSC November 2003 workshop only happened because of the parliamentary activity in the preceding 6 months – so our thanks to everyone who involved their MP in the campaign, and to all the MPs who helped by asking questions, writing letters, etc. Your hard work has borne fruit!

The adjournment debate took place in Westminster Hall at 11.00 am on Wednesday, 9th July 2003. The text of the debate is available here.

This photo shows Craig & Alison Richards, David Cameron MP and Jane & Robert Plumb outside the Houses of Parliament shortly after the debate.

This paper published in the Lancet on June 7th 2003 suggests that the level of early-onset GBS infection may be higher than previously thought, lending support to the need for prevention strategies.

Revised GBS Guidelines from the U.S. Center for Disease Control

The CDC has issued some much-anticipated revised guidelines for the prevention of perinatal GBS. In a nutshell, the main change is the recommendation to test all pregnant women at 35-37 weeks' gestation for vaginal and rectal colonisation using reliable enrichment culture methods. Follow this link to view the full revised guidelines.

The Public Health Laboratory Service (PHLS) issued Interim Good Practice recommendations for the prevention of early-onset GBS infection in the UK. These were produced by the PHLS GBS Working Group and were subsequently replaced by the Royal College of Obstetricians & Gynaecologists' Green Top Guideline No 36 published in 2003. 

In August 2000, a research article was published entitled “Late third-trimester treatment of rectovaginal group B streptococci with benzathine penicillin G.” It reported on a small study of 78 women who carried GBS at 34-37 weeks gestation (tested using the highly reliable ‘gold standard’ tests used in the US). 28 of these women received intramuscular antibiotics after the positive result, plus intravenous antibiotics during labour. The other 50 women only received intravenous antibiotics during labour. All women were swabbed at delivery using the ‘gold standard’ tests before receiving intravenous antibiotics. The key results were:

• no baby in either group developed a GBS infection; no mothers suffered adverse antibiotic reactions;
• and in the group receiving intravenous antibiotics during labour only, 41/50 (82%) women carried GBS at delivery compared with 7/28 (25%) women who also had the intramuscular antibiotics in late pregnancy.

We believe this is the first time antibiotics have been shown to eradicate any GBS colonisation - so it would be extremely interesting if a larger study showed similar results. Until this happens, we need to treat this research with caution. The study was very small (78 colonised women were studied, of whom only 28 received both lots of antibiotics), no babies were infected with GBS in either group (intravenous antibiotics given during labour are highly effective); and late-pregnancy intramuscular antibiotics did not eradicate GBS colonisation in 25% of the women who received them. Clearly it wouldn’t be advisable for all women who carry GBS to have intramuscular antibiotics in late-pregnancy to try to eradicate GBS colonisation and then to have the recommended preventative intravenous antibiotics once labour starts or waters break - risks of allergic reactions and antibiotic resistance spring to mind, as well as the additional ‘medicalisation’ of pregnancy. However, were a larger study to show similar results, this could well prove a useful additional line of defence against GBS for pregnant women who have previously had a baby with a severe GBS infection and for those with a history of quick labours found to carry GBS during a pregnancy.