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Group B Strep FAQ


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Archive-name: misc-kids/pregnancy/group-b-strep
Posting-Frequency: monthly
Expires: Sept 1,1999 00:00:00 GMT
Last-Modified: 1997/01/20

See reader questions & answers on this topic! - Help others by sharing your knowledge
Group B Strep FAQ

For some birth stories involving Group B Strep, contact me at cheryls@wco.com.

We also run a mailing list for Group B Strep. The goal is to inform
ourselves about GBS,its effects and treatment, so that we may increase
awareness of it among OB/GYN's, midwives, childbirth instructors and the
general community
while lending a a listening ear to those who have lost babies to GBS or who
have had children become sick from it. We are excited about giving each
other support and helping each other educate other people so they don't
have to go through what we did.

send request to:
<gbstrep-request@kjsl.com>
with 'subscribe' in the subject line




~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
For those of you with the urge to do some more research on the subject:

http://www.angelfire.com/ca/gbstrep/index.html

http://www.cdc.gov/ncidod/diseases/bacter/strep_b.htm
This is the Center for Disease Control FAQ page on Group B Strep.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~


This is the FAQ for Group B Streptococcus infection during pregnancy.
It is taken from the Group B Strep Association pamphlet.
It will cover:
*What is Group B Step Infection
*Who may be affected by Group B Strep Disease?
*How Common is GBS Disease in Newborns?
*How Do Babies Get Sick From GBS Disease?
*Are Certain Babies More Vulnerable to GBS Disease?
*How is a baby tested for GBS disease?
*How is GBS Transmitted? IS GBS a Sexually Transmitted Disease?
*Can Pregnant Women Be Checked for GBS Colonization?
*What are a Mother's Risk Factors For Developing GBS Disease?
*How Can GBS Disease in Newborns and Mothers Be Prevented?
*Is There a Vaccine for GBS?
*Should Women Who Have Had A Previous GBS Positive Baby Have More Children?
*GBS and Breastfeeding
*PREVENTION IS KEY!!



For more info contact:
Group B strep Association
PO Box 16515
Chapel Hill, North Carolina 27516
(919) 932-5344

Help protect your baby and yourself!

What is Group B Strep infection?

Group B Streptococcus (GBS) is a type of bacteria that is found in the
lower intestine of 10-35% of all healthy adults and in the vagina and/or
lower intestine of 10-35% of all healthy, adult women. GBS should not be
confused with Group A Strep, which causes strep throat. A person whose body
carries GBS bacteria but who does not show signs of infections is said to
be "colonized" with GBS. GBS colonization is not contagious. GBS bacteria
are a normal part of the commonly found bacteria in the human body.
Normally, the presence of GBS does not cause problems. In certain
circumstances, however, GBS bacteria can invade the body and cause serious
infection: this is referred to as GBS disease.

Who may be affected by Group B Strep Disease?

* 15,000 to 18,000 newborns and adults in the U.S. will contract serious
GBS disease each year, resulting in the bloodstream, respiratory and other
devastating infections.

* About half of all GBS disease occurs in newborns and is acquired during
childbirth when a baby comes into direct contact with the bacteria carried
by the mother.

* GBS causes infection in pregnant women - in the womb, in the amniotic
fluid, following caesarean sections, and in the urinary tract. Each year
there are over 50,000 cases of such infections in pregnant women.

* 35-40% of GBS disease occurs in the elderly or in adults with chronic
medical conditions.

GROUP B STREP AND YOUR BABY

How Common is GBS Disease in Newborns?

Approximately 8,000 babies in the U.S. contract serious GBS disease each
year. Up to 800 of these babies may die from it and up to 20% of the babies
who survive GBS-related meningitis are left permanently handicapped.

In newborns, GBS is the most common cause of sepsis (infection of the
blood) and meningitis (infection of the fluid and lining surrounding the
brain) and is a frequent cause of newborn pneumonia. GBS disease is more
common than other, better known, newborn problems such as rubella,
congenital syphilis, and spina bifida. Some babies that survive, especially
those who develop meningitis, may develop tong-term medical problems,
including hearing or vision loss, varying degrees of physical and learning
disabilities, and cerebral palsy.

How Do Babies Get Sick From GBS Disease?

Typically, babies are exposed to GBS during labor and delivery; they may
also be exposed after the mother's membranes rupture ("water breaks").
Babies can come in contact with GBS if the bacteria travels upward from the
mothers' vagina into the uterus; they may also be exposed to it while
passing through the birth canal. The babies become infected when they
swallow or inhale the bacteria. There is also evidence that GBS may cross
intact membranes to expose the baby while it is still in the womb. There it
may cause preterm births, stillbirths or miscarriages. However, these may
be caused by a variety of factors; other infections, stress, genetic
defects for example- so be sure that any of these complications are
investigated fully even if you are colonized with GBS.

Are Certain Babies More Vulnerable to GBS Disease?

Premature babies, with their less-developed bodies and immune systems, are
more vulnerable to GBS infections than other older infants. Premature
babies infected with GBS are at higher risk for long-term complications
and/or death. Since most babies are born full term, however, full term
babies account for 70% of the cases of GBS disease in newborns.

The majority (80%) of the cases of GBS disease among newborns occur in the
first week of life. This is called *early onset* disease. Most of these
babies are ill within a few hours after birth. Babies who develop early
onset disease may have one or more of the following symptoms: problems with
temperature regulations, grunting sounds, fever, seizures, breathing
problems, unusual change in behavior, stiffness, or extreme limpness.

GBS disease may also develop in infants one week to several months after
birth. This is called *late onset* disease. Meningitis is more common with
late onset GBS disease. About half of late onset GBS disease can be linked
to a mother who is colonized with GBS; the source of infections for other
babies with late onset GBS disease in unknown. The baby who develops late
onset GBS disease may exhibit the following signs: stiffness, limpness,
inconsolable screaming, fever, or refusal to feed.

How is a baby tested for GBS disease?

Babies who develop the signs listed above should be evaluated immediately
by a doctor. Blood  tests, cultures, and x-rays can help determine if a
baby has GBS disease, and treatment should begin immediately.

GBS BACTERIA AND DISEASE IN PREGNANT WOMEN

How is GBS Transmitted? IS GBS a Sexually Transmitted Disease?

GBS is naturally occurring bacterium in the human body of both women and
men. Since it is commonly found in the vagina, some people wonder whether
GBS is a sexually transmitted disease. The answer is "no". GBS bacteria
usually do not cause genital symptoms of discomfort and are not linked
with increased sexual activity. Women found to carry GBS do not need to
change their sexual practices.

Can Pregnant Women Be Checked for GBS Colonization?

The GBS Association advocates that every pregnant woman be screened for
GBS. One third, or 1,200,000 pregnant women carry GBS Bacteria. Knowing
your culture result before you go into labor can help protect your baby's
life.

The test should be performed late in pregnancy, around 35 -37 weeks of
gestation. The test involves collecting a swab or swabs from the lower
vagina and rectum and culturing the sample on a special medium (LIM or
selective broth medium). The test result is usually ready in 2 or 3 days and
it usually costs between $15 and $35. This culture is considered the "Gold
Standard"-- *It is the best screening available*. Unfortunately, it is not
perfect and may miss a small number of women (approx 5%) who carry GBS.
Fortunately, it is accurate in detecting the bacteria as the "Gold
Standard" culture but may be beneficial in a setting where a pregnant woman
had not received prenatal care.

A positive culture result means that the mother is colonized with GBS.  It
does *NOT* mean that she has GBS disease or that her baby will become ill.
Rather, a positive test means that a woman and her doctor need to plan for
her labor and delivery with this test result in mind. The results of GBS
cultures should be available at delivery. If they are not available a woman
should not hesitate to tell a doctor or nurse her results as soon as she
arrives in the Labor and Delivery ward.

If you are pregnant, ask your health care professional about testing for
GBS. If the test is not offered, you should request it. Ask to be cultured
for GBS during pregnancy, discuss treatment plans with your doctor, and
tell your baby's doctor, pediatrician, or newborn nursery nurse about your
culture result. By doing these things you can help prevent a GBS infection.

What are a Mother's Risk Factors For Developing GBS Disease?

* Positive culture for GBS colonization at 35-37 weeks

* Having already had a baby who had a GBS infection

* GBS bacteria in urine (bacteriuria, either with or with our symptoms)

* Membrane rupture (having your "water break"more than 18 hours before
delivery)

* Labor or membrane rupture before 37 weeks

* Developing a fever during labor (higher than 100.4F)



The baby's doctor and nurse should be told if the mother has any of the
above risk factors.

PREVENTING GBS DISEASE

How Can GBS Disease in Newborns and Mothers Be Prevented?

Giving antibiotics (such as penicillin) through the vein during labor and
delivery to women who have a positive GBS test or who have certain risk
factors effectively prevents most GBS infections in women and their
newborns. For best protection, the mother would receive intravenous
antibiotics at least 4- 6 hours before delivery. However, the earlier the
administration of antibiotics the better once a risk  factor has been
identified. For example , a woman who has had  a previous GBS baby should
have IV antibiotics started at the time of hospital admission, whether
labor takes 14  hours or 6 hours.

If a woman's labor begins or her membranes rupture before 37 weeks of
pregnancy (before a culture is collected) she should be offered IV
antibiotics.

Since the antibiotics can cause side-effects, which are usually mild but
can be severe, their use should be limited to those women who have one or
more of the  listed risk factors- the decisions to take antibiotics during
labor should balance risks and benefits. If you are allergic to penicillin,
consult your doctor to learn about other effective antibiotics.

Caesarean sections are not likely to prevent GBS disease.

Unfortunately, no prevention plan is 100% effective. Some women with GBS
escape detection because they do not have risk factors. *All* women should
be tested for GBS with **EACH** pregnancy to ensure that the very best
available protection is provided for their babies.

Is There a Vaccine for GBS?

Researchers are actively working to develop a GBS vaccine. Use of the
vaccine in adult women will stimulate the immune system to make
protective proteins, called antibodies, which could cross the placenta
later in pregnancy and protect the baby. Although widespread use of the
vaccine is still years away, vaccination will one day protect babies and
others from this bacterial infection.

Should Women Who Have Had A Previous GBS Positive Baby Have More Children?

Women who have had problems due to GBS in the past should inform their
prenatal care provider  and pediatrician. GBS infections can be prevented
and managed in subsequent pregnancies so that babies are protected and born
healthy and free of GBS.

GBS and Breastfeeding

No data suggests that breastfeeding can pass GBS from a mother to her
baby; women colonized with GBS may breastfeed without concern about
harming their newborns. As always, keep hands and nipple area clean.

PREVENTION IS KEY!!

In at least 90% of the births where the mother is properly tested and
treated for GBS colonization, the babies are healthy, so remember to:

* Ask your heath care professional to culture you for GBS between 35 -37 weeks

* Discuss antibiotic treatment plans with your doctor

* Tell your baby's doctor and nurse about your culture result before the
baby is born.

* Some doctors may not routinely offer testing for GBS but may base
treatment decisions on obstetric risk factors alone. 25% of all GBS
infected babies will be born to a mother who had no obstetric
complications. This prevention plan will not prevent as many infections as
routine screening combined with antibiotics for those mothers who culture
positive for GBS.

ROUTINE PRENATAL CULTURE AT 35 -37 WEEKS OF PREGNANCY ALONG WITH IV
ANTIBIOTICS DURING DELIVERY FOR THOSE MOTHERS WHO CULTURE POSITIVE FOR GBS
OFFERS THE VERY BEST PROTECTION AVAILABLE FOR THE NEWBORN. According to
the Centers for Disease Control and Prevention, this method potentially
protects more babies than  prevention by obstetric risk factors evaluation
alone.



GROUP B STREP ASSOCIATION
Dedicated to the fight against GBS infection. It was formed
In memory of all the babies who have died In sympathy for all the babies
left handicapped
For the sake of all the babies yet to come

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