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Surprisingly, the potentially devastating infection GBS is one many people have never heard about. This month the national charity Group B Strep Support is redoubling efforts to rectify this situation by promoting Group B Strep Awareness Month. This is an initiative we are very keen to support as we know only too well the difficulties associated with GBS detection and treatment, acting as we do for the families of affected babies in claims for medical negligence.
Fortunately, there appears to be hope on the horizon with clinical trials and research into a suitable vaccine ongoing.
According to the charity, on average two babies a day develop GBS infection, one a week dies and one a week survives with a disability. However, most of these infections are preventable.
We have discussed some issues surrounding Group B Strep in our previous blog and there is further information on our GBS webpage. Essentially, it is a bacteria that normally lives harmlessly within the body and without symptoms.
Yet, if the bacteria is present in a mother it can pass to a baby during birth, leading to infection. Without treatment, a baby can become seriously ill. GBS most commonly causes infections such as sepsis, meningitis and pneumonia (an infection of the lungs) which can in turn cause brain injuries and conditions such as Cerebral Palsy.
Although many babies who come into contact with GBS will not become ill, around one in 400 born to women known to carry the bacteria go on to develop an infection. Prompt treatment will usually lead to a full recovery, therefore early detection is vital. We are acutely aware from our work as clinical negligence solicitors that GBS is not always detected or treated quickly enough.
GBS infection is more likely to occur in certain circumstances. These include those born before 37 weeks gestation, those born to mothers who have previously had a baby with a GBS infection, those whose mothers have tested positive for GBS in the pregnancy and those whose mothers have a high temperature in labour. In these circumstances, intravenous antibiotics during labour should be offered to prevent infection passing to the baby. If antibiotics were not offered and a baby goes on to develop an infection then there may be a claim for clinical negligence.
No routine testing in the UK – will this change?
Rates of GBS are rising here in the UK and, as matters stand, there is no routine testing during pregnancy, unlike the position in many other developed countries. The bacteria may be incidentally found during testing for other purposes. Specific testing for GBS is available privately.
Group B Strep Support has been fighting for many years for the implementation of routine testing of pregnant women. Countries including the USA, France, Canada, Spain and Germany recommend universal testing for GBS in late pregnancy.
In 2017, the UK National Screening Committee (NSC) concluded that they could not recommend universal screening for GBS in the UK. The reasons for this were said to include that screening may result in women being given antibiotics who do not need them and that a woman can be positive for GBS a few weeks before labour but then negative at the time of birth. NSC suggested that a trial was undertaken to gather evidence on whether a universal screening program is both clinically and cost effective. One such trial is currently taking place, despite previously reported fears that it would not be possible due to a lack of hospitals taking part. The trial ‘GBS3’ is being run by the Nottingham Clinical Trials Unit and involves 71 hospitals in England and Wales with the purpose of establishing whether testing all pregnant women is better than the UK’s current approach. The trial is expected to report its findings in 2025.
Vaccine?
Several Strep B vaccines are currently under development. A global maternal immunisation programme for GBS ‘would save millions of dollars in healthcare costs by reducing death and disability’ a team led by researchers from the London School of Hygiene & Tropical Medicine has found. However, the research suggests that ‘without tiered pricing equitable access to life-saving vaccines would probably not be achieved.’
Improvements in Training
In the meantime, while we await the GBS3 results and for further developments in terms of a vaccine, NHS England has now included ‘group b strep in labour’ amongst topics that must be covered in training for staff in their latest Core Competency Framework. We at Kingsley Napley join with the Group B Strep Support in their hope that ‘this England-wide requirement for training will improve staff awareness and education around group B Strep, and reduce the postcode lottery of information, care, and support families face.’
We act for families of babies affected by GBS where there has been a medical mistake. For those children left with long term disabilities we fight for the best award of compensation to meet their lifelong needs and bring fresh hope for their future.
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