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04. NEONATAL HEALTH
A preventable tragedy
Group B Streptococcus is the most common cause of life threatening infection in new born babies, writes David Cameron MP. Many other western countries now routinely test for it - so why don't we?

Until a few months ago I had never heard of group B streptococcus (or GBS for short). I wouldn't claim to be an expert on health issues, still less would I pretend any special knowledge about child birth and all its complications. But I read the papers, attend health debates and like to think that I am relatively up to speed. GBS is the most common cause of life threatening infection in new born babies - but it was news to me, and, I suspect, to many other MPs.

First, a few facts. It is estimated that GBS infects up to 700 babies a year - that is one in 1,000. It can cause septicaemia, pneumonia and meningitis, typically in the first days of life and up to the age of three months. About 10 to 15 per cent - perhaps as many as 100 babies a year - die from the infection. It is difficult to deal with, because GBS is carried by up to 30 per cent of adults without symptoms. It is a normal part of our systems that cannot be eradicated. It normally lives in the intestines. Up to 25 per cent of women carry it at any time in the vagina without problems or symptoms. In cases, with tragic results, the infection is passed from mother to child.

I found out about this because two brave parents - Craig and Alison Richards - came to one of my constituency surgeries. They had lost their son Owen to GBS just a short while after his birth. They wanted to know why more was not being done about GBS. Above all, they wanted to make sure that other parents would not have to suffer as they had done.

I tabled an Early Day Motion, which was signed by 216 MPs of all parties, and held a debate in Westminster Hall. These debates provide an excellent opportunity to air an issue - like GBS - which is serious but has not been raised on the floor of the House.

The tragedy of GBS infections is that they are basically preventable. If mothers with GBS are given intravenous antibiotics during labour, the risk of infection is radically reduced.The difficulty up to now has been twofold. First, there has not been a particularly reliable test to find out which mothers are carrying GBS and which are not.

Second, because there are so many carriers, taking action would mean much more widespread use of antibiotics during labour. Without adequate screening the best that can be done is to give antibiotics to those mothers who display "risk factors" such as the early onset of labour, waters breaking early or a high temperature during labour.All of this has now changed, because there is a much more reliable "enriched culture method" test available. Other countries, including much of the US, Canada, Australia and parts of Europe now routinely test for GBS. So why don't we?The whole point of the debate I launched in Parliament was to ask the minister some important questions.

First, why are pregnant women not given more information about GBS? As it is the most common life threatening infection in new born babies, information should be provided at every GP surgery, maternity unit and health centre.Second, what is the government doing to ensure that all health care professionals are fully briefed on this issue? From all the letters and e-mails I have received since launching my debate, it is quite clear that practice across the country is different and the provision of information is patchy.

Third, when will the government look at introducing a screening programme for GBS? Now that the test is available, surely all mothers should be told about it and the government should look at making it available on the NHS. While the cost is currently £18 per test, costs would fall radically.

The minister - Dr Stephen Ladyman - gave a mildly encouraging response. Instead of the usual practice of reading out a pre-prepared speech, he went "off message" and gave a personal pledge that he would look at this whole issue very carefully.

The two issues he raised were the danger of pregnant women reacting against antibiotics and the need for more research and evidence. The third, unspoken, issue is always the same - "resources".Let me add a word about each of the three points. Of course there is a problem with people who are allergic to penicillin and other antibiotics, but surely the number who are and who do not know about it by the time they give birth must be shrinking all the time?

In any event, the right answer must be to test all women for GBS, explain the issue and then offer antibiotics to those who are carriers.

Second, of course we need to see more research, but my plea would be that we look at evidence from abroad where there are successful screening programmes rather than feel that we have to re-invent the wheel all over again in the UK.

Finally, resources. As I have said, the cost of a screening programme will fall once it gets under way. We already routinely screen for other things - would one more make such a difference? My other plea would be that when considering the costs the government needs to think of the hundreds of babies each year that get an infection and have lengthy stays in hospital which require complex treatments, some of whom will require life-long care. All of this pain and suffering - to say nothing of the costs - could be cut with a proper screening programme.

The Minister also agreed to meet a delegation of mothers and fathers who have lost children to GBS, or seen them suffer with the consequences of infections. I will hold him to this promise and hope that when we go and see him he will give us positive news!

David Cameron is theConservative MP for Witney.Group B Strep Support(preventing GBS infection in newborn babies),www.gbss.org.uk, can becontacted on: 01444 416176or info@gbss.org.uk.


 
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