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Group B streptococcus stillbirths, deaths remain high despite vaccine feasibility
Group B streptococcal infections are a major contributor to poor health in both mothers and children and is responsible for nearly 150,000 stillbirths and infant deaths, according to a new research supplement launched at the American Society of Tropical Medicine and Hygiene Annual Meeting.
This research suggests that the if 90% of women were administered a group B streptococcus (GBS) vaccine with an efficacy of 80%, 231,000 cases of the infection might be averted in both mothers and infants. Currently, no GBS immunizations are available despite the finding that the number of GBS-related deaths is more than the combined total of deaths caused by tetanus, pertussis and respiratory syncytial virus.
“Too many parents around the world face the death of a baby or a young child. Avoidable GBS deaths are happening in every country,” Joy E. Lawn, MD, professor of maternal, reproductive and child health at the London School of Hygiene and Tropical Medicine, said in a press release. “Antibiotics currently prevent an estimated 29,000 cases of early-onset group B streptococcal disease per year, almost all in high-income settings. However, this approach may be difficult in low-income settings, where many births take place at home, and laboratory capacity for screening is limited.”
Infection from GBS bacteria is prevalent among pregnant women globally, with approximately one in five carrying the bacteria. This burden ranges from 11% of women infected in eastern Asia to 35% of women infected in the Caribbean. The total number of cases, according to the researchers, is estimated to be at 21.7 million within 195 countries around the world.
Lawn and colleagues estimate that approximately 410,000 GBS infections occur annually, causing at least 147,000 stillbirths and infant deaths around the world. The countries with the highest number of infections include India (2,466,500), China (1,934,900), Nigeria (1,060,000), the United States (942,800) and Indonesia (799,100).
Although these countries contain the highest number of GBS cases, the greatest burden of disease was observed in Africa, containing only 13% of the world world’s population but experiencing 54% of estimated cases of GBS and 65% of stillbirths and infant deaths.
“These disease burden estimates highlight the importance of perinatal infection prevention. Existing recommendations should be implemented, but these are insufficient, and the number of affected families remain unacceptable,” Johan Vekemans, MD, PhD, medical officer in the Initiative for Vaccine Research at WHO, said in the release. “It is now essential to accelerate GBS vaccine development activities.”
Currently, antibiotics are commonly given to women in labor who are at risk of infecting their newborns. A limited number of countries have antimicrobial policies related to GBS in pregnant women (n = 60), with only 35 countries requiring testing for all pregnant women.
Untreated GBS can lead to later infections from meningitis and septicemia. Hearing and vision loss or cerebral palsy are also possible outcomes of children who survive.
“Even if antibiotics were given to all pregnant women identified through screening strategies, they target mainly early-onset GBS disease in newborns, not GBS disease in pregnant women, GBS disease before delivery causing stillbirth or GBS disease in infants more than a couple days old,” Anna C. Seale, DPhil, associate professor at the London School of Hygiene and Tropical Medicine, said in the release. “A maternal GBS vaccine could prevent many more cases and deaths worldwide.”– by Katherine Bortz
Disclosures: The authors report no relevant financial disclosures.
