Researchers recently discovered that a bacterial infection in pregnant women has been the cause of many stillbirths and infant deaths, which could have been prevented had there been a vaccine available that could stop this bacterial infection from spreading.

Presented at the American Society of Tropical Medicine and Hygiene Annual Meeting in Baltimore, this research involved a worldwide participation of over 100 researchers, who documented their findings in a series of 11 research papers.

This finding was shared in the journal of Clinical Infectious Diseases and it is also the first study that provides a comprehensive look at how the Group B Streptococcus (GBS) infection affects stillbirths and infant deaths. According to this global study, there are 21.7 million pregnant women that carry the bacteria.

What is GBS – how does it affect foetuses and infants?

The Group B Streptococcus (GBS) infection does not affect all pregnant ladies. GBS lives in the intestinal tracts of over one third of all adults. It is hard for women to know that they are carrying GBS in their digestive system or lower vaginal tract since this infection has no visible symptoms to speak of.

If a pregnant woman has the bacteria, her foetus can also get it via the amniotic fluid. The infection attacks the infant during birth as it passes through the vaginal canal. GBS attacks babies and foetuses because of their weak immune systems, which are not strong enough to fight this infection and stop it from multiplying.

The effects of GBS are deadly as it has been found to lead to meningitis and septicaemia. For babies that survive this infection, they may end up developing several problems, including permanent sight and hearing problems, or cerebral palsy.

Through the findings of this study led by the researchers of the London School of Hygiene and Tropical Medicine, they realise how big of a problem GBS is. Out of 410,000 GBS cases yearly, there are 147,000 stillbirths and infant deaths that have been reported around the world.

Highest GBS incidence reported in Africa

From all these GBS cases worldwide, it has been reported that Africa, despite having only 13% of the world’s population, has experienced most cases of GBS with 65% of stillbirths and infant deaths, and 54% cases of infections. Other countries affected are India, China, Nigeria, United States of America and Indonesia.

"The burden of Group B strep has been underappreciated, particularly in low and middle-income countries," Shabir Madhi, co-author of Wits University in South Africa told the Thomson Reuters Foundation. The rate of infection in pregnant women in Africa, which ranges about 25% to 35%, is higher than other countries with no known reason, he added.

Researchers warn that if a vaccine is not created sooner, there will be more cases of death or babies with serious health issues. As of now, several vaccines are reportedly in development to help deal with this deadly situation. Scientists are still testing these vaccines to make sure that there’s a 100% chance of fighting this infection.

Urgent need to fix this problem

Johan Vekemans, a medical officer of the Initiative for Vaccine Research at the World Health Organisation (WHO), said “These disease burden estimates highlight the importance of perinatal infection prevention. It is now essential to accelerate the GBS vaccine development activities. The technical feasibility is estimated to be high.”

According to Joy Lawn, professor of Maternal, Reproductive and Child Health at the London School of Hygiene and Tropical Medicine, this approach is not the right solution for this problem. “Antibiotics currently prevent an estimated 29,000 cases of early-onset Group B Streptococcal disease per year, almost all in high-income settings.”

Explaining further, she added “However, this approach may be difficult in low-income settings where many births take place at home, and laboratory capacity for screening for GBS is limited.”

There are 60 countries that employ the antibiotic-use-in-pregnancy policy to prevent the GBS disease from being transmitted to newborns. From these countries, only 35 nations have the policy to test every pregnant woman to see if there are signs of the GBS infection. The rest of the 25 countries have only the ability to identify GBS in women with clinical risk factors.

The implementation of these policies is different everywhere worldwide. However, as far as antibiotics go, Joy Lawn thinks that “giving antibiotics to 21.7 million women may contribute to antimicrobial resistance – a major global health crisis”. Anna Seale, Series co-lead and Associate Professor at the London School of Hygiene & Tropical Medicine also thinks that antibiotics should not be the only solution.

Johan Vekemans reiterated the need to “accelerate the GBS vaccine development activities”. He said, “Work is ongoing to strengthen existing maternal immunisation programmes. Next steps include a comprehensive evaluation of cost-effectiveness. We will be working with Professor Lawn and others at London School of Hygiene & Tropical Medicine, and global partners to lead on these activities.” MIMS

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