Early-onset GBS infection (age 0-6 days)
In the UK, up to two-thirds of GBS infection in babies are of early onset (showing within the first 6 days of life).
Early-onset GBS infection usually presents as sepsis with pneumonia. These early-onset infections are usually apparent at or soon after birth, with the typical signs including:
Typical EOGBS infection symptoms
- Grunting, noisy breathing, moaning, seems to be working hard to breathe when you look at the chest or tummy, or not breathing at all.
- Being very sleepy and/or unresponsive
- Inconsolable crying
- Being unusually floppy
- Not feeding well or not keeping milk down
- Having a high or low temperature (if parents have a thermometer), and/or be hot or cold to the touch
- Having changes in their skin colour (including blotchy skin)
- Having an abnormally fast or slow heart rate or breathing rate
- Having low blood pressure (identified by tests done in hospital)
- Having low blood sugar (identified by tests done in hospital)
Most early-onset GBS infections show symptoms within the first 12 hours after birth so will often be identified at the maternity unit.
Babies can be exposed to GBS around birth when Mum, usually unknowingly, is carrying the bacteria. Most babies do not develop GBS infection, though a relatively small number will, and the infection may be severe.
Most early-onset GBS infections can be prevented.
Late-onset GBS infection (age 7-90 days)
Up to a third of GBS infections in babies are of late onset, occurring after the baby’s first 6 days, usually as meningitis with sepsis. It is uncommon after a baby reaches one month old and very rare after the age of three months.
Typical signs of late-onset group B Strep infection are similar to those associated with early-onset GBS infection and may include signs associated with meningitis such as:
Typical LOGBS infection symptoms (in addition to EOGBS symptoms)
- Being irritable with high pitched or whimpering cry, or moaning;
- Blank, staring or trance-like expression;
- Floppy, may dislike being handled, being fretful;
- Tense or bulging fontanelle (soft spot on babies’ heads);
- Turning away from bright light;
- Involuntary stiff body or jerking movements; and/or
- Pale, blotchy skin.
Babies can be exposed to GBS from a variety of sources after birth, including from Mum or from other people. Most babies will not develop late-onset GBS infection, though a relatively small number will, and the infection may be severe.
Testing for group B Strep during pregnancy and having intravenous antibiotics during labour will prevent most cases of early-onset group B Strep infection, but have not been shown to reduce late-onset GBS infection.
There are no known ways of preventing late-onset GBS infections (although one day a vaccine should do this), so speedy identification of the signs of these infections and urgent escalation are vital for early diagnosis and treatment. A vaccine is in development but will take many years before being available.
IF YOU NOTICE ANY OF THESE SIGNS OR ARE WORRIED ABOUT YOUR BABY, YOU SHOULD URGENTLY CONTACT YOUR HEALTHCARE PROFESSIONAL AND ALSO MENTION GBS.
IF YOUR BABY HAS GBS INFECTION, EARLY DIAGNOSIS AND TREATMENT IS IMPORTANT AS DELAY COULD BE VERY SERIOUS, OR EVEN FATAL.
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