Group B Streptococcal (GBS) meningitis

Babies are at the highest risk of GBS meningitis. One study, carried out over a 20-year period in England and Wales, found that 87% of all cases of GBS disease resulting in meningitis occurred in young infants. For other age groups combined this was 13%. This is because young infants’ immune systems are not as well developed and they may come into contact with the bacteria during labour, around birth, when breastfeeding or when being handled.

GBS meningitis in older children and adults is very rare. Older age groups can develop invasive GBS disease (a term used to describe when bacteria invades places in the body that they don’t usually live), but this is much more likely to result in urinary tract infections, pneumonia or blood and soft tissue infections than meningitis. 

Around one in five pregnant women carry the bacteria in the gut or vagina. In most cases this will not cause harm to the mother or the baby. Most mothers who carry GBS bacteria during pregnancy will give birth to healthy babies, but in some cases the bacteria can pass to the baby during labour causing the child to become unwell. There is also a small risk of GBS bacteria causing babies to be born prematurely or causing babies to be stillborn, if the baby becomes infected with the bacteria in the womb.

Most babies that come into contact with GBS bacteria during birth will not become unwell. But some do become very ill and it’s vital they are treated with antibiotics as soon as possible.

The majority of infants that do become very poorly with a GBS infection recover fully with treatment. But, for some, it can cause life-threatening infections, like meningitis or sepsis, and sadly, even death.

There are two types of GBS infection in babies. They are:

Early onset GBS disease

Approximately 60 - 70% of GBS infections are early onset. This is when GBS infection occurs within the first six days of life, when the baby is likely to have caught the bacteria from the birth canal during labour. It causes breathing difficulties and mainly results in sepsis and septicaemia.

Late onset GBS disease

This is when GBS infection occurs in babies in the first seven to 90 days of life. It more commonly results in meningitis and causes fever, breathing difficulty, feeding problems and fits.

Group B Streptococcal (GBS) meningitis is the leading cause of bacterial meningitis in young infants in the UK and many other countries around the world. 

It has been estimated that there were nearly 400,000 cases of GBS disease in babies worldwide in 2020, resulting in more 90,000 deaths and more than 37,000 children predicted to have a damage to the brain resulting in significant neurodevelopmental impairments such as seizures, problems with movement, and difficulties with speech, learning or memory. Of those 400,000 cases of GBS disease, we estimate that around quarter (nearly 100,000 cases) presented as meningitis which likely resulted in around 20,000 deaths. Survivors of meningitis are more likely to be left with moderate to severe impairments than sepsis survivors. 

Rates of neurodevelopmental impairment after invasive GBS disease in babies varies according to country because in some settings background rates of neurological impairments are higher than others. However recent studies have shown that the risk of any neurological impairment after GBS disease including milder impairments in both high and low income settings can be as high as around 40%^5,6. Many neurological effects will not be apparent at the time these babies are discharged from hospital because they won't have reached many of their developmental milestones yet. This highlights the need for longer term follow up of these infants.

Group B Streptococcal (GBS) meningitis is the leading cause of bacterial meningitis in young infants in the UK and many other countries around the world.

It has been estimated that there were nearly 400,000 cases of GBS disease in babies worldwide in 2020. This resulted g in more 90,000 deaths and more than 37,000 children predicted to have a damage to the brain leading to significant impairments such as seizures, problems with movement, and difficulties with speech, learning or memory. Of those 400,000 cases of GBS disease, we estimate that around a quarter (nearly 100,000 cases) presented as meningitis (which likely resulted in around 20,000 deaths). Survivors of meningitis are more likely to be left with impairments than sepsis survivors. What are the signs to look for?

GBS meningitis symptoms can appear in any order and not everyone gets all the symptoms. Symptoms in babies include: poor feeding, lethargy, irritability, grunting, fast breathing or difficulty breathing, fever, and a tense or bulging soft spot.

GBS meningitis in adults is very rare but adults can get meningitis from many different types of bacteria so it is important to be aware of the symptoms.

If someone you care about is showing signs of the disease, it's important to seek urgent medical treatment.

GBS meningitis predominately affects newborns and most commonly occurs as a result of a late onset GBS infection in the first weeks of life. Unfortunately, there is no way to prevent this type of infection at the moment but research is ongoing into vaccinations which may offer protection in the future.

To protect against early onset GBS disease, pregnant women can get tested to see if they are carrying the bacteria before labour. Routine testing is offered in countries including America, Spain and France. Pregnant women found to be carrying the bacteria will be offered antibiotics in labour to protect infants against infection.

In the UK, routine testing is not recommended by the UK national screening committee. Instead, clinicians will decide whether to provide antibiotics during labour based on risk factors which include (but are not limited to) the mother having a fever during labour, or having previously had a baby affected by GBS infection. However, home testing kits can be bought privately.

Is there a vaccine to protect against GBS meningitis? There are immunisations to protect against many of the common strains of meningitis but, at the moment, there are currently no vaccines to protect against disease caused by GBS bacteria, including meningitis.

There are currently several vaccines in development for pregnant women to protect unborn babies against invasive GBS disease but none of these are licensed yet.

Further information about GBS can be found by visiting:

Group B Strep Support, a charity working to eradicate group B Strep in babies which includes providing support and information to families affected by GBS infection.

Royal College of Obstetricians and Gynaecologists - Patient information leaflets on Group B Streptococcus (GBS) in pregnancy and newborn babies.

Centers for Disease Control and Prevention