Screening Best Way To Stop Deadly Strep
The Centers
for Disease Control and Prevention announced that screening pregnant women
before they give birth is the most effective method for preventing mother-to-child
transmission of a particular type of strep bacteria that can cause death
and lifelong mental problems in infants.
Bacteria called
group B streptococcus, which are generally harmless to healthy adults and
found in the gut of 25 percent of people, can be passed from mother to
infant during birth. Giving antibiotics to women infected with the bacteria
can lower the chance that they will pass it to their child, but the problem
is identifying which mothers are infected.
Until now,
two methods that were thought to be equally effective were recommended
to prevent the transmission. The so-called prenatal screening method involves
screening pregnant women for infection with the bacteria shortly before
giving birth. The second method involves giving antibiotics without screening
to pregnant women who have symptoms indicating they might transmit the
bacteria to their children.
A new study
conducted by the CDC shows the prenatal screening method is much more effective
at preventing mother-to-child transmission, Anne Schuchat, chief of the
respiratory diseases branch at the CDC and senior author of the study,
told United Press International.
"This is very
exciting new data," Schuchat said. "We've now shown ... prenatal screening
can prevent substantially more infections than the alternative risk-based
approach."
Stephanie Schrag,
a CDC epidemiologist and lead author of the study, said in a written statement,
"The main reason for the benefit of routine screening over the risk-based
approach is that prenatal screening identifies silent carriers who can
pass on the infection to newborns even when no clinical risk factors are
present during labor."
Schuchat noted
that most women who carry the bacteria will not show any signs that they
are infected or are at risk of passing it to their child.
The CDC researchers
used data from more than 600,000 births in eight states over a two-year
period between 1998 and 1999. They found the prenatal screening approach
was 50 percent more effective than the other approach, Schuchat said. The
findings are important because 1,600 infants are infected with strep B
every year and 80 die from it. Those who survive can have long-term problems
such as cerebral palsy and mental retardation, she said. It also can cause
pneumonia, infection of the lining around the brain and shock. Some infants
may need to be placed on life-support.
Keith Powell,
chairman of pediatric medicine at Children's Hospital Medical Center in
Akron, Ohio, told UPI, "The disease is pretty scary and can be pretty devastating
for the newborn. That's why it's important to try to prevent babies from
getting infected in the first place."
Strep B infection
in infants has been a problem for the last 30 years but over the last decade,
prevention strategies have achieved a 70 percent reduction in cases of
the disease, Schuchat said. She noted that the prevention strategies currently
in place prevent more than 200 deaths per year.
The prenatal
screening strategy should reduce the number of infections and deaths due
to strep B even further. "We should see the number of cases continue to
fall," Powell said.
Some infections
and deaths due to the bacteria will continue to occur, Schuchat said. This
is why many experts think a vaccine that can prevent infection will be
the only way to eradicate this problem, she said.
The CDC now
will recommend the pre-natal screening strategy as the best choice for
preventing this disease to healthcare professionals. The agency said several
other medical organizations, including the American College of Obstetricians
and Gynecologists, have already decided to revise their recommendations
based on this study.
Powell, who
sits on the infectious diseases committee of the American Academy of Pediatrics,
noted that the academy also will be revising their recommendation.
The study is
published in the July 25 issue of the New England Journal of Medicine.
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Copyright 2002 by United
Press International.
All rights reserved.
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