Reporting Obligations
Individuals with suspect or confirmed cases must be reported to the Thunder Bay District Health Unit by the next working day by fax, phone or mail.
- Fax: (807) 625-4822
- Phone: 625-8318 or toll-free at 1-888-294—6630, ext. 8318
- Mail: 999 Balmoral Street, Thunder Bay, ON P7B 6E7
Epidemiology
Aetiologic Agent:
Group B streptococci (GBS) (S. agalactiae) are gram-positive cocci which are the most common cause of sepsis and meningitis in "at risk" newborns.
Clinical Presentation:
Two distinct forms of illness can occur:
(1) Early onset disease (1 – 7 days after birth) presents with sepsis, respiratory disease, apnea, shock, pneumonia and meningitis;
(2) Late onset disease (≥ 7 days to several months after birth) presents with sepsis and meningitis, however note that only illness up to 28 days after birth is reportable.
Modes of transmission:
Early onset transmission occurs via the infected birth canal as well as in utero. Late onset transmission can also be through person to person contact.
Incubation Period:
For early onset disease, the incubation period is from 1-7 days, presenting most frequently within the first 24 hours of life. The incubation period for late onset GBS disease in infants is unknown, as it can occur from ≥ 7 days to several months, but typically within 3-4 weeks.
Period of Communicability:
Group B streptococci are transmissible to infants during labour if the mother is colonized; however, a negative vaginal culture at the time of labour does not guarantee absence of colonization.
Risk Factors/Susceptibility
- Risk is greater among premature babies; delivery at less than 37 weeks
- Intrapartum temperature greater than 38 degrees Celsius
- Rupture of membranes for 18 hours or longer
- Having had a previous newborn with group B streptococcus infection
Diagnosis & Laboratory Testing
Laboratory confirmation of Group B Streptococcus (Streptococcus agalactiae) from a normally sterile site (e.g., cerebrospinal fluid), with clinically compatible signs and symptoms of invasive disease in a newborn up to 28 days after birth.
Clinically compatible signs and symptoms are characterized by the following: early onset disease (1-7 days), characterized by sepsis, pneumonia, and less frequently meningitis, osteomyelitis or septic arthritis or late onset disease (7 days to 1 month), characterized by sepsis and meningitis.
Testing Information & Requisition
Treatment & Case Management
Treatment is under the direction of the attending health care provider.
Patient Information
References
- Ministry of Health and Long Term Care, Infectious Diseases Protocol - Appendix 1 (2022) Group B Streptococcal Disease, neonatal.
- SOGC. "The Society of Obstetricians and Gynaecologists of Canada- Group B Streptococcal Infection in Pregnancy."
Additional Resources
CDC. "GBS: Prevention in Newborns."