Urgent need for vaccines to prevent fatal group B strep infection

A new report from the World Health Organization (WHO) and the London School of Hygiene and Tropical Medicine (LSHTM) reveals the alarming global impact of group B streptococcus (GBS), a common bacterium that can be passed from mother to child in the womb. , during childbirth or in the first weeks of the newborn's life and which causes some 150,000 infant deaths a year, more than half a million premature births and significant long-term disability.

The report urgently calls for the development of maternal GBS vaccines to reduce these numbers, noting that such vaccines could be highly cost-effective and have significant health benefits in all regions of the world.

Dr Phillipp Lambach, Medical Officer in WHO's Department of Immunization, Vaccines and Biologicals and author of the report, said: "This new research shows that group B streptococcus is a major and underappreciated threat to the survival and well-being of newborns and has devastating effects for many families around the world. WHO joins partners in calling for the urgent development of a maternal GBS vaccine, which would have profound benefits in countries around the world."

For the first time, this new research quantifies the important contribution of GBS to preterm birth, as well as neurological impairments—such as cerebral palsy and hearing and vision loss—that can occur after GBS infections.

Several GBS vaccine candidates are in development, but none are yet available despite having been in development for several decades.

Professor Joy Lawn, Director of the LSHTM Center for Reproductive and Maternal, Adolescent and Child Health, and a contributor to the report, said: “Group B strep infection is a serious problem for all affected families in all countries. Maternal vaccination could save the lives of hundreds of thousands of babies in the coming years, and yet, 30 years after this measure was first proposed, the world has not supplied a vaccine. Now is the time to act to protect the world's most vulnerable citizens with a vaccine against GBS infection."

An average of 15% of pregnant women around the world - almost 20 million a year - carry the GBS bacteria in the vagina, usually without symptoms. It can be transmitted from the pregnant woman to the fetus in the womb, or to the newborn during childbirth.

Currently, antibiotic prophylaxis given to women during labor is the main means of preventing group B strep disease in newborns if the bacteria are detected during pregnancy. However, even in regions with high prophylaxis coverage, significant health risks remain, as this intervention is unlikely to prevent most stillbirths and preterm births associated with GBS or group B strep disease that occurs. later after birth.

Importantly, the greatest burden of GBS is found in low- and middle-income countries, where screening and intrapartum administration of antibiotics are more difficult to implement, thus requiring a vaccine most urgently. Highest rates of infection Breastfeeding from GBS occurs in sub-Saharan Africa (where about half the global burden is accounted for) and in East and Southeast Asia.

Dr. MartinaLukong Baye, Coordinator of the National Multisectoral Program to Fight Maternal, Neonatal and Child Mortality at Cameroon's Ministry of Public Health, who also collaborated on the report, said: "A new GBS maternal vaccine would be a game changer in the reduction of neonatal and maternal mortality in the most affected countries, especially in sub-Saharan Africa, where the burden of these deaths is alarming. We call on all stakeholders to treat this issue as a moral priority."

The report calls on researchers, vaccine developers, and funders to accelerate the development of an effective GBS vaccine that can be given to pregnant women during routine pregnancy checkups.

Estimates suggest that if GBS vaccination reached more than 70% of pregnant women, it could prevent more than 50,000 GBS-related deaths each year, as well as more than 170,000 preterm births. According to the report, if the vaccines had a At an affordable price, the net monetary benefits of one year of maternal GBS vaccination could be as high as $17 billion cumulative over several years.

The report highlights significant data gaps that cause some uncertainty around the total burden of GBS-related deaths and illnesses. For example, infectious causes of stillbirths are often not sufficiently investigated in all countries, which means that the actual contribution of GBS may be even greater.

Debbie Forwood, whose daughter Ada was stillborn after she became infected with GBS, said: "It's hard to describe the magnitude or depth of the pain when your child dies, or the guilt that accompanies it, and how that pain changes you, your family and your relationships forever. Only a GBS vaccine could have saved Ada. When a vaccine becomes widely available, I will cry and scream at the injustice that it is too late for her and all the other babies who suffer and die needlessly every year it is delayed. But I will also cry with joy because in the future many more will live, and their families will be saved from the living hell that the death of a child means.»

For more information or to request an interview, please contact Tilly Haynes, [email protected], and Laura Keenan, [email protected] and [email protected]

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Datos posteriores al embargo del informe conjunto de la OMS y la LSHTM: www.who.int/teams/immunization-vaccines-and-biologicals/immunization-analysis-and-insights/vaccine-impact-value/group-b-streptococcus-full-value-of-vaccine-assessment

Post embargo data from the Clinical Infectious Diseases supplement: https://academic.oup.com/cid/pages/strep-b-worldwide

Embargoed copies of the CID report and articles can also be found here.

Notes for editors

This report will be presented at the International Symposium on Streptococcus agalactiae Disease (ISSAD) that the WHO and the LSHTM will hold from Wednesday 3 to Friday 5 November 2021. This conference aims to mobilize researchers on how to fill data gaps and accelerate science to reduce the effects of this potentially lethal bacterium throughout the world.

Annual GBS infection burden in figures for 2020

About the report and related documents

The Global Importance of Group B Streptococcus Vaccine Report updates current global estimates of GBS burden, first published in 2017 by WHO and LSHTM and funded by the Bill & Melinda Gates Foundation. For the first time, these new estimates include data on GBS-associated preterm births, as well as the risk of neurodevelopmental impairment in survivors of GBS infection, based on the new data from Denmark and five income countries. low and medium (Argentina, India, Kenya, Mozambique and South Africa).

A series of nine articles by 61 authors from six continents has been published in conjunction with this report in the Clinical Infectious Disease supplement: "Every Country, Every Family: Group B Streptococcal Disease Worldwide." These articles provide more detailed data on GBS as well as the high costs of group B strep disease to families. Two WHO-led articles reveal the state of programmatic readiness for vaccine adoption and provide further insight into the size and sustainability of the market.

This report is the first output of the 'Defeat Meningitis by 2030' roadmap developed by WHO and its partners, including the LSHTM.

About ISSAD

The International Symposium on Streptococcus agalactiae Disease 2021 (ISSAD2021) is a global conference on group B streptococcus with the theme "Accelerating evidence-based action, for every family, everywhere." every family, everywhere). It is organized by the World Health Organization and the Center for Vaccines and the Center for Reproductive and Maternal, Adolescent and Child Health at the London School of Hygiene and Tropical Medicine. The conference, which is free to register and can be done online at ISSAD.org, will be held from Wednesday, November 3 to Friday, November 5.

About the London School of Hygiene and Tropical Medicine

The London School of Hygiene and Tropical Medicine (LSHTM) is a world-leading center for research, postgraduate study and continuing education in global and public health. It has a strong international presence, with more than 3,500 staff and 5,000 students working in the UK and in countries around the world, and annual research revenue of £180 million.

The LSHTM is one of the UK's highest rated research institutions. It is associated with two Medical Research Council university units in The Gambia and Uganda, and was named University of the Year at the Times Higher Education Awards 2016. Our mission is to improve health and health equity in the UK and around the world, collaborating to achieve excellence in global and public health research, education, and the translation of knowledge into policy and practice.

Follow @LSHTM on Twitter/Listen to the LSHTM Viral Podcast

www.lshtm.ac.uk

About WHO

Founded in 1948, WHO is the United Nations agency connecting nations, partners and individuals to promote health, keep the world safe and serve the vulnerable so that everyone, everywhere, can reach the highest level of health.

www.who.int