The UK Health Security Agency (UKHSA) plays a key role in addressing group B streptococcus (GBS) infection both through routine service activities and innovative research.

The UKHSA does not believe that there is a rationale at present for GBS being added to the Health Protection Notification Regulations. There are no immediate and specific public health actions required to be taken in response to a case being diagnosed. Whilst periods of enhanced surveillance suggest routine surveillance may be underestimating numbers of infections, this has not been audited to identify the source and reason for discrepancies between different sources of reports during these periods. Given the largely automated nature of laboratory surveillance, making GBS notifiable would not necessarily address any deficits in reporting.

The list of notifiable disease is kept under review by the Department with the UKHSA involvement. Further information is available at the following link:

https://www.gov.uk/government/consultations/health-protection-notification-regulations-2010-proposed-amendments/outcome/government-response-to-the-health-protection-notification-regulations-2010-proposed-amendments

On all aspects of population and targeted screening, Ministers are advised by the UK National Screening Committee (UK NSC).

The UK NSC last reviewed the evidence to screen for group B streptococcus (GBS) at 35 to 37 weeks of pregnancy in 2017 and concluded that there was insufficient evidence to demonstrate that the benefits of screening would outweigh the harms.

This was because the test currently available cannot accurately distinguish between those mothers whose babies are at risk and those who are not.

This means that many women would unnecessarily be offered antibiotics during labour, with the balance of harms and benefits from this approach being unknown.

The National Institute for Health Research funded a large-scale clinical trial to compare universal screening for GBS against the usual risk factor-based strategy.

Recruitment to the trial ended in March 2024 and a report is expected in early 2026. The UK NSC Secretariat is in contact with the researchers. The UK NSC will review its recommendation considering the evidence from the trial, after the report is presented.

The UK Health Security Agency (UKHSA) does not recommend adding Group B Streptococcus as a notifiable disease. Existing national surveillance effectively captures Group B Streptococcus infections, monitors trends, and informs antibiotic prescribing policy. The UKHSA has assessed that mandatory notification for Group B Streptococcus would provide no additional public health benefit beyond this.

The United Kingdom uses the Royal College of Obstetricians and Gynaecologists’ risk-based approach whereby those women identified as being at increased risk of having a baby affected by Group B streptococcus (GBS) are managed according to agreed clinical guidelines on the prevention of early on-set neonatal GBS infection.

To improve understanding, prevention, and treatment of GBS infection, the Department is supporting a trial, funded by the National Institute for Health and Care Research. It aims to determine whether routine testing for GBS for all women, either in late pregnancy or on admission for labour with point of care testing, reduces early-onset neonatal sepsis compared to the current approach of risk-based screening.

The UK National Screening Committee (NSC) will review its recommendation considering the evidence from the trial, after the report is presented.

The UK NSC previously reviewed the evidence to screen for GBS at 35 to 37 weeks of pregnancy in 2017 and concluded that there was insufficient evidence to demonstrate that the benefits of screening would outweigh the harms. This was because the test currently available cannot accurately distinguish between those mothers whose babies are at risk and those who are not. This means that many women would unnecessarily be offered antibiotics during labour, with the balance of harms and benefits from this approach being unknown.

Practitioners are expected to take a risk-based approach to the screening, diagnosis, and treatment of group B streptococcus (GBS). Under current National Institute for Health and Care Excellence guidance, pregnant women who are known to carry GBS, or who have risk factors such as a previous baby with GBS infection or fever during labour, should be offered antibiotics during labour to help prevent early-onset infection in their baby.

To improve understanding, prevention, and treatment of GBS infection, the Department is supporting a trial, funded by the National Institute for Health and Care Research. It aims to determine whether routine testing for GBS for all women, either in late pregnancy or on admission for labour with point of care testing, reduces early-onset neonatal sepsis compared to the current approach of risk-based screening. Findings from the trial will be submitted to the Department and reviewed by the UK National Screening Committee to inform future decisions on national screening policy.

Practitioners are expected to take a risk-based approach to the screening, diagnosis, and treatment of group B streptococcus (GBS). Under current National Institute for Health and Care Excellence guidance, pregnant women who are known to carry GBS, or who have risk factors such as a previous baby with GBS infection or fever during labour, should be offered antibiotics during labour to help prevent early-onset infection in their baby.

People from certain ethnic groups may be predisposed to health conditions which may affect their maternity outcomes, and a study led by the UK Health Security Agency did conclude that the rate of GBS was higher in those of black or Asian ethnicity.

To improve understanding, prevention, and treatment of GBS infection, the Department is supporting a trial, funded by the National Institute for Health and Care Research. It aims to determine whether routine testing for GBS for all women, either in late pregnancy or on admission for labour with point of care testing, reduces early-onset neonatal sepsis compared to the current approach of risk-based screening.

Findings from the trial will be submitted to the Department and reviewed by the UK National Screening Committee to inform future decisions on national screening policy.

The provision of group B streptococcal microbiological laboratory testing is under review with clinical stakeholders. At present, this service, with respect to enriched culture medium testing, in accordance with Public Health England’s guidance on Standards for Microbial Investigations B 58, is not offered within regional UK Health Security Agency (UKHSA) microbiology laboratories. The Bacteria Reference Department in UKHSA Colindale had specific accreditation under the United Kingdom Accreditation Service for group B Streptococci testing, which provides confirmation of group B Streptococci status and typing, based on the identification of 10 polysaccharide antigens.

The UK National External Quality Assessment Service’s (NEQAS) microbiology service, hosted by The UK Health Security Agency (UKHSA), has introduced a group B Streptococcus Screening External Quality Assessment scheme as of April 2025.

The UKHSA does not currently collect regional variations in the provision of group B testing services.

The UK Health Security Agency (UKHSA) has co-ordinated periods of enhanced surveillance of invasive group B Streptococcal (GBS) in infants younger than 90 days, allowing for a greater understanding of the risk factors and outcomes of infection, which is vital in identifying opportunities for prevention. For example, a population-wide data analysis on race and ethnicity in neonatal GBS in England between 2016 and 2020 revealed marked differences in invasive GBS rates among black and minority ethnic infants. Further details of this study are available at the following link:

https://pubmed.ncbi.nlm.nih.gov/35979728/

The UKHSA is working to identify target groups for future GBS vaccination through epidemiological analysis of invasive and non-invasive disease phenotypes in adults and children, and to identify ethnic disparities in rates of infant and maternal GBS. The UKHSA has also been progressing the development of maternal carriage studies to investigate differential rates of carriage according to ethnicity and other characteristics, including socioeconomic factors.

The UK National Screening Committee does not run its own trials. The committee is currently awaiting the findings of an independent trial into Group B Streptococcus, which concluded its recruitment phase in 2024. Neither the committee nor my Rt Hon. Friend, the Secretary of State for Health and Social Care have any influence over the date of publication for this independent trial.

The Department recognises the importance of raising awareness of conditions such as paediatric acute-onset neuropsychiatric syndrome (PANS) and paediatric autoimmune neuropsychiatric disorder associated with streptococcus (PANDAS) among healthcare professionals, and improving the health and care system for the people living with them.

The National Institute for Health and Care Excellence (NICE) is the independent, expert body that develops evidence-based guidelines for the National Health Service on best practice. While the NICE currently has no plans to issue guidance on PANS and PANDAS, should the evidence base develop further, we would look to the NICE to update clinical policy.

In the meantime, integrated care systems are responsible for planning care for their populations’ conditions, and clinicians will want to take account of any new research and developments in guidance, such as those being overseen by the PANS PANDAS Steering Group, to ensure that they can continue to provide high quality care to their patients.

Enriched culture medium testing is used in National Health Service laboratories. Current clinical practice is that if a routine urine test in pregnancy indicates a bacterial infection, microbiology techniques, such as enriched culture medium plates, should be used to identify the bacteria.

The UK National Screening Committee (UK NSC) stands ready to receive the results of the GBS3 trial. The UK NSC Secretariat is in close and regular contact with the researchers. The committee will consider the evidence from the trial, once the report is available.

The Joint Committee on Vaccination and Immunisation (JCVI) has identified that maternal vaccine products to protect infants against group B streptococcus (GBS) are currently in development. A sub-committee of the JCVI will be stood up to evaluate the benefits of a GBS vaccination programme.

Should a GBS vaccine be approved for use by the Medicines and Healthcare products Regulatory Agency, the JCVI would review evidence on the safety, efficacy, impact, and cost-effectiveness of a potential vaccination programme. Based on this evidence, the JCVI would provide advice to the Department in order to develop a vaccination policy and decide on any potential future roll out in England.

The Department works closely with the UK Health Security Agency (UKHSA) and NHS England, with expert advice from the independent Joint Committee on Vaccination and Immunisation, to design, implement, and deliver vaccination programmes offering high levels of long-term protection.

There is currently no licensed vaccine for the Group A Streptococcus (GAS) bacterium in the world. In the absence of a vaccine, UKHSA has been actively involved in several projects to increase our understanding of the transmission of GAS infections and identification of key risk factors. These have formed the basis of national public health guidelines to control the spread of infection and protect those most at risk.

NHS England also provides public guidance on how parents can protect themselves and their children against GAS, including recognising the symptoms and getting treatment. Further information is available at the following link:

https://www.nhs.uk/conditions/strep-a/

Recruitment to the Group B Streptococcus trial undertaken by the University of Nottingham has ended. The researchers are analysing the data and will draft a report in due course.

The UK National Screening Committee’s Secretariat is in close and regular contact with the researchers. The committee will review the evidence from the trial, once the report is available.

Recruitment to the GBS3 trial ended in May 2024. The researchers are analysing the data, and a report is expected in Summer 2025. The UK National Screening Committee Secretariat is in close and regular contact with the researchers. The committee will review its recommendation, considering the evidence from the trial, once the report is available.

As part of this, the UK National Screening Committee will engage with stakeholders, in line with its usual processes.

Recruitment to the GBS3 trial ended in May 2024. The researchers are analysing the data, and a report is expected in Summer 2025. The UK National Screening Committee Secretariat is in close and regular contact with the researchers. The committee will review its recommendation, considering the evidence from the trial, once the report is available.

As part of this, the UK National Screening Committee will engage with stakeholders, in line with its usual processes.

The UK Health Security Agency’s Vaccine Development and Evaluation Centre (VDEC) has been supporting the creation of a safe and effective maternal vaccine for Group B Streptococcus (GBS).

A maternal vaccine for GBS, which protects infants from both the early and late onset of the disease, will have a positive impact on infant mortality and morbidity. It will also lead to a sharp reduction in the use of antibiotics in neonatal units worldwide. By focusing on effectiveness, through advanced immune response evaluations, these efforts are accelerating the development of a reliable GBS vaccine that can protect vulnerable populations worldwide. Further information on how VDEC is supporting a GBS vaccine to prevent newborn deaths is available at the following link:

https://www.gov.uk/government/case-studies/vdec-is-supporting-a-gbs-vaccine-to-prevent-newborn-deaths.

Screening for group B streptococcus (GBS) is not routinely offered to all pregnant women. The UK National Screening Committee (UK NSC) last reviewed the evidence to screen for GBS at 35 to 37 weeks of pregnancy in 2017, and concluded that there was insufficient evidence to demonstrate that the benefits of screening would outweigh the harms. This is because the test currently available cannot accurately distinguish between those mothers whose babies are at risk, and those who are not. This means that many women would unnecessarily be offered antibiotics during labour.

A risk-based approach is taken, whereby those women identified as being at increased risk of having a baby affected by GBS are managed according to agreed clinical guidelines on the prevention of early on-set neonatal GBS infection.

The National Institute for Health Research funded a large-scale clinical trial to compare universal screening for GBS against the usual risk factor-based strategy. The UK NSC will review its recommendation, considering the evidence from the trial, once the report is available.