July is “Group B Strep International Awareness Month” – a month to promote international awareness and prevention of Group B Strep (GBS) disease in babies during pregnancy through infancy. Sponsored by the Group B Strep International (GBSI), the campaign goal is to serve as a central resource for GBS information for both the general public and medical professionals. Regarded as the leading cause of sepsis and meningitis in newborns in the United States and one of the most notable infectious causes of newborn illness and death worldwide, Group B streptococcus (GBS), also known as Streptococcus agalactiae is a common bacterium naturally found in the digestive and lower reproductive tracts of both men and women. Usually, the bacterium is harmless in healthy adults. However, in newborns, it can cause a serious illness known as group B strep disease. Not all babies exposed to GBS become infected, but for those who get infected – the results can be devastating. If left untreated or undetected at an early stage, the infection can lead to life-threatening complications in infants like – pneumonia, inflammation of the membranes and fluid (surrounding the brain and spinal cord) and infection in the bloodstream (bacteremia).
Treatment for this condition involves antibiotic treatment that can protect a baby during pregnancy and all through infancy. Physician specialists offering treatment for this condition must use the correct medical codes on their medical claims. Professional companies offering medical billing services can help these specialists report the condition and the treatment provided on the medical claims using specific ICD-10 codes.
The 2021 July campaign aims to spread word out to healthcare providers, current parents, future parents and anyone involved in perinatal research that they can be a source of change in group B strep (GBS) awareness. It aims to get as many people as possible involved in generating awareness and funds for Group B Strep education, awareness and prevention efforts of individuals and organizations on a community or national level. According to the US Centers for Disease Control and Prevention (CDC), approximately 1 in 4 pregnant women carry GBS. Many healthy people carry Group B strep bacteria in their bodies. Group B strep can spread to a baby during a vaginal delivery if the baby is exposed to, or swallows fluids containing group B strep. For pregnant women, GBS can cause infection in different areas like the urinary tract, bloodstream, placenta and amniotic fluid and membrane lining the uterus. GBS can cause babies to be miscarried, stillborn, born prematurely and can have lifelong handicaps, or even death. Even babies born to a mother who tests negative can become infected by Group B strep.
GBS is a transient bacterium which means that a woman could test negative, but be colonized later in pregnancy and vice versa. Among infants, there are three different types of GBS disease. These are – Prenatal-onset GBS disease (before birth), Early-onset GBS disease (birth through the first 6 days of life) and Late-onset GBS disease (7 days of age through usually 3 months of age). Signs and symptoms of this condition can be different in newborns when compared to people of other age groups. As GBS is a fast-acting type of bacteria, it is imperative that everyone who takes care of a baby knows the symptoms of possible GBS infection in babies. The symptoms of GBS disease can seem like other health problems in newborns and babies and generally include – fever, difficulty feeding/breathing, irritability or lethargy (limpness or hard to wake up the baby), blue-ish color to skin, sluggishness and a lack of energy (lethargy), heart and blood pressure instability and jaundice. Most newborns with early-onset disease have symptoms on the day of birth. On the other hand, babies who develop disease later may appear healthy at birth and during their first week of life. A woman who gives birth to a baby that develops GBS disease usually does not feel sick or present any symptoms.
The Centers for Disease Control and Prevention (CDC) has set screening guidelines for Group B Strep (GBS) disease for all pregnant women. They recommend a routine screening between the 35th and 37th weeks of pregnancy. Physicians will collect swab samples from their vagina and rectum and send them to a lab for testing. If a woman tests positive for GBS – this doesn’t mean that she is a carrier or the disease would affect the baby. Not every infant born to a mother who tests positive for GBS will become ill. Certain symptoms like – fever during labor, urinary tract infection during pregnancy,and rupture of membrane (before 37 weeks or 18 hours before delivery) indicates that they are at a higher risk of passing GBS to an infant during birth. In such cases, it is important to immediately consult a physician so that they can take adequate steps to protect the newborn. On the other hand, after delivery, if a physician suspects that an infant has GBS disease, a sample of the baby’s blood or spinal fluid will be sent for a detailed lab evaluation. If an infant appears seriously ill, additional tests like – urine culture, lumbar puncture and chest X-ray will also be performed to confirm the diagnosis. Treatment for this condition will depend on the type, location and extent of the infection caused by the bacterium. If an infant is tested positive for Group B strep, she will be given intravenous (IV) antibiotics. Depending on the condition, babies may be given IV fluids, oxygen or other medications. For pregnant women with this bacterium infection, oral antibiotics, usually penicillin or cephalexin (Keflex), will be administered, which are considered safe during pregnancy period.
Physician specialists treating pregnant women or infants with GBS disease must correctly document the diagnosis and treatment modalities performed using the right medical codes. Medical billing outsourcing services can help physicians use the correct codes for their billing purposes.
ICD-10 diagnosis codes for GBS disease include –
- O99.82 Streptococcus B carrier state complicating pregnancy, childbirth and the puerperium
- O99.820 Streptococcus B carrier state complicating pregnancy
- O99.824 Streptococcus B carrier state complicating childbirth
- O99.825 Streptococcus B carrier state complicating the puerperium
- O99.83 Other infection carrier state complicating pregnancy, childbirth and the puerperium
- O99.830 Other infection carrier state complicating pregnancy
- O99.834 Other infection carrier state complicating childbirth
- O99.835 Other infection carrier state complicating the puerperium
In April 2006, Group B Strep International was found by John MacDonald and Marti Perhach who each lost a daughter to Group B strep (GBS). Both of their daughters were born stillborn full-term. As both these deaths were preventable, this inspired John and Marti to promote GBS awareness. Initially, GBS awareness and prevention were planned on a national level throughout the United States – first with The Jesse Cause, Saving Babies from Group B Strep, and then founding GBSI as a sister organization to expand the scope and audience of the campaign. Over the years, the scope of the campaign widened. The US CDC changed its recommendation from risk-based screening of pregnant women for GBS to universal screening of all pregnant women.
Since its inception, the observance has been a focal opportunity for organizations and individuals around the world to tell their stories, share information, and promote healthy outcomes for babies worldwide. People can join the campaign against GBS disease in babies by donating to GBS organizations, joining fundraising events, distributing GBS awareness brochures/postures, joining private GBS discussion groups and sharing personal stories(of how group B Strep affected them) via social media platforms. You can show your support on social media by adding profile frame on Facebook (FB) and posting hashtags like GBSAM21, #GBSI, #GroupBStrep, #Sepsis, #Meningitis, #Pregnancy, #Infancy, #July2021 etc.
Let’s join hands this July to spread awareness, raise money and save lives of infants with GBS disease.