delivered. Each year there are more than 50,000 cases in pregnant women. It is the most common cause of blood infections (sepsis), meningitis, and pneumonia in newborns. About 15,000 to 18,000 infants are infected in the United States each year, and up to 15 percent of these die. Those who survive may have hearing or vision problems or developmental disabilities. While many people carry group B strep in their bodies, most do not get sick. Other common diseases caused by GBS include blood infections, skin or soft tissue infections, and pneumonia.

Symptoms About 2 percent of infants infected with GBS develop symptoms, most appearing during the first week of life—usually within a few hours after birth. It is also possible for infants to contract GBS several months after birth; meningitis is more common with this type of late-onset disease.

Diagnosis GBS can be diagnosed by growing bacteria in spinal fluid or blood cultures, which can take a few days to complete.

Treatment Antibiotics (penicillin or ampi-cillin) are the treatment of choice.

Prevention Since one-third of pregnant women carry GBS bacteria, all pregnant women should be screened for the bacteria at 3 5 to 37 weeks of pregnancy. Most GBS among newborns can be prevented by giving infected pregnant women antibiotics through the vein during labor. Any pregnant woman who has had a baby with GBS disease, or who has GBS infection should receive antibiotics during labor. Women who have been diagnosed with GBS infection at labor are at higher risk if they have fever during labor, rupture of membranes 18 hours or more before delivery, are black, are under age 20, or have labor or rupture of membranes before 37 weeks. Women who have GBS but do not have these risk factors have a relatively low risk of delivering a baby with GBS disease. Unfortunately, some babies still get GBS in spite of testing and antibiotics. Vaccines to prevent GBS disease are being developed, but are still years away.

stroke Sudden interrupted flow of blood to the brain that can cause symptoms that vary in severity from a temporary weakness to profound paral ysis, coma, and death. A stroke occurs when the blood supply to any part of the brain is interrupted, resulting in tissue death and loss of brain function. If blood flow in any of the arteries that lead to the brain is interrupted for longer than a few seconds, brain cells can die, causing permanent damage. There are two types of stroke: hemorrhagic stroke, caused by blood leaking from blood vessels into the brain, or ischemic stroke, caused by a blockage. Although childhood strokes are far less common than adult strokes, they, too, can kill or leave survivors disabled.

Between 1979 and 1998 there were an average of 244 deaths a year due to childhood stroke in the United States. Overall, stroke deaths declined by 58 percent in the 20-year period, but the reduction in deaths varied by type of stroke. Although deaths from stroke in children have declined sharply, black children still have higher stroke death rates than other youngsters.

Recent declines in stroke deaths may be related to better detection methods and to the fact that children now survive previously fatal conditions that can cause strokes, such as prematurity, congenital heart disease, and leukemia.

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