J. Perinat. Med. 41 (2013) 227 • Copyright © by Walter de Gruyter • Berlin • Boston. DOI 10.1515/jpm-2012-0172 Letter to the Editor Vegan carriage of group B streptococcus: a questionnaire study utilising social media Abdul Qader Ismail 1,a, *, Raveem Ismail 2,a and Mark Anthony 3 1 Walsall Manor Hospital, Walsall, UK 2 Trinakria Ltd., Oxford, UK 3 John Radcliffe Hospital, Headley Way, Oxford, UK Keywords: Group B streptococcus; questionnaire; social media; vegan. Sir, We sought to investigate the hypothesis that we have put forward in our previous letter on cross-species transfer of group B streptococcus (GBS) via ingestion [1] by creating a questionnaire survey for vegans, to determine whether the maternal GBS colonisation rate in vegans is reduced com- pared with the general population. To obtain a sufficient number of replies from such a select target group, we utilised social media. Our survey asked respondents for background information (country of residence and vegan status of partner) and infor- mation on their own vegan status (strictness, number of years, and adherence during pregnancies). These were followed by queries ascertaining the number and age of children, results from vaginal swabs, and any GBS-affected babies. The questionnaire was created using Google’s online docu- ment suite. Forty group administrators of well-trafficked online vegan groups agreed to place the survey link on their web presences, which included the news/blog sections on vegan groups’ websites, Facebook, Twitter, Google+, and LinkedIn. Our local ethics committee (National Research Ethics Service) did not require ethics submission to carry out this anonymised online survey, which did not involve National Health Service (NHS) patients from our own institution. A total of 148 questionnaires were correctly completed by vegan mothers from the US, UK, Germany, Sweden, Canada, New Zealand, Australia, and Singapore. The majority of replies were from the US and UK (85 and 39, respectively). There was only one case of neonatal GBS disease, and this was in Germany. Of the 148 respondents, 54 were strict vegans with strict vegan partners, and of these women, 17 had previously had GBS colonisation (31.5%). This figure is in keeping with the known maternal GBS colonisation rate in the general popu- lace for the countries surveyed [2]. Our aim was to investigate whether vegans had similar GBS colonisation rates to the general public, which we found to be the case. To gather these data, we used social media, which allows the targeting of desired respondents who may be geographically dispersed and not typically accessible to the researcher. This is a relatively novel technique, allowing us to collect 148 international respondents within the span of 2 months. Although in real terms a low number, it helped confirm our null hypothesis that vegans are not universally free from GBS. Investigating routes of GBS acquisition is not merely aca- demic; it may lead to novel ways to prevent neonatal GBS dis- ease through public health measures applied in pregnancy. The results of this study support the argument that if cross-species transfer of GBS was of relevance in its emergence as a neona- tal pathogen in man, this is only of historical significance. In today’s world, is does not appear that GBS is predominantly acquired through dairy, meat, or fish consumption. References [1] Ismail AQ, Anthony M. Cross-species transfer of group B strep- tococcus via ingestion? J Perinat Med. 2012;40:201–2. [2] Schuchat A. Epidemiology of group B streptococcal disease in the United States: shifting paradigms. Clin Microbiol Rev. 1998;11:497–513. The authors stated that there are no conflicts of interest regarding the publication of this article. Received July 19, 2012. Accepted July 30, 2012. Previously pub- lished online August 19, 2012. a Abdul Qader Ismail and Raveem Ismail contributed equally to this work. *Corresponding author: Abdul Qader Ismail Walsall Manor Hospital Moat Road Walsall WS2 9PS UK E-mail: aqt.ismail@bnc.oxon.org Brought to you by | University of Iowa Libraries Authenticated Download Date | 6/3/15 1:33 PM