Surveillance of neonatal group B streptococcus infection in Sunderland identified 15 confirmed cases (with positive cultures from blood or CSF) in three years from 1995 to 1997, equivalent to an incidence of 1.42 per 1000 live births, not much lower than the estimate of 1.8 used in the United States to justify the introduction of preventative policies. Confirmed early-onset cases may represent only a fraction of the true number of cases, and a modified risk factor-based policy was introduced in Sunderland in June 1998.