document_title: Harry Potter and the Half-Blood Prince (film)

question_text: who died in harry potter half blood prince

text: Plot[edit]

text: Lord Voldemort is tightening his grip on both the wizarding and Muggle worlds, kidnapping Ollivander from Diagon Alley and destroying the Millennium Bridge. After the Malfoy family is disgraced when Lucius is apprehended and sent to Azkaban for his involvement with the Death Eaters, Voldemort chooses Draco to carry out a secret mission at Hogwarts. Bellatrix Lestrange and Narcissa Malfoy, Draco's mother, seek help from Severus Snape, who claims to have been acting as a mole within the Order of the Phoenix all along. Snape makes an Unbreakable Vow with Narcissa to protect Draco and fulfill the assignment if he fails.

text: Harry accompanies Albus Dumbledore from Surbiton to the village of Budleigh Babberton to visit former Potions professor Horace Slughorn. Professor Slughorn has been in hiding but agrees to return to teach at Hogwarts. Dumbledore then takes Harry to The Burrow, where Harry reunites with his best friends, Ron Weasley and Hermione Granger. When the three go visit Fred and George Weasley's new joke shop at Diagon Alley, they see Draco entering Knockturn Alley with a group of Death Eaters including Fenrir Greyback. Harry believes Voldemort has made Draco a Death Eater, but Ron and Hermione are skeptical. On the Hogwarts Express, Harry hides in the Slytherin carriage using his Invisibility Cloak. Harry is spotted by Malfoy, who petrifies him and breaks his nose. Harry is found and saved by Luna Lovegood.

text: At Hogwarts, Harry and Ron borrow textbooks for Slughorn's Potions class, and Harry is stuck with a copy that turns out to be filled with helpful notes and spells left by the "Half-Blood Prince". Harry uses the book to excel in the class and impresses Slughorn, winning a vial of Liquid Luck. Ron becomes Keeper of the Gryffindor Quidditch team and forms a romantic relationship with Lavender Brown, upsetting Hermione. Harry consoles Hermione and reveals that he now has feelings for Ron's younger sister, Ginny Weasley.

text: Harry spends the Christmas holidays with the Weasleys. On Christmas Eve, Harry discusses his suspicions about Draco to the Order of the Phoenix. Harry's suspicions are dismissed by the Order, but later on Arthur Weasley tells Harry privately that the Malfoys may have been interested in a Vanishing Cabinet. Bellatrix and Greyback attack the Burrow and burn it down, drawing Harry into a battle before the Order arrive and fight them off. At Hogwarts, Dumbledore reveals to Harry that Slughorn possesses a memory of Voldemort that Dumbledore needs desperately. Slughorn gave Dumbledore the memory, but it was an altered version that made it appear that Slughorn didn't know anything. Dumbledore shows Harry the altered memory and asks him to confront Slughorn and retrieve the real one, but when Harry brings it up Slughorn gets angry and refuses to talk any more about it. After Ron accidentally ingests a love potion, Harry brings him to Slughorn for a cure and to smooth over their argument from earlier. After curing Ron, the trio celebrate with mead that Slughorn had intended to gift to Dumbledore. The mead poisons Ron, and Harry is forced to save his life after Slughorn hesitates. Ron murmurs Hermione's name while recovering in the infirmary, causing Lavender to end their relationship. Harry confronts Draco about the poisoned mead and a cursed necklace, and the two duel. Harry uses a curse from the Half-Blood Prince's potion book to severely injure Malfoy, who is rescued and healed by Professor Snape. Fearing the potion book may be filled with more Dark Magic, Ginny and Harry hide it in the Room of Requirement and share their first kiss.

text: Harry decides to use his Liquid Luck potion to convince Slughorn to give up the memory Dumbledore needs. Harry views the memory with Dumbledore and learns that Voldemort wanted information for creating Horcruxes, magical objects that could contain pieces of a wizard's soul and save them from death. Dumbledore concludes that Voldemort successfully created seven Horcruxes, two of which have already been destroyed: Tom Riddle's diary and Marvolo Gaunt's ring. Harry and Dumbledore travel to a seaside cave where Harry aids Dumbledore in drinking a potion that hides another Horcrux, Slytherin's locket. A weakened Dumbledore defends them from Inferi and apparates back to Hogwarts. Bellatrix, Greyback, and more Death Eaters enter Hogwarts with Draco's help through the vanishing cabinet in the Room of Requirement that Draco managed to connect to the one he had been working on in Knockturn Alley.

text: Dumbledore instructs Harry to hide and not to interfere no matter what happens. Draco arrives and disarms Dumbledore revealing that he has been chosen by Voldemort to kill the headmaster. When Draco is unable to bring himself to do it, Snape casts the killing curse instead. Harry confronts and attacks Snape, but Snape overpowers him, and reveals himself as the Half-Blood Prince before escaping. Harry returns to Hogwarts, where the students, staff, and a few guests mourn Dumbledore's death. Harry later reveals to Ron and Hermione that the locket Horcrux was a fake. The locket contains a message from "R.A.B.", stating that he has stolen the real Horcrux with the intent of destroying it. Rather than returning for their final year at Hogwarts, the three decide to hold out, and track down the remaining Horcruxes.

text: Cast[edit]

text:
Daniel Radcliffe as Harry Potter
Rupert Grint as Ron Weasley, one of Harry's two best friends.
Emma Watson as Hermione Granger, one of Harry's two best friends.
Michael Gambon as Albus Dumbledore, the headmaster of Hogwarts.
Helena Bonham Carter as Bellatrix Lestrange, one of Voldemort's principal Death Eaters and Draco Malfoy's aunt.
Jim Broadbent as Horace Slughorn, the newly appointed Potions master who held the position before.
Robbie Coltrane as Rubeus Hagrid, the Hogwarts gamekeeper and Care of Magical Creatures teacher at Hogwarts.
Warwick Davis as Filius Flitwick, the Charms master and head of Ravenclaw.
Tom Felton as Draco Malfoy, Harry's rival and recipient of Voldemort's secret mission.
Alan Rickman as Severus Snape, the former Potions master, current Defence Against the Dark Arts teacher and head of Slytherin.
Maggie Smith as Minerva McGonagall, the Hogwarts Transfiguration teacher, deputy headmistress and head of Gryffindor.
Timothy Spall as Peter Pettigrew, the Death Eater who betrayed Harry's parents to Voldemort. Pettigrew has no lines in this film, but appears as a servant at Snape's house.
David Thewlis as Remus Lupin, a member of the Order of the Phoenix and Harry's ex-Defence Against the Dark Arts teacher.
Julie Walters as Molly Weasley, the Weasley matriarch and a mother figure to Harry.

text: Production[edit]

text: Development[edit]

text: Before David Yates was officially chosen to direct the film, many directors had expressed an interest in taking the helm. Alfonso Cuarón, the director of the third film, stated he "would love to have the opportunity" to return.[13] Goblet of Fire director Mike Newell declined a spot to direct the fifth film, and was not approached for this one.[14] Guillermo del Toro turned down the chance to direct the film in order to direct Hellboy II: The Golden Army.[citation needed] Terry Gilliam was Rowling's personal choice to direct Philosopher's Stone. When asked whether he would consider directing a later film, Gilliam said, "Warner Bros. had their chance the first time around, and they blew it."[15]

text: In an interview with Dark Horizons, Yates said that "I was still working on Order of the Phoenix when they asked me to do Half-Blood Prince. So they were really delighted with the material that they were seeing while we were in post-production, and the conversations happened before the movie was released, because I had to start pre-production on it while Order of the Phoenix was being promoted. It was just something they see in the work that they really liked, and responded to."[16] Yates described Half-Blood Prince as being "a cross between the chills of Prisoner of Azkaban and the fantastical adventure of Goblet of Fire."[17]

text: Emma Watson considered not returning for the film,[18] but eventually decided that, "the pluses outweighed the minuses," and could not bear to see anyone else play Hermione. Composer Nicholas Hooper returned from the last film; he included a reworking of John Williams's Hedwig's Theme, which has recurred in all scores. Also maintained were costume designer Jany Temime, visual effects supervisor Tim Burke, creature and make-up effects designer Nick Dudman, and special effects supervisor John Richardson from the third film.[19]

text: Yates and Heyman have noted that some of the events of Harry Potter and the Deathly Hallows influenced the script of Half-Blood Prince.[20]

text: Casting[edit]

text: Christian Coulson, who played the young Tom Riddle in Chamber of Secrets, expressed an interest in returning in the role for flashback sequences;[21] Yates responded that Coulson was too old, nearing 30, to be playing the role.[22] Jamie Campbell Bower, who appeared in Sweeney Todd: The Demon Barber of Fleet Street, previously noted that he had his "fingers crossed" he would be cast as a young Riddle.[23] (Bower was, however, later cast as the teenage Gellert Grindelwald in Harry Potter and the Deathly Hallows – Part 1.) Thomas James Longley was the original choice to take on the role but Riddle was ultimately played by Hero Fiennes-Tiffin as a child and Frank Dillane as a teenager.[24][25]

text: Helen McCrory appears as Narcissa Malfoy, Draco's mother and younger sister of Bellatrix. McCrory was originally cast as Bellatrix in Order of the Phoenix, but had to drop out due to pregnancy.[26] Naomi Watts was previously reported as having accepted the role,[27] only for it to be denied by her agency.[28]

text: Both Clémence Poésy, who has played Fleur Delacour, and Chris Rankin, who has played Percy Weasley, were interested in returning, but did not appear in the film.[29][30] After Bill Nighy expressed an interest in appearing,[31] Yates confirmed that Nighy would be his first choice for the role of Minister for Magic Rufus Scrimgeour.[32] Scrimgeour's character was ultimately cut from the film, but Nighy appeared in his role in Deathly Hallows.[33]

text: Sets[edit]

text: Stuart Craig, the production designer of the first five films, stayed on to design all the sets in Half-Blood Prince.[34] Several new sets are introduced, including Tom Riddle's Orphanage, Astronomy Tower and the Cave. Craig noted that the film used several CGI sets, noticeably the interior of the Cave where Harry and Dumbledore both go to hunt Horcruxes. The exterior of the cave scene was filmed at the Cliffs of Moher in the west of Ireland, the only location to be filmed outside of the United Kingdom throughout the film series. The interior of the cave is made up of geometric crystal formations. Craig noted "Apart from the point at which Harry and Dumbledore first arrive and the island formation on which everything inside the cave happens, the set is entirely virtual, designed in the computer. We'd had our first totally virtual set on the last film, so we approached this one with a bit more confidence."[35]

text: Filming[edit]

text: Before filming began, there was belief that filming might move from the UK, where all previous films were shot. The crew also scouted around Cape Wrath in Scotland, for use in the cave scene.[36] Filming returned to Glen Coe and Glenfinnan, both which have appeared in the previous films, to preserve the continuity of the landscape.[37]

text: Following a week of rehearsals, principal photography began on 24 September 2007 and ended on 17 May 2008.[38] Though Radcliffe, Gambon and Broadbent started shooting in late September 2007, some other cast members started much later: Grint did not begin until November 2007, Watson did not begin until December 2007, Rickman until January 2008, and Bonham Carter until February 2008.[39][40]

text: On the weekend of 6 October 2007, the crew shot scenes involving the Hogwarts Express in the misty and dewy environment of Fort William, Scotland.[37] A series of night scenes were filmed in the village of Lacock and the cloisters at Lacock Abbey for three nights starting 25 October 2007. Filming took place from 5 pm to 5 am daily, and residents of the street were asked to black out their windows with dark blinds.[41][42][43] On set reports indicated that the main scene filmed was Harry and Dumbledore's visit to Slughorn's house.[43] Further filming took place in Surbiton railway station in October 2007,[44] Gloucester Cathedral, where the first and second films were shot, in February 2008,[45][46] and at the Millennium Bridge in London in March 2008.[47]

text: Cinematography[edit]

text: Due to cinematographer Bruno Delbonnel's use of de-focussing and soft wipes in the digital grade, Warner Bros. asked director David Yates to add more colours to the film. Yates didn't want to lose the "very European look" of the film, but after retouching the picture, he said, "It's not what you wanted, but we're happy with it." After five minutes of watching the film, the studio were pleased with the changes.[48][49] In an interview with Total Film, Yates said that "the choice of angles, the extreme close-ups, [and] the pacing of the scenes" made the film "incredibly rich".[50] The palette and lighting was heavily inspired by the Dutch painter Rembrandt.[51] Half-Blood Prince is the only film in the series to be nominated for the Best Cinematography accolade at the Academy Awards.[8]

text: One of the major challenges for Delbonnel was lighting the film. In an interview with the Academy, he said, "Some of the sets are there since the very first Potter. How could I light them in a different way? This question brought another one based on the series itself... I thought it would be interesting to have those very intimate stories amidst this very dark mood. As if the school was a dark character. That's when I suggested to go for this (again) dark moody variations of greys. Fortunately David Yates, and the producers liked the idea." In reference to the cave scene Delbonnel said, "I wanted to have some kind of 'dynamism' with the light. I thought it could be interesting and more dramatic if the light was floating, circling above the characters faces: sometimes lighting them, sometimes hiding them in a very random and unpredictable way."[52]

text: Visual effects[edit]

text: Tim Burke and Tim Alexander were the visual effects supervisors for the film. Tim Alexander said that completing the Inferi-attack scene took several months. He said, "It's certainly much bolder and scarier than we imagined that they'd ever go in a 'Potter' movie. Director David Yates was cautious of not making this into a zombie movie, so we were constantly trying to figure out how not to make these dead people coming up look like zombies. A lot of it came down to their movement – they don't move fast, but they don't move really slow or groan and moan. We ended up going with a very realistic style." He also noted that Inferi are skinnier than zombies, waterlogged and grey.[53]

text: About Dumbledore's ring of fire, he noted that the effect would look as if someone sprayed propane and then lit it. He added, "We did a lot of research on molten volcanoes, which have a lot of heat going on but no actual flames, and collected a bunch of other references, including flares that burn underwater, and showed them to the Potter folks." The visual effects team emulated these six fire parameters: heat ripples, smoke, buoyancy, viscosity, opacity, and brightness. Since the whole fire scene was very time consuming, computer graphics artist Chris Horvath spent eight months finding a faster way to conjure flames.[54][55]

text: The opening scenes of the Death Eaters' attack on Diagon Alley and London was created by Double Negative, led by VFX Supervisor Paul Franklin. Double Negative spent six months surveying and documenting the environment around the River Thames and Trafalgar Square to create the swooping views of the city. Double Negative also contributed the Pensieve sequences, developing complex directed fluid simulations to realise the swirling world of memory and the past.[56]

text: Music[edit]

text: The film's score was composed by Nicholas Hooper, who also composed the music for Harry Potter and the Order of the Phoenix. The soundtrack was released on an Audio CD format on 14 July 2009, a day before the film was released in cinemas.[57]

text: The album debuted at number twenty-nine on the Billboard 200 chart, thus making it the highest-charting soundtrack among all the six movie soundtracks released.[58] It was nominated for the 2010 Grammy Award for Best Score Soundtrack Album For Motion Picture, Television or Other Visual Media.[59]

text: Differences from the book[edit]

text: While at the middle of the series in length, the film Half-Blood Prince did add or change events in the literary canon. The book begins with a scene involving the Muggle Prime Minister. Yates and his crew debated over this scene, as well as the character Rufus Scrimgeour, but gave up the beginning of the movie to events described but not seen in the book.[60] Yates thought it would give the audience a feel for what the Death Eaters were doing if they showed the collapse of the Millennium Bridge rather than describe it.[61] As with Goblet of Fire, the Dursleys were cut, which Steve Kloves did to "break the pattern".[60] Further background of Tom Riddle was removed, such as the Gaunts because they felt it more important to concentrate on Riddle as a young boy, and an additional action scene at the Burrow was added to keep with the tone of the franchise.[60] Yates felt that they needed "an injection of jeopardy and danger" and that without it there was too much comedy and lightness.[62] A small battle scene at Hogwarts which happened during the end of the book was cut; Heyman commented that it was removed to "[avoid] repetition" with the forthcoming adaptation of the Battle of Hogwarts in Deathly Hallows.[60] Dumbledore's funeral was removed as it was believed it did not fit with the rest of the film.[63]

text: Distribution[edit]

text: Marketing[edit]

text: Warner Bros. has spent an estimated $155 million to market and distribute the film.[64] The special edition two-disc DVD for Harry Potter and the Order of the Phoenix contained two sneak peeks of the film,[65][66] while the US edition included an additional clip.[67] A 15-second teaser for the film was shown alongside the IMAX release of The Dark Knight.[68] The first full-length US teaser trailer was released on 29 July on AOL's Moviefone website.[69] An international teaser was released on 26 October[70] and another teaser trailer was released. The US theatrical trailer was released on 14 November.[71] Another trailer was screened on the Japanese TV station Fuji TV during a screening of Harry Potter and the Goblet of Fire on 18 January 2009.[72][73] Scenes from the film were aired during ABC Family's Harry Potter marathon which took place 5–7 December 2008.[74] On 5 February 2009, the first three promotional teaser posters were released, featuring Dumbledore and Harry.[75] On 5 March and 16 April 2009, new trailers were released by Warner Bros.[76]

text: Warner Bros and MSN ran an online Order of the Phoenix quiz, with the prize being a walk-on part in the Half-Blood Prince.[77] As with the previous films, EA Games produced a video game based on the film.[78] On 10 March 2009, it was announced that there would be a video game soundtrack, which was released on 17 March 2009.[79] On 27 March six character posters were released: Harry, Dumbledore, Ron, Hermione, Draco, and Professor Snape.[80] An English version of the international trailer and a Japanese version of the international trailer were released online 10 April.[81] On 8 May, CW Channel aired 30-second TV Spot, which focused on the romantic side of the film.[82] On 20 May, first clip from the film was released through The Ellen DeGeneres Show's official website, showing love-struck Ron.[83] Another clip of the film, showing Dumbledore visiting Tom Riddle's Orphanage was released on 31 May 2009, at MTV Awards.[84]

text: Theatrical release[edit]

text: The film was released in the United Kingdom, United States, France, Belgium, Germany, Ireland, Italy, Sweden, Canada, Australia, Taiwan, New Zealand, India, Brazil, Spain and Mexico on 15 July 2009.[85] It was originally set to be released on 21 November 2008,[86] but was pushed back by eight months to 17 July, despite being completed. Warner Bros. executive Alan F. Horn noted that the move was meant "to guarantee the studio a major summer blockbuster in 2009," with other films being delayed due to the 2007–2008 Writers Guild of America strike.[87] The box-office success of summer WB films Harry Potter and the Order of the Phoenix and The Dark Knight also motivated the decision.[88] An unnamed rival studio executive told Entertainment Weekly that the move was to "stop next year's profits from looking seriously underwhelming after the phenomenal success of The Dark Knight," as "they don't need the money this year anymore."[89] Dan Fellman, WB head of distribution, said that the studio had considered the date change for three to four weeks prior to the announcement, but gave it serious consideration a week before they came to their final decision.[90] Three months before its release in July, the date was again changed by 2 days from 17 to 15 July, so it could open on a Wednesday like most tentpole summer movies.[91]

text: The date change was met with a heavily negative reaction by Harry Potter fans, as the Los Angeles Times noted: "Petitions were circulating, rumors were flying and angry screeds were being posted on Internet sites within minutes of the Thursday announcement."[88] The move was mocked by Entertainment Weekly which had Half-Blood Prince on the cover on its "Fall Preview Issue". Despite each being owned by Time Warner Inc., EW was unaware of the change until it was publicly announced by WB and noted that readers would now be in possession of a "Dewey Defeats Truman collectible".[89] Several days after the announcement, Horn released a statement in response to the "large amount of disappointment" expressed by fans of the series.[92] Following the date change, Half-Blood Prince's release slot was taken by Summit Entertainment's Twilight[93] and Walt Disney Pictures' Bolt.[94]

text: The sixth film was simultaneously released in regular cinemas and IMAX 3D everywhere but the United States, due to a conflicting agreement in which Transformers: Revenge of the Fallen was given a four-week window by itself in IMAX in that country. Therefore, the IMAX 3D version of the film was released on 29 July 2009 there.[95] The film's opening sequence featuring the destruction of the Millennium Bridge was in 3D.[96] The film had been chosen to be screened at the 2008 Royal Film Performance on 17 November,[97] but was not shown. Cinema and Television Benevolent Fund chief executive Peter Hore noted he was "very disappointed" with Warner Bros' decision.[87]

text: Advance ticket sales on Fandango.com for Half-Blood Prince surpassed advance ticket sales for Transformers 2 at the same point in sale cycles. It is also in MovieTickets.com's top 25 advance sellers of all time.[98]

text: Running 153 minutes (2 hours 33 minutes and 19 seconds) long,[99] Half-Blood Prince is the third longest film in the series, behind Chamber of Secrets (161 minutes)[100] and Goblet of Fire (157 minutes).[101]

text: Home media[edit]

text: Like the previous films, a 1-Disc and 2-Disc Special Edition for the film was released on Blu-ray Disc with a Digital Copy and DVD on 7 December 2009 in the United Kingdom,[102] and 8 December 2009 in the United States.[103] The Blu-ray and DVD includes an 11-minute 38 second feature on the new Wizarding World of Harry Potter mini theme park[104] which opened on 18 June 2010 at Islands of Adventure in Orlando, Florida. Also included are deleted scenes comprising 8 scenes with a running length of 6 minutes and 31 seconds,[105] and a sneak peek of the next Harry Potter movie, Harry Potter and the Deathly Hallows – Part 1 (2010).[106] The Blu-ray and DVD released in India,[107] the Philippines, South Africa, Czech Republic and Israel on 16 November 2009, making them the first countries to get the Half Blood Prince DVD release before the UK and the US. The release date for Australia and New Zealand was 18 November and for Brazil[108] and Chile, 19 November. The Blu-ray and 2-disc DVD editions in North America includes a digital copy of the film.[103] In the United Kingdom, the DVD release became the fastest selling DVD of the year with an estimated 840,000 copies of the film sold in a few hours.[109] In the US, the DVD made a strong debut at number one in both the DVD and Blu-Ray markets widely beating out any competition with sales of 4,199,622 copies. Worldwide DVD and Blu-ray sales of the film show that it is the fastest selling film of 2009.[110]

text: On 14 June 2011, an Ultimate Edition was released simultaneously with the Ultimate Edition of the Order of the Phoenix film on both Blu-ray and DVD, containing new bonus features, documentaries, and collectables.[111]

text: Reception[edit]

text: Box office[edit]

text: Harry Potter and the Half-Blood Prince broke the then-record for biggest midnight showings, making $22.8 million in 3,000 cinemas; The Twilight Saga: New Moon bested this with $26.3 million. Half-Blood Prince opened in the same Wednesday slot that Harry Potter and the Order of the Phoenix did in 2007, which grossed $12 million in midnight runs, on its way to $139.7 million in its five-day debut in the US.[112] The film's box office run was over on 17 December 2009.[113]

text: The film opened in 4,325 cinemas (rising to 4,455 three weeks later, becoming the largest number of cinemas until The Twilight Saga: Eclipse surpassed it with the 4,468 cinemas)[114] and grossed $58.2 million on its opening day at the top of the United States and Canadian box office, the third-highest Wednesday opening of all time behind Transformers: Revenge of the Fallen and The Twilight Saga: Eclipse. It is also the nineteenth-highest single-day gross of all time and the third-highest for a film in the Harry Potter franchise behind Harry Potter and the Deathly Hallows – Part 2's $91.1 million[115] and Harry Potter and the Deathly Hallows – Part 1, which made $61.1 million.[116] It earned an additional $46 million overseas for a worldwide total of $104 million, breaking the record for highest single-day worldwide gross, previously held by The Dark Knight.[117] By 20 July, the film had taken in $158.7 million in the US and $236 million from 85 other markets, for a worldwide tally of $394.7 million.[118] This broke the record for biggest ever worldwide five-day opening, surpassing Spider-Man 3's $381 million; this makes the film the fastest to reach the $350 million mark in worldwide box office of all time. In the US, it surpassed all of its predecessors by a wide margin, achieving the sixth largest ever five-day opening in that country.[119] The film held this record for two years until it was topped by Deathly Hallows – Part 2 ($483.2 million).[120] In the UK, the film grossed £19.75 million (equivalent to about $38.13 million), the highest opening for both the series and releases of 2009.[121] At the end of the film's US and Canadian box office run the total ticket sales of the film were $302 million,[2] making it the third most successful film in the franchise, after Harry Potter and the Deathly Hallows – Part 2 and Harry Potter and the Philosopher's Stone,[122] as well as the third-highest-grossing film of 2009 in these regions behind Avatar and Transformers: Revenge of the Fallen.[123] As with all of the previous films in the franchise, Half-Blood Prince proved to be extremely successful globally with an estimated non-US total gross of $632.5 million, totalling approximately $934.4 million worldwide,[2] making it the second-highest-grossing film of 2009, behind Avatar, and the 34th-highest-grossing film of all time, unadjusted for inflation. It is the fifth-highest-grossing film in the franchise, behind Philosopher's Stone, both parts of Deathly Hallows, and Order of the Phoenix.[7]

text: In South Africa the film opened with the number one position grossing $789,176,[124] it maintained a number one position during the second week too, with a total of $242,336.[125] In Australia, as in most of the world, the film broke records with a debut of $11,492,142 and opening at number one, maintaining a second week at number one with a total of $5,278,096 (down 54%), and grossed a total of $24,208,243.[126] In France the film debuted at $20,541,239 from 949 cinemas.[127]

text: Critical response[edit]

text: On review aggregator Rotten Tomatoes the film has an approval rating of 84% based on 268 reviews, with an average rating of 7.2/10. The site's critical consensus reads, "Dark, thrilling, and occasionally quite funny, Harry Potter and the Half-Blood Prince is also visually stunning and emotionally satisfying."[128] On Metacritic, which assigns a normalised rating to reviews, the film has a score of 78 out of 100, based on 36 critics, indicating "generally favourable" reviews.[129] The film scored an 87 from professional critics at the Broadcast Film Critics Association; it is the first Harry Potter film to receive a Critic's Choice certificate.[130] On CinemaScore, audiences gave the film an average grade of "A-" on an A+ to F scale.[131]

text: The first review of the film came three weeks before the official release. Paul Dergarabedian of Hollywood.com ranked the film with The Lord of the Rings film trilogy and called the film a "possible Oscar contender". He highly praised the performance of Sir Michael Gambon, Alan Rickman and Daniel Radcliffe. He commented, "Harry Potter and the Half-Blood Prince is a tour-de-force that combines style and substance, special effects and heart and most importantly great performances from all of the actors young and not-so-young".[132] Another early review came from the UK tabloid The Sun, whose anonymous reviewer called the film "masterful" and "very emotional". The reviewer praised David Yates' directing and called Jim Broadbent's portrayal of Horace Slughorn "perfect".[133] Devin Faraci of Chud.com called the film not only the best Harry Potter film yet, but also one of the best films of the year.[134]

text: Andrew Pulver of The Guardian wrote a positive review, and gave the film 3.5 out of 5 stars rating.[135] Todd McCarthy of the trade magazine Variety said that the film is "dazzlingly well made" and "less fanciful than the previous entries". He praised Alan Rickman's performance and he described Helena Bonham Carter as "mesmerising" and Jim Broadbent as a "grand eccentric old professor".[136] BBC News's Tim Masters praised the film's cinematography, visual effects, production design, improved acting and darker plotline.[137] The Hollywood Reporter's Kirk Honeycutt noted that the film's first half is "jerky and explosive", but in the second half, the film finds better footing. He adds, "Composer Nicholas Hooper, cinematographer Bruno Delbonnel and designer Stuart Craig deliver a singularly muscular and vigorous chapter".[138] Screen Daily called the film "[s]tunningly shot by Bruno Delbonnel in metallic hues leavened by buttery tones and the thumping beats of Nicholas Hooper's score bear little resemblance to the original and the overall effect is much less tween, much more grown-up".[139]

text: Chris Tilly of IGN UK commented on the length of the film, saying "while on occasion it drags, the 153-minute run-time never feels too long, thanks in no small part to the astonishing visuals and (largely) marvellous performances," and goes on to say, "This is by far the best-looking of the Potter films thus far," commending the "beautiful" Quidditch match and the "stunning" finale.[140] However, Dave Golder of SFX magazine found some aspects of the film to be a disappointment, largely due to the large number of opportunities the director and screenwriter had sacrificed to devote "huge swathes of the film to subplots of Harry and his chums' teenage romances," but nevertheless found the film to be a large enjoyment, praising the performances of Jim Broadbent and Alan Rickman.[141]

text: David Stratton, of Margaret and David at the Movies, gave the film a 2.5 out of a possible 5 stars, remarking, "For non-readers [of the Harry Potter series] the films are now borderline incomprehensible", and that the film was "a little tedious" and "generally less interesting visually than its predecessors." He praised the cast, describing them as "consummate", adding Sir Michael Gambon "really makes Dumbledore an imposing character" and Jim Broadbent was "wonderful". Margaret Pomeranz, the co-host of the television show, gave the film 3 out of 5 stars.[142]

text: At the time of its release, Rowling stated that Half-Blood Prince was her "favourite one" of the six film adaptations.[62] Radcliffe, however, was critical of his own performance in the film, stating in an interview in 2014 that he was "just not very good in it", and calling it "hard to watch".[143]

text: Accolades[edit]

text: The film was nominated for BAFTA Awards in Production Design and Visual Effects,[9] and was in the longlists for five other categories, including Best Supporting Actor for Alan Rickman.[144] Bruno Delbonnel was nominated for the Academy Award for Best Cinematography at the 82nd Academy Awards.[8] The film was also one of the final seven contenders for Best Visual Effects.[145]

text:
[show]List of awards and nominations

Award
Category
Result
Recipient
Source

82nd Academy Awards
Best Cinematography
Nominated
Bruno Delbonnel
[8]

Art Directors Guild Award
Excellence in Production Design For a Feature Film
Nominated
Stuart Craig
[146]

63rd BAFTA Awards
Best Production Design
Nominated
Stuart Craig
Stephenie McMillan
[9]

Best Special Visual Effects
Nominated
John Richardson
Tim Burke
Tim Alexander
Nicolas Aithadi

BAFTA Britannia Awards
Artistic Excellence in Directing
Won
David Yates (for Harry Potter films 5–8)
[147]

BAFTA Kids' Vote
Best Film
Nominated
Harry Potter and the Half-Blood Prince
[148]

Digital Spy Movie Award
Best Family Film
Won
Harry Potter and the Half-Blood Prince
[149]

Golden Reel Award
Best Sound Editing: Sound Effects, Foley, Dialogue and ADR in a Foreign Feature Film
Nominated
Harry Potter and the Half-Blood Prince
[150]

Grammy Award
Best Score Soundtrack Album For Motion Picture
Nominated
Nicholas Hooper
[59]

IFTA Award
Best Supporting Actor
Nominated
Michael Gambon
[151]

IGN
Best Fantasy Movie
Won
Harry Potter and the Half-Blood Prince
[152]

MTV Movie Awards
Best Movie
Nominated
Harry Potter and the Half-Blood Prince
[153]

Best Female Performance
Nominated
Emma Watson

Best Male Performance
Nominated
Daniel Radcliffe

Best Villain
Won
Tom Felton

Best Global Superstar
Nominated
Daniel Radcliffe

National Movie Awards
Best Family Movie
Won
Harry Potter and the Half-Blood Prince
[154]

Best Performance
Nominated
Rupert Grint

Nominated
Daniel Radcliffe

Nominated
Emma Watson

People's Choice Awards
Favorite Movie
Nominated
Harry Potter and the Half-Blood Prince
[155]

Favourite Franchise
Nominated
Harry Potter

Best On-Screen Team
Nominated
Daniel Radcliffe, Rupert Grint, and Emma Watson

Phoenix Film Critics Society Awards
Best Live Action Family Film
Won
Harry Potter and the Half-Blood Prince
[156]

RAAM Awards
Film of the Year
Won
Harry Potter and the Half-Blood Prince
[157]

RAFA Awards
Alan Titchmarsh Show British Film of the Year Award
Won
Harry Potter and the Half-Blood Prince
[158]

Classic FM Film Music of the Year Award
Won
Harry Potter and the Half-Blood Prince

Best Use of UK Locations in a Film
Won
Harry Potter and the Half-Blood Prince

Film of the Year sponsored by The List
Nominated
Harry Potter and the Half-Blood Prince

Satellite Awards
Best Motion Picture, Animated or Mixed Media
Nominated
Harry Potter and the Half-Blood Prince
[159]

Saturn Awards
Best Fantasy Film
Nominated
Harry Potter and the Half-Blood Prince
[160]

Best Costume
Nominated
Jany Temime

Best Production Design
Nominated
Stuart Craig

Best Special Effects
Nominated
Tim Burke
John Richardson
Nicholas Aithadi
Tim Alexander

Scream Award
Best Fantasy Film
Nominated
Harry Potter and the Half-Blood Prince
[161]

Best Fantasy Actress
Nominated
Emma Watson

Best Fantasy Actor
Nominated
Daniel Radcliffe

Best Supporting Actor
Nominated
Rupert Grint

Best Supporting Actress
Nominated
Evanna Lynch

Best Villain
Nominated
Helena Bonham Carter

Best F/X
Nominated
Harry Potter and the Half-Blood Prince

Best Sequel
Nominated
Harry Potter and the Half-Blood Prince

Holy Shit! Scene of the Year
Won
"Death Eaters Attack London" Scene

Best Ensemble
Won
Harry Potter and the Half-Blood Prince

SFX Awards
Best Film
Won
Harry Potter and the Half-Blood Prince
[162]

Switch Live Award
Favourite Flick
Won
Harry Potter and the Half-Blood Prince
[163]

2009 Teen Choice Awards
Choice Summer Movie: Action Adventure
Won
Harry Potter and the Half-Blood Prince
[164]

2010 Teen Choice Awards
Choice Movie: Fantasy
Nominated
Harry Potter and the Half-Blood Prince
[165]

Choice Movie Actress: Fantasy
Nominated
Emma Watson
[165]

VES Awards
Outstanding Matte Paintings in a Feature Motion Picture
Nominated
David Basalla
Emily Cobb
Tania Richard
[166]

Young Artist Award
Best Supporting Actress
Nominated
Evanna Lynch
[167]


document_title: List of Billboard Hot 100 number-one singles of 1983

question_text: what song was number one on april 6 1983

root

text: These are the Billboard Hot 100 number one hits of 1983. The longest running number-one single of 1983 is "Every Breath You Take" by The Police at eight weeks.

tag: p

text:
Key

The yellow background indicates the #1 song on Billboard's 1983 Year-End Chart of Pop Singles.

tag: table

text:
Issue Date

Song

Artist(s)

Reference

January 1

"Maneater"

Hall & Oates

[1]

January 8

[2]

January 15

"Down Under"

Men at Work

[3]

January 22

[4]

January 29

[5]

February 5

"Africa"

Toto

[6]

February 12

"Down Under"

Men at Work

[7]

February 19

"Baby, Come to Me"

Patti Austin and James Ingram

[8]

February 26

[9]

March 5

"Billie Jean"

Michael Jackson

[10]

March 12

[11]

March 19

[12]

March 26

[13]

April 2

[14]

April 9

[15]

April 16

[16]

April 23

"Come On Eileen"

Dexys Midnight Runners

[17]

April 30

"Beat It"

Michael Jackson

[18]

May 7

[19]

May 14

[20]

May 21

"Let's Dance"

David Bowie

[21]

May 28

"Flashdance... What a Feeling"

Irene Cara

[22]

June 4

[23]

June 11

[24]

June 18

[25]

June 25

[26]

July 2

[27]

July 9

"Every Breath You Take"

The Police

[28]

July 16

[29]

July 23

[30]

July 30

[31]

August 6

[32]

August 13

[33]

August 20

[34]

August 27

[35]

September 3

"Sweet Dreams (Are Made of This)"

Eurythmics

[36]

September 10

"Maniac"

Michael Sembello

[37]

September 17

[38]

September 24

"Tell Her About It"

Billy Joel

[39]

October 1

"Total Eclipse of the Heart"

Bonnie Tyler

[40]

October 8

[41]

October 15

[42]

October 22

[43]

October 29

"Islands in the Stream"

Kenny Rogers and Dolly Parton

[44]

November 5

[45]

November 12

"All Night Long (All Night)"

Lionel Richie

[46]

November 19

[47]

November 26

[48]

December 3

[49]

December 10

"Say Say Say"

Paul McCartney and Michael Jackson

[50]

December 17

[51]

December 24

[52]

December 31

[53]


document_title: Three-Point Contest

question_text: who won the nba 3 point contest 2017

question_tokens: who won the nba 3 point contest 2017

text: Three-Point Contest

text: Rules[edit]

text: In this contest, participants attempt to make as many three-point field goals as possible from five positions behind the three-point arc in one minute. Players begin shooting from one corner of the court, and move from station to station along the three point arc until they reach the other corner.[3] At each shooting station is a rack with five basketballs. Out of the five balls, four are worth one point (the standard orange Spalding game balls) and the fifth one (a red/white/blue ABA-style ball; often nicknamed the "money ball")[4][5] is worth two points. The goal of this contest is to score as many points as possible within one minute. A perfect score used to be 30 points.[6][7] In the 2014 contest, a rack consisting only of "money balls" was added, and can be placed on any of the 5 spots of the player's choice, bringing up the maximum possible score to 34 points.[8]

text: In the qualifying round, each player has a chance to score as many points as possible. The three players with the top scores advance to the finals. The final round is played in the same way as the qualifying round, but players shoot according to the ascending order of their first-round scores. In each round, the shots and the score are confirmed by the referee and the television instant replay system.[5][9] The final round will be shot in reverse direction (left to right corner for a left-handed shooter and vice versa). In the case of a tie, multiple extra rounds of 30 seconds (60 seconds in the final) are played to determine the winner.

text: Prize money[edit]

text: Contestants compete for a total of $86,000. The first-place winner receives $35,000; the second-place finisher receives $22,500, and the third-place winner receives $15,000. Finishers, from fourth to sixth place, receive $4,500 each.[9]

text: Milestones[edit]

text:
Larry Bird, the inaugural winner of this contest, and Craig Hodges have each won three consecutive times, while Mark Price, Jeff Hornacek, Peja Stojaković and Jason Kapono have each won two consecutive times.
Craig Hodges holds the record for most shots made in one round (21/25), as well as most consecutive shots made (19).
Devin Booker (final round, 2018) holds the record with 28 points, albeit in the newer 34-point format.
Detlef Schrempf and Michael Jordan share the record for the fewest points scored in any round with five in 1988 and 1990 respectively.[10]
Kyrie Irving is the youngest player to win the contest at the age of 20.
Rimas Kurtinaitis is the only non-NBA player to participate in the contest.
Dirk Nowitzki is the only 7-foot player to win the contest.

tag: ul

text: Winners[edit]

text:
Players with multiple wins

#
Player
First Place
Second Place

T-1
Craig Hodges
3
2

T-1
Larry Bird
3
0

2
Peja Stojaković
2
2

T-3
Jeff Hornacek
2
0

T-3
Mark Price
2
0

T-3
Jason Kapono
2
0

text:
^
Denotes players who are still active

*
Elected to the Basketball Hall of Fame

Player (#)
Denotes the number of times the player has won

Team (#)
Denotes the number of times a player from this team has won

text:
Season
Location
Player
Team
Final score / max

1985–86
Dallas, TX
Larry Bird*
Boston Celtics
7001220000000000000♠22 / 30

1986–87
Seattle, WA
Larry Bird* (2)
Boston Celtics (2)
7001160000000000000♠16 / 30

1987–88
Chicago, IL
Larry Bird* (3)
Boston Celtics (3)
7001170000000000000♠17 / 30

1988–89
Houston, TX
Dale Ellis
Seattle SuperSonics
7001190000000000000♠19 / 30

1989–90
Miami, FL
Craig Hodges
Chicago Bulls
7001190000000000000♠19 / 30

1990–91
Charlotte, NC
Craig Hodges (2)
Chicago Bulls (2)
7001170000000000000♠17 / 30

1991–92
Orlando, FL
Craig Hodges (3)
Chicago Bulls (3)
7001160000000000000♠16 / 30

1992–93
Salt Lake City, UT
Mark Price
Cleveland Cavaliers
7001180000000000000♠18 / 30

1993–94
Minneapolis, MN
Mark Price (2)
Cleveland Cavaliers (2)
7001240000000000000♠24 / 30

1994–95
Phoenix, AZ
Glen Rice
Miami Heat
7001170000000000000♠17 / 30

1995–96
San Antonio, TX
Tim Legler
Washington Bullets
7001200000000000000♠20 / 30

1996–97
Cleveland, OH
Steve Kerr
Chicago Bulls (4)
7001220000000000000♠22 / 30

1997–98
New York City, NY
Jeff Hornacek
Utah Jazz
7001160000000000000♠16 / 30

1998–99[a]
Canceled due to the 1998-99 NBA lockout[a]

1999–00
Oakland, CA
Jeff Hornacek (2)
Utah Jazz (2)
7001130000000000000♠13 / 30

2000–01
Washington, D.C.
Ray Allen
Milwaukee Bucks
7001190000000000000♠19 / 30

2001–02
Philadelphia, PA
Peja Stojaković
Sacramento Kings
7001190000000000000♠19 / 30[b]

2002–03
Atlanta, GA
Peja Stojaković (2)
Sacramento Kings (2)
7001220000000000000♠22 / 30[b]

2003–04
Los Angeles, CA
Voshon Lenard
Denver Nuggets
7001180000000000000♠18 / 30

2004–05
Denver, CO
Quentin Richardson
Phoenix Suns
7001190000000000000♠19 / 30

2005–06
Houston, TX
Dirk Nowitzki^
Dallas Mavericks
7001180000000000000♠18 / 30

2006–07[11]
Las Vegas, NV
Jason Kapono
Miami Heat (2)
7001240000000000000♠24 / 30

2007–08[2]
New Orleans, LA
Jason Kapono (2)
Toronto Raptors
7001250000000000000♠25 / 30

2008–09
Phoenix, AZ
Daequan Cook
Miami Heat (3)
7001190000000000000♠19 / 30[b]

2009–10
Dallas, TX
Paul Pierce
Boston Celtics (4)
7001200000000000000♠20 / 30

2010–11
Los Angeles, CA
James Jones
Miami Heat (4)
7001200000000000000♠20 / 30

2011–12
Orlando, FL
Kevin Love^
Minnesota Timberwolves
7001170000000000000♠17 / 30[b]

2012–13
Houston, TX
Kyrie Irving^
Cleveland Cavaliers (3)
7001230000000000000♠23 / 30

2013–14
New Orleans, LA
Marco Belinelli^
San Antonio Spurs
7001240000000000000♠24[b] / 34[c]

2014–15
New York City - Brooklyn, NY
Stephen Curry^
Golden State Warriors
7001270000000000000♠27 / 34[c]

2015–16
Toronto, ON
Klay Thompson^
Golden State Warriors (2)
7001270000000000000♠27 / 34[c]

2016–17
New Orleans, LA
Eric Gordon^
Houston Rockets
7001210000000000000♠21[b] / 34[c]

2017–18
Los Angeles, CA
Devin Booker^
Phoenix Suns (2)
28 / 34[c]

text: All-time participants[edit]

text:
Player
(in bold text)
Indicates the winner of the contest

Player (#)
Denotes the number of times the player has been in the contest

text:
Season
Players

1985–86
Larry Bird, Dale Ellis, Sleepy Floyd, Craig Hodges, Norm Nixon, Kyle Macy, Trent Tucker, Leon Wood

1986–87
Danny Ainge, Larry Bird (2), Michael Cooper, Dale Ellis (2), Craig Hodges (2), Detlef Schrempf, Byron Scott, Kiki Vandeweghe

1987–88
Danny Ainge (2), Larry Bird (3), Dale Ellis (3), Craig Hodges (3), Mark Price, Detlef Schrempf (2), Byron Scott (2), Trent Tucker (2)

1988–89
Michael Adams, Danny Ainge (3), Dale Ellis (4), Derek Harper, Gerald Henderson, Craig Hodges (4), Rimas Kurtinaitis, Reggie Miller, Jon Sundvold

1989–90
Larry Bird (4), Craig Ehlo, Bobby Hansen, Craig Hodges (5), Michael Jordan, Reggie Miller (2), Mark Price (2), Jon Sundvold (2)

1990–91
Danny Ainge (4), Clyde Drexler, Tim Hardaway, Hersey Hawkins, Craig Hodges (6), Terry Porter, Glen Rice, Dennis Scott

1991–92
Dell Curry, Craig Ehlo (2), Craig Hodges (7), Jeff Hornacek, Jim Les, Dražen Petrović, Mitch Richmond, John Stockton

1992–93
B. J. Armstrong, Dana Barros, Craig Hodges (8), Dan Majerle, Reggie Miller (3), Terry Porter (2), Mark Price (3), Kenny Smith

1993–94
B. J. Armstrong (2), Dana Barros (2), Dell Curry (2), Dale Ellis (5), Steve Kerr, Eric Murdock, Mark Price (4), Mitch Richmond (2)

1994–95
Nick Anderson, Dana Barros (3), Scott Burrell, Steve Kerr (2), Dan Majerle (2), Reggie Miller (4), Chuck Person, Glen Rice (2)

1995–96
Dana Barros (4), Hubert Davis, Steve Kerr (3), Tim Legler, George McCloud, Glen Rice (3), Dennis Scott (2), Clifford R. Robinson

1996–97
Dale Ellis (6), Steve Kerr (4), Tim Legler (2), Terry Mills, Sam Perkins, Glen Rice (4), John Stockton (2), Walt Williams

1997–98
Hubert Davis (2), Dale Ellis (7), Jeff Hornacek (2), Sam Mack, Reggie Miller (5), Tracy Murray, Glen Rice (5), Charlie Ward

1998–99[a]
Cancelled due to the 1998-99 NBA lockout

1999–00
Ray Allen, Mike Bibby, Hubert Davis (3), Jeff Hornacek (3), Allen Iverson, Dirk Nowitzki, Terry Porter (3), Bob Sura

2000–01
Ray Allen (2), Pat Garrity, Allan Houston, Rashard Lewis, Dirk Nowitzki (2), Steve Nash, Bryon Russell, Peja Stojaković

2001–02
Ray Allen (3), Wesley Person, Mike Miller, Steve Nash (2), Paul Pierce, Quentin Richardson, Steve Smith, Peja Stojaković (2)

2002–03
Brent Barry, Pat Garrity (2), Wesley Person (2), Peja Stojaković (3), Antoine Walker, David Wesley

2003–04
Chauncey Billups, Kyle Korver, Voshon Lenard, Rashard Lewis (2), Cuttino Mobley, Peja Stojaković (4)

2004–05
Ray Allen (4), Joe Johnson, Voshon Lenard (2), Kyle Korver (2), Vladimir Radmanović, Quentin Richardson (2)

2005–06
Gilbert Arenas, Ray Allen (5), Chauncey Billups (2), Dirk Nowitzki (3), Quentin Richardson (3), Jason Terry

2006–07
Gilbert Arenas (2), Damon Jones, Jason Kapono, Mike Miller (2), Dirk Nowitzki (4), Jason Terry (2)

2007–08
Daniel Gibson, Richard Hamilton, Jason Kapono (2), Steve Nash (3), Dirk Nowitzki (5), Peja Stojaković (5)

2008–09
Mike Bibby (2), Daequan Cook, Danny Granger, Jason Kapono (3), Rashard Lewis (3), Roger Mason

2009–10
Chauncey Billups (3), Daequan Cook (2), Stephen Curry, Channing Frye, Danilo Gallinari, Paul Pierce (2)

2010–11
Ray Allen (6), Kevin Durant, Daniel Gibson (2), James Jones, Paul Pierce (3), Dorell Wright

2011–12
Ryan Anderson, Mario Chalmers, James Jones (2), Anthony Morrow, Kevin Love, Kevin Durant (2)

2012–13
Ryan Anderson (2), Matt Bonner, Stephen Curry (2), Paul George, Kyrie Irving, Steve Novak

2013–14
Arron Afflalo, Bradley Beal, Marco Belinelli, Stephen Curry (3), Kyrie Irving (2), Joe Johnson (2), Damian Lillard, Kevin Love (2)

2014–15
Marco Belinelli (2), Stephen Curry (4), James Harden, Kyrie Irving (3), Kyle Korver (3), Wesley Matthews, J.J. Redick, Klay Thompson

2015–16
Devin Booker, Stephen Curry (5), James Harden (2), Kyle Lowry, Khris Middleton, J.J. Redick (2), Klay Thompson (2), C.J. McCollum[d]

2016–17
Klay Thompson (3), C. J. McCollum (2), Kyle Lowry (2), Eric Gordon, Kyrie Irving (4), Kemba Walker, Nick Young, Wesley Matthews (2)

2017–18
Bradley Beal (2), Devin Booker (2), Wayne Ellington, Paul George (2), Tobias Harris, Kyle Lowry (3), Klay Thompson (4), Eric Gordon (2)

text: Records[edit]

text:
Most points in a round

Player
Score/Max
Season

Devin Booker
28 / 34[c]
2018

Stephen Curry
27 / 34[c]
2015

Klay Thompson
27 / 34[c]
2016

Craig Hodges
25 / 30
1986

Jason Kapono
25 / 30
2008

Eric Gordon
25 / 34[c]
2017

Klay Thompson 2
25 / 34
2018

Craig Hodges 2
24 / 30
1991

Mark Price
24 / 30
1994

Hubert Davis
24 / 30
1998

Jason Kapono 2
24 / 30
2007

Marco Belinelli
24[b] / 34[c]
2014

Klay Thompson 3
24 / 34[c]
2015

Minimum 24

Most points in the finals

Player
Score/Max
Season

Devin Booker
28 / 34[c]
2018

Stephen Curry
27 / 34[c]
2015

Klay Thompson
27 / 34[c]
2016

Jason Kapono
25 / 30
2008

Klay Thompson 2
25 / 34
2018

Mark Price
24 / 30
1994

Jason Kapono 2
24 / 30
2007

Marco Belinelli
24[b] / 34[c]
2014

Kyrie Irving
23 / 30
2013

Larry Bird
22 / 30
1986

Steve Kerr
22 / 30
1997

Peja Stojaković
21 / 30
2004

Eric Gordon
21[b] / 34[c]
2017

Tim Legler
20 / 30
1996

Paul Pierce
20 / 30
2010

James Jones
20 / 30
2011

Matt Bonner
20 / 30
2013

Minimum 20

text:
Most shots made in one round (max 25)

Player
Shots
Season

Craig Hodges
21
1991

Craig Hodges 2
≥ 20[e]
1986

Mark Price
20
1994

Jason Kapono
20
2008

Kyrie Irving
20
2013

Stephen Curry
20
2015

Devin Booker
20
2018

Hubert Davis
19
1998

Jason Kapono 2
19
2007

Larry Bird
18
1986

Larry Bird 2
18
1988

Tim Legler
18
1996

Tim Legler 2
18
1996

Gilbert Arenas
18
2007

James Jones
18
2012

Marco Belinelli
18
2014

Klay Thompson
18
2016

Eric Gordon
18
2017

Klay Thompson 2
18
2018

Minimum 18

Most consecutive shots made (max 25)

Player
Shots
Season

Craig Hodges
19
1991

Stephen Curry
13
2015

Larry Bird
11
1986

Hubert Davis
11
1996

Stephen Curry 2
11
2016

Jason Kapono
10
2008

Ray Allen
10
2011

Kyrie Irving
10
2013

Dennis Scott
9
1991

Steve Kerr
9
1997

Kyle Korver
9
2004

Minimum 9

text: Notes[edit]

text:
a The 1999 All-Star Game was cancelled due to the 1998–99 NBA lockout.
b Denote contests that required a tiebreaking round. The final score given here came from the tiebreaker.[14]
c Starting with the 2014 Three-Point Contest, the format includes four extra "money balls".
d C.J. McCollum was named as a replacement to Chris Bosh due to the latter being unable to participate in the event with a calf injury (and later on, a blood clot in his leg).
e It is unknown how many of the five "money balls" Hodges hit during his round.


document_title: mailto

question_text: what is the use of mailto in html

question_tokens: what is the use of mailto in html

text: mailto

text: mailto is a Uniform Resource Identifier (URI) scheme for email addresses. It is used to produce hyperlinks on websites that allow users to send an email to a specific address without first having to copy it and enter it into an email client. It was originally defined in Request for Comments (RFC) 2368, published in July 1998,[1] and refined in RFC 6068, published in October 2010.[2]

text: Examples[edit]

text: Using "mailto" within an HTML document to generate a link for sending email:

text: It is also possible to specify initial values for headers (e.g. subject, cc, etc.) and message body in the URL. Blanks, carriage returns, and linefeeds cannot be embedded but must be percent-encoded.

text: Multiple addresses can also be specified:[2]

text: The address can also be omitted:

text: Security and privacy[edit]

text: This section needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. (September 2015) (Learn how and when to remove this template message)

text: A number of security issues are mentioned in RFC2368, however the greatest concern is that of robotic address harvesting. Mailto constructs are locatable within HTML pages by automated means which typically include the use of DOM constructs or regular expressions. Addresses harvested by such means are liable to be added to spammers' mass-mailing lists and thus to receive large amounts of unwanted mail.

text: While methods exist to "harden" mailto links against harvesting—address munging and JavaScript-based address obfuscation among them—these protections can be circumvented by sufficiently sophisticated harvesting robots. Other techniques, like walling the address behind a CAPTCHA or similar "humanity check", provide security on par with that available for other contact methods, most notably web forms, which experience similar challenges with preventing spam.


document_title: Group B streptococcal infection

question_text: when did they start testing for strep b

question_tokens: when did they start testing for strep b

text: Group B streptococcal infection

text: Diagnosis[edit]

text: As mentioned, S. agalactiae is a Gram-positive coccus with a tendency to form chains, beta-haemolytic, catalase-negative, and facultative anaerobe. GBS grows readily on blood agar plates as microbial colonies surrounded by a narrow zone of β-haemolysis. GBS is characterized by the presence in the cell wall of the group B antigen of the Lancefield classification (Lancefield grouping) that can be detected directly in intact bacteria using latex agglutination tests.[9] The CAMP test is also another important test for the identification of GBS. The CAMP factor acts synergistically with the staphylococcal β-haemolysin inducing enhanced haemolysis of sheep or bovine erythrocytes.[9]

text: GBS is also able to hydrolyse hippurate, and this test can also be used to identify GBS. Haemolytic GBS strains produce an orange-brick-red nonisoprenoid polyene pigment (ornythinrhamnododecaene) (granadaene) when cultivated on granada medium that allows its straightforward identification.[18]

text: Identification of GBS could also be carried out easily using modern methods as matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry.[19]

text: Colonization versus infection[edit]

text: GBS is found in the gastrointestinal and genitourinary tract of humans. In different studies, GBS vaginal colonization rate ranges from 4 to 36%, with most studies reporting rates over 20%. These variations in the reported prevalence of asymptomatic (presenting no symptoms of disease) colonization could be related to the different detection methods used, and differences in populations studied.[20][21][22]

text: Though GBS is an asymptomatic colonizer of the gastrointestinal human tract in up to 30% of otherwise healthy adults, including pregnant women,[5][20] this opportunistic harmless bacterium can, in some circumstances, cause severe invasive infections.[4]

text: Pregnancy[edit]

text: Though GBS colonization is asymptomatic and, in general, does not cause problems, it can sometimes cause serious illness for the mother and the baby during gestation and after delivery. GBS infections in the mother can cause chorioamnionitis (intra-amniotic infection or severe infection of the placental tissues) infrequently, and postpartum infections (after birth). GBS urinary tract infections may induce labour and cause premature delivery (preterm birth) and miscarriage.[5][23]

text: Newborns[edit]

text: In the western world, GBS (in the absence of effective prevention measures) is the main cause of bacterial infections in newborns, such as septicemia, pneumonia, and meningitis, which can lead to death or long-term after effects.[5][24]

text: GBS infections in newborns are separated into two clinical types, early-onset disease (GBS-EOD) and late-onset disease (GBS-LOD). GBS-EOD manifests from 0 to 7 living days in the newborn, most of the cases of EOD being apparent within 24 h from birth. GBS-LOD starts between 7 and 90 days after birth.[5][22]

text: The most common clinical syndromes of GBS-EOD are septicemia without apparent location, pneumonia, and less frequently meningitis. Bacteremia without a focus occurs in 80-85%, pneumonia in 10-15%, and meningitis in 5-10% of cases. The initial clinical findings are respiratory signs in more than 80% of cases. Neonates with meningitis often have an initial clinical presentation identical to presentation in those without meningeal affectation. An exam of the cerebrospinal fluid is often necessary to rule out meningitis.[5][25][26]

text: Colonization with GBS during labour is the primary risk factor for the development of GBS-EOD. GBS-EOD is acquired vertically (vertical transmission), through exposure of the fetus or the baby to GBS from the vagina of a colonized woman, either in utero (because of ascending infection) or during birth, after rupture of membranes. Infants can also be infected during passage through the birth canal, nevertheless, newborns who acquire GBS through this route can only become colonized, and these colonized infants usually do not develop GBS-EOD.

text: Roughly 50% of newborns of GBS colonized mothers are also GBS colonized and (without prevention measures) 1-2% of these newborns will develop GBS-EOD.[27] In the past, the incidence of GBS-EOD ranged from 0.7 to 3.7 per thousand live births in the US,[5] and from 0.2 to 3.25 per thousand in Europe.[21] In 2008, after widespread use of antenatal screening and intrapartum antibiotic prophylaxis, the Centers for Disease Control and Prevention of United States reported an incidence of 0.28 cases of GBS-EOD per thousand live births in the US.[28]

text: Though maternal GBS colonization is the key determinant for GBS-EOD, other factors also increase the risk. These factors are:[5][22]

text:
Onset of labour before 37 weeks of gestation (premature birth)
Prolonged rupture of membranes (longer duration of membrane rupture) (≥18 h before delivery)
Intrapartum (during childbirth) fever (>38 °C, >100.4 °F)
Amniotic infections (chorioamnionitis)
Young maternal age

text: Nevertheless, most babies who develop GBS-EOD are born to colonized mothers without any of these risk factors.[22] Heavy GBS vaginal colonization is also associated with a higher risk for GBS-EOD. Women who had one of these risk factors but who are not GBS colonized at labour are at low risk for GBS-EOD compared to women who were colonized prenatally, but had none of the aforementioned risk factors.[27]

text: Presence of low levels of anticapsular antibodies against GBS in the mother are also of great importance for the development of GBS-EOD.[29][30] Because of that, a previous sibling with GBS-EOD is also an important risk factor for the development of the infection in subsequent deliveries, probably reflecting the lack of protective antibodies in the mother. [22]

text: Overall, the case fatality rates from GBS-EOD have declined, from 50% observed in studies from the 1970s to between 2 and 10% in recent years, mainly as a consequence of improvements in therapy and management. Fatal neonatal infections by GBS are more frequent among premature infants. [5] [22] [31]

text: GBS-LOD affects infants from 7 days to 3 months of age and has a lower case fatality rate (1%-6%) than GBS-EOD. Clinical syndromes of GBS-EOD are bacteremia without a focus (65%), meningitis (25%), cellulitis, osteoarthritis, and pneumonia. Prematurity has been reported to be the main risk factor. Each week of decreasing gestation increases the risk by a factor of 1.34 for developing GBS-LOD. [32]

text: GBS-LOD is not acquired through vertical transmission during delivery; it can be acquired later from the mother from breast milk or from environmental and community sources. GBS-LOD commonly shows nonspecific signs, and diagnosis should be made obtaining blood cultures in febrile newborns. Hearing loss and mental impairment can be a long-term consequence of GBS meningitis.[5][24]

text: Prevention of neonatal infection[edit]

text: Currently, the only reliable way to prevent GBS-EOD is intrapartum antibiotic prophylaxis (IAP) - administration of antibiotics during delivery. Intravenous penicillin or ampicillin given at the onset of labour and then again every four hours until delivery to GBS colonized women have been proven to be very effective at preventing vertical transmission of GBS from mother to baby and GBS-EOD (penicillin G, 5 million units IV initial dose, then 2.5–3.0 million units every 4 hours until delivery or ampicillin, 2 g IV initial dose, then 1 g IV every 4 hours until delivery).[5][22]

text: Penicillin-allergic women without a history of anaphylaxis (angioedema, respiratory distress, or urticaria) following administration of a penicillin or a cephalosporin (low risk of anaphylaxis) could receive cefazolin (2 g IV initial dose, then 1 g IV every 8 hours until delivery) instead of penicillin or ampicillin.[22] Clindamycin (900 mg IV every 8 hours until delivery), and vancomycin (1 g IV every 12 hours until delivery) are used to prevent GBS-EOD in infants born to penicillin-allergic mothers.[22] Erythromycin is not recommended under any circumstances today.[22]

text: Antibiotic susceptibility testing of GBS isolates is crucial for appropriate antibiotic selection for IAP in penicillin-allergic women, because resistance to clindamycin, the most common agent used (in penicillin-allergic women), is increasing among GBS isolates. Appropriate methodologies for testing are important, because resistance to clyndamicin (antimicrobial resistance) can occur in some GBS strains that appear susceptible (antibiotic sensitivity) in certain susceptibility tests. [22]

text: If appropriate IAP in GBS colonized women starts at least 2 hours before the delivery, the risk of neonatal infection is also somehow reduced.[33][34][35]

text: True penicillin allergy is rare with an estimated frequency of anaphylaxis of one to five episodes per 10,000 cases of penicillin therapy.[36] Penicillin administered to a woman with no history of β-lactam allergy has a risk of anaphylaxis of 0.04 to 4 per 100,000. Maternal anaphylaxis associated with GBS IAP occurs, but any morbidity associated with anaphylaxis is offset greatly by reductions in the incidence of GBS-EOD. [22]

text: Home births are becoming increasingly popular in the UK. Recommendations for preventing GBS infections in newborns are the same for home births as for hospital births. Around 25% of women having home births probably carry GBS in their vaginas at delivery without knowing, and it could be difficult to follow correctly the recommendations of IAP and to deal with the risk of a severe allergic reaction to the antibiotics outside of a hospital setting.[37]

text: IAPs have been considered to be associated with the emergence of resistant bacterial strains and with an increase in the incidence of early-onset infections caused by other pathogens, mainly Gram-negative bacteria such as Escherichia coli. Nevertheless, most studies have not found an increased rate of non-GBS early-onset sepsis related to the widespread use of IAP. [22] [38] [39] [40]

text: Other strategies to prevent GBS-EOD have been studied, and chlorhexidine intrapartum vaginal cleansing has been proposed to help preventing GBS-EOD, nevertheless no evidence has been shown for the effectiveness of this approach.[22][41][42]

text: Identifying candidates to receive IAP[edit]

text: Two ways are used to select female candidates to IAP: the culture-based screening approach and the risk-based approach.[43] The culture-based screening approach identifies candidates using lower vaginal and rectal cultures obtained between 35 and 37 weeks of gestation, and IAP is administered to all GBS colonized women. The risk-based strategy identifies candidates to receive IAP by the aforementioned risk factors known to increase the probability of GBS-EOD without considering if the mother is or is not a GBS carrier.[5][22][44]

text: IAP is also recommended for women with intrapartum risk factors if their GBS carrier status is not known at the time of delivery, and for women with GBS bacteriuria during their pregnancy, and for women who have had an infant with GBS-EOD previously. The risk-based approach is, in general, less effective than the culture-based approach, [45] because in most cases, GBS-EOD develops among newborns who have been born to mothers without risk factors.[22][27][46]

text: IAP is not required for women undergoing planned caesarean section in the absence of labour and with intact membranes, irrespective of the carriage of GBS.[22][47]

text: Routine screening of pregnant women is performed in most developed countries such as the United States, France, Spain, Belgium, Canada, and Australia, and data have shown falling incidences of GBS-EOD following the introduction of screening-based measures to prevent GBS-EOD.[21][46] [48]

text: The risk-based strategy is advocated, among other counties, in the United Kingdom, the Netherlands, New Zealand, and Argentina.[21]

text: In the UK, the Royal College of Obstetricians and Gynaecologists does not recommend bacteriological screening of pregnant women for antenatal GBS carriage.[47] [49] Instead, women are treated according to their risk in labour. IAP is given to women where GBS has been found from their urine or vaginal/rectal swabs taken during the pregnancy, and to women who have previously had a baby with GBS disease. Immediate induction of labour and IAP should be offered to all women with prelabour rupture of membranes at 37 weeks of gestation or more, to women whose membranes are ruptured more than 18 hours and to those who have fever in labour. Women who are pyrexial in labour should be offered broad-spectrum antibiotics including an antibiotic appropriate for preventing EOD-GBS.[47] [50]

text: The issue of cost-effectiveness of both strategies for identifying candidates for IAP is less clear-cut, and some studies have indicated that testing low risk women, plus IAP administered to high-risk women, and to those found to carry GBS is more cost-effective than the current UK practice. [51] Other evaluations have also found the culture-based approach to be more cost-effective than the risk-based approach for the prevention of GBS-EOD.[52][53]

text: IAP has been reported to not prevent all cases of GBS-EOD; its efficacy is estimated at 80%. The risk-based prevention strategy does not prevent about 33% of cases with no risk factors.[54]

text: Testing pregnant women to detect GBS carriers has also been proposed, and giving IAP to those carrying GBS and to high-risk women, is significantly more cost-effective than the use of the risk-factor approach. One research paper calculated an expected net benefit to the UK government of such an approach of around £37million a year, compared with the current RCOG approach.[51][52]

text: In the UK, it has also been suggested that: "For women known to carry GBS where it is not expected that the intravenous antibiotics can be given for at least 4 hours before delivery, an intramuscular injection of 4.8 MU (2.9 g) of Penicillin G at about 35 weeks of pregnancy may be useful in addition to intravenous antibiotics given from the onset of labour or membranes rupturing until delivery to try to eradicate GBS colonisation until after delivery". [55] However, this recommendation IS NOT supported by the present guidelines.[22][47]

text: Up to 90% of cases of GBS-EOD would be preventable if IAP were offered to all GBS carriers identified by universal screening late in pregnancy, plus to the mothers in higher risk situations.[56]

text: Where insufficient intravenous antibiotics are given before delivery, the baby may be given antibiotics immediately after birth, although evidence is inconclusive as to whether this practice is effective or not.[22][57][58][59]

text: Screening for colonization[edit]

text: About 10–30% of women are colonized with GBS during pregnancy. Nevertheless, during pregnancy, colonization can be temporary, intermittent, or continual.[22] Because the GBS colonization status of women can change during pregnancy, only cultures carried out ≤5 weeks before delivery predict quite accurately the GBS carrier status at delivery. In contrast, if the prenatal culture is carried out more than 5 weeks before delivery, it is unreliable for accurately predicting the GBS carrier status at delivery. Because of that, testing for GBS colonization in pregnant women is recommended by the CDC at 35–37 weeks of gestation.[22][60]

text: The clinical samples recommended for culture of GBS are swabs collected from the lower vagina and rectum through the external anal sphincter. The sample should be collected swabbing the lower vagina (vaginal introitus) followed by the rectum (i.e., inserting the swab through the anal sphincter) using the same swab or two different swabs. Cervical, perianal, perirectal, or perineal specimens are not acceptable, and a speculum should not be used for sample collection.[22] Samples can be taken by healthcare professionals, or by the mother herself with appropriate instruction. [61][62][63]

text: Following the recommendations of the CDC, these swabs should be placed into a non-nutritive transport medium. When feasible, specimens should be refrigerated and sent to the laboratory as soon as possible.[22] Appropriate transport systems are commercially available, and in these transport media, GBS can remain viable for several days at room temperature. However, the recovery of GBS declines over one to four days, especially at elevated temperatures, which can lead to false-negative results.[22][64]

text: Culture methods[edit]

text: Samples (vaginal, rectal, or vaginorectal swabs) should be inoculated into a selective enrichment broth, (Todd Hewitt broth with selective antibiotics, enrichment culture). This involves growing the samples in an enriched medium to improve the viability of the GBS and simultaneously impairing the growth of other naturally occurring bacteria. After incubation (18–24 hours, 35-37 °C), the enrichment broth is subcultured to blood agar plates and GBS-like colonies are identified by the CAMP test or using latex agglutination with GBS antiserum.[22][65] In the UK, this is the method described by the Health Protection Agency [66]

text: After incubation, the enrichment broth can also be subcultured to granada agar where GBS grows as pink-red colonies[18][65][67] [68] or to chromogenic agars, where GBS grows as coloured colonies.[22]

text: Today, in the UK, the detection of GBS colonization using the enrichment broth technique is not offered from most laboratories serving the NHS. However, the implementation of this test seems to be a viable option. At present, culture for GBS (using enriched culture medium) at 35–37 weeks to define an at-risk group of women appears to be the most cost-effective strategy.[52][53]

text: The charitable organization Group B Strep Support have published a list of hospitals in the UK that offer the detection of GBS using the enrichment broth culture method (enrichment culture medium, ECM).[69] This test is also available privately from around £35 per test for a home-testing pack, and it is offered by private clinics.[69] The test is also available privately, for a UK-wide postal service.[70] [71]

text: Inoculating directly the vaginal and rectal swabs or the vaginorectal swab in a plate of an appropriate culture medium (blood agar, granada medium or chromogenic media) is also possible. However, this method (bypassing the selective enrichment broth step) can lead to some false-negative results, and this approach should be taken only in addition to, and not instead of, inoculation into selective broth.[22]

text: Point-of-care testing[edit]

text: No current culture-based test is both accurate enough and fast enough to be recommended for detecting GBS once labour starts. Plating of swab samples requires time for the bacteria to grow, meaning that this is unsuitable as an intrapartum point-of-care test.

text: Alternative methods to detect GBS in clinical samples (as vaginorectal swabs) rapidly have been developed, such are the methods based on nucleic acid amplification tests, such as polymerase chain reaction (PCR) tests, and DNA hybridization probes. These tests can also be used to detect GBS directly from broth media, after the enrichment step, avoiding the subculture of the incubated enrichment broth to an appropriate agar plate.[22][72]

text: Testing women for GBS colonization using vaginal or rectal swabs at 35–37 weeks of gestation and culturing them in enriched media is not as rapid as a PCR test that would check whether the pregnant woman is carrying GBS at delivery. And PCR tests, allow starting IAP on admission to the labour ward in those women in whom it is not known if they are GBS carriers or not.[22] PCR testing for GBS carriage could, in the future, be sufficiently accurate to guide IAP. However, the PCR technology to detect GBS must be improved and simplified to make the method cost-effective and fully useful as point-of-care testing]] to be carried out in the labour ward (bedside testing). These tests still cannot replace antenatal culture for the accurate detection of GBS carriers.[22][73]

text: Missed opportunities prevention[edit]

text: The important factors for successful prevention of GBS-EOD using IAP and the universal screening approach are:

text:
Reach most pregnant women for antenatal screens
Proper sample collection
Using an appropriate procedure for detecting GBS
Administering a correct IAP to GBS carriers

text: Most cases of GBS-EOD occur in term infants born to mothers who screened negative for GBS colonization and in preterm infants born to mothers who were not screened, though some false-negative results observed in the GBS screening tests can be due to the test limitations and to the acquisition of GBS between the time of screening and delivery. These data show that improvements in specimen collection and processing methods for detecting GBS are still necessary in some settings. False-negative screening test, along with failure to receive IAP in women delivering preterm with unknown GBS colonization status, and the administration of inappropriate IAP agents to penicillin-allergic women account for most missed opportunities for prevention of cases of GBS-EOD.

text: GBS-EOD infections presented in infants whose mothers had been screened as GBS culture-negative are particularly worrying, and may be caused by incorrect sample collection, delay in processing the samples, incorrect laboratory techniques, recent antibiotic use, or GBS colonization after the screening was carried out.[46][74][75][76][77]

text: Epidemiology[edit]

text: In 2000–2001, the reported overall incidence of GBS infection in newborn babies in the UK was 0.72 per 1,000 live births, 0.47 per 1,000 for GBS-EOD and 0.25 per 1,000 for GBS-LOD. Very marked variations were observed, the incidence in Scotland was 0.42 per 1,000, whilst in Northern Ireland, it was 0.9 per 1,000 live births. [78][79]

text: Nevertheless, it may be a serious underestimation of the real incidence of GBS infections in newborns. A plausible explanation of this is that a considerable number of infants with probable GBS-EOD had negative cultures as a result of a previous maternal antibiotic treatment that inhibits the growth of GBS in blood and cerebrospinal fluid cultures, but does not mask clinical symptoms.[80][81]

text: Data collected prospectively for neonates that required a septic screen in the first 72 hrs of life in the UK, indicated a combined rate of definite and probable GBS-EOD infection of 3.6 per 1,000 live births. [82] Another study on the epidemiology of invasive GBS infections in England and Wales, reported a rise in the incidence of GBS-EOD between 2000 and 2010 from 0.28 to 0.41 per 1,000 live births. Rates of GBS-LOD also increased between 1991 and 2010 from 0.11 to 0.29 per 1,000 live births in England and Wales.[83]

text: In the US, the incidence of GBS-EOD has also been reported to have decreased from 0.47 per 1,000 live births in 1999-2001 to 0.34 per 1,000 live births in 2003-2005,[48] and the CDC reported an incidence of GBS-EOD of 0.25 per 1,000 live births in 2010. In contrast, the incidence of GBS-LOD has remained unchanged at 0.26 per 1,000 live births in the US.[84]

text: In Spain, the incidence of GBS vertical sepsis declined by 73.6%, from 1.25/1,000 live births in 1996 to 0.33/1,000 in 2008.[85] In the Barcelona area between 2004 and 2010, the incidence of GBS-EOD was 0.29 per thousand living newborns, with no significant differences along the years. The mortality rate was 8.16%.[46][86]

text: In France since 2001, a rapid decrease in the incidence of the neonatal GBS infections has also been reported after widespread use of IAP, from 0.7 to 0.2 per 1,000 births between 1997 and 2006.[87]

text: Recently (since 2012) the incidence of neonatal GBS infection has been estimated as 0.53 per 1,000 births in the European region, 0.67 in America, and 0.15 in Australasia. Countries reporting no use of IAP had a 2.2-fold higher incidence of GBS-EOD compared with those reporting any use of IAP.[31][79]

text: The following are estimates of the chances that a baby will be infected with a GBS neonatal infection if no preventive measures are taken and no other risk factors are present: [88]

text:
One in 1,000 where the woman is not a known GBS carrier
One in 400 where the woman carries GBS during the pregnancy
One in 300 where the woman carries GBS at delivery
One in 100 where the woman had a previous baby infected with GBS

text: If a woman who carries GBS is given IAP during labour, the baby’s risk is reduced significantly:

text:
One in 8,000 where the mother carries GBS during pregnancy;
One in 6,000 where the mother carries GBS at delivery; and
One in 2,200 where the mother has previously had a baby infected with GBS

text: Guidelines[edit]

text: United Kingdom[edit]

text: Royal College of Obstetricians and Gynaecologists[edit]

text: The Royal College of Obstetricians and Gynaecologists (RCOG) issued their Green Top Guideline No 36 "Prevention of early onset neonatal Group B streptococcal disease" in November 2003.[89] The guideline clearly states: "Routine bacteriological screening of all pregnant women for antenatal GBS carriage is not recommended, and vaginal swabs should not be taken during pregnancy unless there is a clinical indication to do so." But, "Intrapartum antibiotic prophylaxis should be offered if GBS is detected on a vaginal swab in the current pregnancy."

text: Nevertheless, this guideline uses minimum incidence figures from a study undertaken in 2000-2001, [90] so it could not only have underestimated the true incidence of GBS infection, but it could also have underestimated the risks to babies from GBS infection. GBS infection in babies has increased in England, Wales, and Northern Ireland since 2003 (when the guideline was introduced). Voluntarily reported cases from the Communicable Disease Report/Health Protection Agency show 0.48 cases per 1,000 live births in 2003, and this figure increased to 0.64 per 1,000 in 2009.[91]

text: In 2007, the RCOG published the findings of their audit to evaluate practice in the UK obstetric units against their recommendations.[92] The audit started out by comparing international guidelines for prevention of GBS-EOD: highlighting the fact that, in contrast to the UK and New Zealand guidelines, most of the other countries recommended identifying women for IAP by offering sensitive tests to all pregnant women. The audit reviewed hospitals’ protocols against GBS infection in newborns. Of the 161 UK units, which submitted their protocol, four units did not even have a protocol for GBS, of those that did, 35% did not mention the 2003 RCOG guideline, and only a minority of units had protocols entirely consistent with the guideline.

text: Further UK research published in 2010 looked at the opportunities for prevention of GBS-EOD following the introduction of the RCOG guideline. They found that, in the 48 cases of GBS during 2004 to 2007 (0.52/1,000 live births), only 19% of the mothers in whom risk factors were present were given adequate IAP. The researchers stated: "if all women with risk factors received prophylaxis, 23 cases (48%) may have been prevented."[54]

text: The 2003 RCOG guideline was reviewed in July 2012,[47] but no substantial changes were made, the most notable being the clarification of procedure when a woman carrying GBS has PROM and the clarification that oral antibiotics are not recommended in labour against GBS infection in the baby.

text: The review also dealt with a common misconception regarding vaginal cleansing, stating that no evidence shows that this procedure can reduce GBS infection in the baby. New evidence and guidance in this field were reviewed by the RCOG in 2014, and it was decided that revision of the guideline would be deferred to a later date, and in the mean time, the version available on the website will remain valid until replaced.[49]

text: The second and final audit report into GBS (Audit of current practice in preventing early-onset neonatal group B streptococcal disease in the UK) has been published.[93] As a result of the audit, the RCOG have recommended that the national guidelines for preventing GBS infection in newborns should be updated.[94]

text: NICE guidelines[edit]

text: The UK's National Institute for Health and Care Excellence (NICE) does not recommend routine testing for GBS, stating: "Pregnant women should not be offered routine antenatal screening for group B streptococcus because evidence of its clinical and cost effectiveness remains uncertain."[95]

text: Nevertheless, the NICE guideline "Neonatal infection: antibiotics for prevention and treatment" states: "Intrapartum Antibiotic Prophylaxis should be offered if group B streptococcal colonisation, bacteriuria or infection are detected in the current pregnancy".[96]

text: National Screening Committee[edit]

text: The UK National Screening Committee’s current policy position on GBS is: "screening should not be offered to all pregnant women."[97] This policy was reviewed in 2012, and despite receiving 212 responses, of which 93% advocated screening,[98] the NSC decided to not recommend antenatal screening.

text: This decision was strongly criticized by the charity Group B Strep Support as ignoring both the wishes of the public and the rising incidence rates of GBS infection in the UK.[99] In May 2006, the UK National Screening Committee launched their GBS online learning package. This learning package was developed to raise awareness of GBS amongst health care professionals. Developed by the Women’s Health Specialist Library (part of the National Library for Health), the learning package is based upon the current UK guidelines published by the RCOG, and it is divided into three sections – antenatal, delivery, and postnatal. Within each section, the option exists to access an introduction to GBS, different clinical scenarios, a series of quiz questions to test knowledge, and a FAQs section.[100]

text: United States[edit]

text: Recommendations for IAP to prevent perinatal GBS disease were issued in 1996 by the CDC. In these guidelines, the use of one of two prevention methods was recommended, either a risk-based approach or a culture-based screening approach.[43] The CDC issued updated guidelines in 2002; these guidelines recommended the universal culture-based screening of all pregnant women at 35–37 weeks’ gestation to optimize the identification of women who must receive IAP. CDC also recommended that women with unknown GBS colonization status at the time of delivery be managed according to the presence of intrapartum risk factors. Because of this strategy, the US has seen a major reduction in the incidence of GBS-EOD. [101]

text: The CDC issued updated guidelines again in 2010. However, the foundations of prevention in the CDC`s 2010 guidelines remain unchanged.[22] The following were the main additions in the 2010 guidelines:

text:
Expanded options for laboratory detection of GBS include the use of pigmented media and PCR assays.
A revised colony count threshold was set for laboratories to report GBS in the urine of pregnant women.
Revised algorithms for GBS screening and use of IAP for women with threatened preterm delivery include one algorithm for preterm labor and one for preterm premature rupture of membranes.
Recommendations for IAP agents are presented in an algorithm format in an effort to promote the use of the most appropriate antibiotic for penicillin-allergic women.
A minor change has been made to penicillin dosing to facilitate implementation in facilities with different packaged penicillin products.
The neonatal management algorithm’s scope was expanded to apply to all newborns.
Management recommendations depend upon clinical appearance of the neonate and other risk factors such as maternal chorioamnionitis, adequacy of IAP if indicated for the mother, gestational age, and duration of membrane rupture.
Changes were made to the algorithm to reduce unnecessary evaluations in well-appearing newborns at relatively low risk for GBS-EOD.[102]

text: Other guidelines[edit]

text: National guidelines in most developed countries advocate the use of universal screening of pregnant women late in pregnancy to detect GBS carriage and use of IAP in all colonized mothers. e.g. Canada, [103] Spain,[104] Switzerland,[105] Germany,[106] Poland,[107] Czech Republic,[108] France,[109] Norway, and Belgium.[110]

text: In contrast, risk factor-based guidelines were issued in the Netherlands, [111] New Zealand,[112] Argentina,[113] and Queensland. [114] Nevertheless, the Royal Australian and New Zealand College of Obstetricians and Gynaecologists does not recommend clearly one of both prevention strategies -either the risk-based or the culture-based approach to identify pregnant women for IAP, and allow practitioners to choose according jurisdictional guidelines.[115]

text: Nevertheless, in Argentina, it has been established by law, in 2008, the realization of GBS screening to all pregnant women between weeks 35 and 37, but this law is not regulated as of February 2016.[116]

text: Adults[edit]

text: GBS is also an important infectious agent able to cause invasive infections in adults. Serious life-threatening invasive GBS infections are increasingly recognized in the elderly and in individuals compromised by underlying diseases such as diabetes, cirrhosis and cancer. GBS infections in adults include urinary tract infection, skin and soft-tissue infection (skin and skin structure infection) bacteremia without focus, osteomyelitis, meningitis and endocarditis.[4] GBS infection in adults can be serious, and mortality is higher among adults than among neonates. In general, penicillin is the antibiotic of choice for treatment of GBS infections. Erythromycin or clindamycin should not be used for treatment in penicillin-allergic patients unless susceptibility of the infecting GBS isolate to these agents is documented. Gentamicin plus penicillin (for antibiotic synergy) in patients with life-threatening GBS infections may be used.[117][118][119]

text: Vaccination[edit]

text: Though the introduction of national guidelines to screen pregnant women for GBS carriage and the use of IAP has significantly reduced the burden of GBS-EOD disease, it has had no effect on preventing either GBS-LOD in infants or GBS infections in adults.[120] Because of this, if an effective vaccine against GBS were available, it would be an effective means of controlling not only GBS disease in infants, but also infections in adults. The capsular polysaccharide of GBS, which is an important virulence factor, is also an excellent candidate for the development of an effective vaccine. As early as 1976,[29] low levels of maternal antibodies against the capsular polysaccharide were shown to be correlated with susceptibility to GBS-EOD and GBS-LOD. Maternal-specific antibodies, transferred from the mother to the newborn, were able to confer protection to babies against GBS infection.[121] Vaccination is considered an ideal solution to prevent not only GBS-EOD and GBS-LOD, but also infections in adults at risk. Nevertheless, though research and clinical trials for the development of an effective vaccine to prevent GBS infections are underway, no vaccine is available in 2016.[122] At present, the licensing of GBS vaccines is difficult because of the challenge in conducting efficacy clinical trials in humans due to the low incidence of GBS neonatal diseases.[21][123][124]

text: Society and culture[edit]

text: July has been recognised as Group B Strep Awareness Month,[125] a time when information about group B Strep aimed at families and health professionals is shared, predominantly in the UK and the US. In the UK, this is led by Group B Strep Support [126]

text: Other animals[edit]

text: GBS has been found in many mammals and other animals such as camels, dogs, cats, seals, dolphins, and crocodiles.[127]

text: Cattle[edit]

text: In cattle, GBS causes mastitis, an infection of the udder. It can produce an acute febrile disease or a subacute, more chronic disease. Both lead to diminishing milk production (hence its name: agalactiae meaning "no milk"). Mastitis associated with GBS can have an important effect on the quantity and quality of milk produced, and is also associated with elevated somatic cell count and total bacteria count in the milk. Outbreaks in herds are common, and as this is of major significance for the dairy industry, programs to reduce the impact of GBS have been enforced in many countries.[128]

text: Fish[edit]

text: GBS it is also an important pathogen in a diversity of fish species, leading to serious economic losses in many species of fish worldwide. GBS causes severe epidemics in farmed fish, causing septicemia and external and internal hemorrhages. GBS infection has been reported from wild and captive fish and has been involved in epizootics in many countries.[129][130] Vaccines to protect fish against GBS infections are under development.[131]