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Neonatal Herpes
   
Neonatal herpes is the term used when a baby develops symptoms of herpes infection before he/she is born or within the first 6 weeks of life. It may occur when the baby is still in the womb (intra uterine/congenital infection) (<5%), during delivery (85%), or after delivery (less than 15%). The estimated rate of neonatal herpes is one case in 2,000-5,000 deliveries a year, resulting in approximately 1,500 to 2,200 infants with the disease each year in the United States.
Neonatal herpes simplex virus infections can result in serious morbidity and mortality. Many of the infections result from asymptomatic cervical shedding of virus after a primary episode of genital HSV in the third trimester. Antibodies to HSV-2 have been detected in approximately 20 percent of pregnant women, but only 5 percent report a history of symptomatic infection.
Neonatal herpes is not a reportable disease in most states, so there are no hard statistics on the number of cases nationwide. However, most researchers estimate between 1,000 and 3,000 cases a year in the United States, out of a total of 4 million births.
Unfortunately, when infants do contract neonatal herpes, the results can be tragic. About half of infants who are treated with antiviral medication escape permanent damage. But others may suffer serious neurological damage, mental retardation or death. It's fear of these terrible consequences, rather than the level of risk, that makes neonatal herpes a concern.
Most babies with disseminated herpes have nonspecific symptoms, including apparent sluggishness, going off feeding, and vomiting. An affected baby may become gravely ill very rapidly. Jaundice (yellow skin) is very common in infants. Jaundice may be the result of herpes or it may be caused by many other things. Sometimes a baby with herpes gets pneumonia, has difficulty breathing, or has apnea - spells with no breathing at all. These are serious problems that require intensive investigation in hospital. If the mother has herpes, the pediatrician needs to know in order to consider this possibility.
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