How serious is it if a baby born with HSV?
Neonatal herpes simplex virus (HSV) infection is a serious condition that can cause significant morbidity and mortality. The risk of severe disease is highest in neonates who acquire HSV during the perinatal period, particularly those who are born to mothers with primary HSV infection.
Clinical Manifestations
Neonatal HSV infection can manifest in several ways:
- Skin, eye, and mouth (SEM) disease is the most common form of neonatal HSV infection. It is characterized by vesicles and ulcers on the skin, eyes, and mouth. SEM disease can be mild or severe, and it can lead to scarring and blindness.
- Central nervous system (CNS) disease occurs when HSV infects the brain and spinal cord. CNS disease can cause seizures, lethargy, irritability, and developmental delays. It is the most severe form of neonatal HSV infection and can be fatal.
- Disseminated disease occurs when HSV spreads throughout the body. Disseminated disease can affect multiple organs and systems, and it is often fatal.
Risk Factors
The risk of neonatal HSV infection is highest in the following situations:
- Primary HSV infection in the mother is the most significant risk factor for neonatal HSV infection. Primary HSV infection occurs when a woman acquires HSV for the first time during pregnancy. The risk of neonatal HSV infection is highest in women who acquire HSV in the third trimester of pregnancy.
- Recurrent HSV infection in the mother is a less common risk factor for neonatal HSV infection. Recurrent HSV infection occurs when a woman has had HSV before pregnancy and experiences a recurrence during pregnancy. The risk of neonatal HSV infection is lower in women with recurrent HSV infection than in women with primary HSV infection.
- Preterm birth is another risk factor for neonatal HSV infection. Preterm infants are more likely to develop severe HSV disease than full-term infants.
- Low birth weight is also a risk factor for neonatal HSV infection. Low birth weight infants are more likely to develop severe HSV disease than infants with normal birth weight.
Treatment
Neonatal HSV infection is a medical emergency and requires prompt treatment with intravenous acyclovir. Acyclovir is an antiviral medication that can help to reduce the severity of HSV disease and prevent complications.
Prevention
There is no vaccine to prevent HSV infection. The best way to prevent neonatal HSV infection is to prevent HSV infection in pregnant women. Pregnant women should avoid contact with people who have HSV lesions, and they should practice good hand hygiene. Women who have HSV should be closely monitored during pregnancy and may be given antiviral medication to reduce the risk of transmission to their babies.