Birth-acquired herpes
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Definition
Birth-acquired herpes is a herpes virus infection that an infant gets (acquires) at the time of birth.
Alternative Names
HSV; Congenital herpes; Herpes - congenital
Causes, incidence, and risk factors
Newborn infants can become infected with herpes virus:
Passing through the birth canal (birth-acquired herpes, the most common method of infection)
Right after birth (postpartum) from kissing or having other contact with someone who has herpes mouth sores
If the mother has an active genital herpes infection at the time of delivery, the baby is more likely to become infected during birth. Some mothers may not be aware they have internal (inside the vagina) herpes sores.
Some people have had herpes infections in the past, but were not aware of it. These people, not knowing that they have herpes, may pass it to their baby.
Herpes type 2 (genital herpes) is the most common cause of herpes infection in newborn babies, but herpes type 1 (oral herpes) can also occur.
References
Red Book: 2009 Report on The Committee on Infectious Diseases, American Academy of Pediatrics.
Cernik C, Gallina K, Brodell RT. The treatment of herpes simplex infections: An evidence-based review. Arch Intern Med. 2008;168(11):1137-1144.
Hollier LM, Wendel GD. Third trimester antiviral prophylaxis for preventing maternal genital herpes simplex virus (HSV) recurrences and neonatal infection. Cochrane Database Syst Rev. 2008;23(1):CD004946.
Review Date: 9/16/2010
Reviewed By: Sameer Patel, MD, Assistant Professor of Pediatrics, Columbia University, New York, NY. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
HSV; Congenital herpes; Herpes - congenital
Symptoms
Herpes may only appear as a skin infection. Small, fluid-filled blisters (vesicles) may appear. These blisters rupture, crust over, and finally heal, often leaving a mild scar.
Herpes infection may also spread throughout the body (called disseminated herpes). In this type, the herpes virus can affect many different parts of the body.
Herpes infection in the brain is called herpes encephalitis
The liver, lungs, and kidneys may also be involved
There may or may not be blisters on the skin
Newborn infants with herpes that has spread to the brain or other parts of the body are often very sick. Symptoms include:
- Bleeding easily
- Breathing difficulties
- Blue appearance (cyanosis)
- Flaring of the nostrils
- Grunting
- Rapid breathing (tachypnea)
- Short periods without breathing (apneic episodes)
- Coma
- Jaundice
- Lethargy
- Low body temperature (hypothermia)
- Poor feeding
- Seizures
- Shock
- Skin lesions, fluid-filled blisters
Herpes that is caught in the period shortly after birth has symptoms similar to those of birth-acquired herpes.
Intrauterine herpes can cause:
Signs and tests
Tests for birth-acquired herpes include:
Additional tests that may be done if the baby is very sick include:
Coagulation studies (
PT, PTT)
Electrolyte measurements
Tests of liver function
References
Red Book: 2009 Report on The Committee on Infectious Diseases, American Academy of Pediatrics.
Cernik C, Gallina K, Brodell RT. The treatment of herpes simplex infections: An evidence-based review. Arch Intern Med. 2008;168(11):1137-1144.
Hollier LM, Wendel GD. Third trimester antiviral prophylaxis for preventing maternal genital herpes simplex virus (HSV) recurrences and neonatal infection. Cochrane Database Syst Rev. 2008;23(1):CD004946.
Review Date: 9/16/2010
Reviewed By: Sameer Patel, MD, Assistant Professor of Pediatrics, Columbia University, New York, NY. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
HSV; Congenital herpes; Herpes - congenital
Treatment
Herpes virus infections in infants are generally treated with medicine given through a vein (intravenous). Acyclovir is the most common antiviral medicine used for this purpose. The baby may need to take the medicine for several weeks.
Other therapy is often needed to treat the effects of herpes infection, such as shock or seizures. Often, because these babies are very ill, treatment is done in an intensive care unit.
Expectations (prognosis)
Infants with systemic herpes or encephalitis often do poorly, despite antiviral medications and early treatment.
In infants with skin disease, the vesicles may come back repeatedly even after treatment is finished. These recurrences put them at risk for learning disabilities, and may need to be treated.
Complications
- Bacterial or fungal infection of skin lesions
- Coma
- Death
- Developmental delay
- Excessive bleeding, disseminated intravascular coagulation (DIC)
- Eye problems (chorioretinitis, keratitis)
- Gastrointestinal problems, including diarrhea
- Hepatitis
- Jaundice
- Liver failure
- Lung problems including pneumonia or pneumonitis
- Brain and nervous system (neurological) problems
- Respiratory distress
- Seizure
- Shock
- Skin lesions
Calling your health care provider
If your baby has any symptoms of birth-acquired herpes, including skin lesions alone, have the baby seen by your health care provider promptly.
References
Red Book: 2009 Report on The Committee on Infectious Diseases, American Academy of Pediatrics.
Cernik C, Gallina K, Brodell RT. The treatment of herpes simplex infections: An evidence-based review. Arch Intern Med. 2008;168(11):1137-1144.
Hollier LM, Wendel GD. Third trimester antiviral prophylaxis for preventing maternal genital herpes simplex virus (HSV) recurrences and neonatal infection. Cochrane Database Syst Rev. 2008;23(1):CD004946.
Review Date: 9/16/2010
Reviewed By: Sameer Patel, MD, Assistant Professor of Pediatrics, Columbia University, New York, NY. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
HSV; Congenital herpes; Herpes - congenital
Prevention
It is important for women to tell their doctor if they have a history of genital herpes.
Safer sexual practices can help prevent the mother from getting genital herpes. Mothers who are not infected with herpes cannot pass the herpes virus to the baby during delivery.
People with "cold sores" (herpes labialis) should avoid contact with newborn infants. Caregivers who have a cold sore should wear a surgical mask and wash their hands carefully before coming into contact with the infant to prevent transmitting the virus.
Mothers should speak to their health care providers about the best way to minimize the risk of transmitting herpes to their infant.
References
Red Book: 2009 Report on The Committee on Infectious Diseases, American Academy of Pediatrics.
Cernik C, Gallina K, Brodell RT. The treatment of herpes simplex infections: An evidence-based review. Arch Intern Med. 2008;168(11):1137-1144.
Hollier LM, Wendel GD. Third trimester antiviral prophylaxis for preventing maternal genital herpes simplex virus (HSV) recurrences and neonatal infection. Cochrane Database Syst Rev. 2008;23(1):CD004946.
Review Date: 9/16/2010
Reviewed By: Sameer Patel, MD, Assistant Professor of Pediatrics, Columbia University, New York, NY. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Review Date: 9/16/2010
Reviewed By: Sameer Patel, MD, Assistant Professor of Pediatrics, Columbia University, New York, NY. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.