Neonatal Herpess

Neonatal herpes simplex virus in a child causes serious condition and occurs rarely. The herpes virus is transmitted to the baby mostly during birth if the mother is suffering from the virus. Almost...

Neonatal herpes simplex virus in a child causes serious condition and occurs rarely. The herpes virus is transmitted to the baby mostly during birth if the mother is suffering from the virus. Almost negligible cases have been seen in which acquires the virus post natal.

It has been seen that in adults the genital herpes is caused due to the HSV-1. The probability of acquiring the HSV in mothers is 31% yearly if the couple is discordant. If the mother is infected in the later stage of pregnancy then there are 50% chances that he new born baby will be infected by the virus. If the mother has HSV-1 and HSV-2 during the initial stages of the pregnancy then the probability of newly born baby getting infection is 3%. This is because there is enough time to build antibodies to fight against the virus and hence these antibodies are transferred to the new born and hence are saved against the onset of neonatal herpes. Neonatal herpes virus leads to many complication like premature birth (nearly 50% are born earlier by 38 weeks), low weight at the time of birth.

In developing countries the occurrence of HSV-1 is rare because the exposure to HSV-1 in developing countries occurs in adolescence and childhood. HSV-2 infection is more prevalent in developing countries. In developed countries too, the prevalence of HSV-1 is reducing because better hygienic condition, smaller family, and less overcrowding. The increase cases of HSV-1 in developed countries were due to increase in number of women as HSV -1 sero negative.

Asymptomatic genital herpes virus HSV-1 is found to be more infectious then HSV-2 in producing neonatal herpes. With the early and prompt use of antiviral therapy, the diagnosis of neonatal herpes HSV-1 infection is superior then HSV-2.

Neonatal herpes occurs in three forms: DIS (disseminated herpes), SEM (skin, eyes and mouth herpes) and CNS (central nervous system herpes).

SEM can be characterized by no involvement of internal organ and existence of external lesions and can be diagnosed best.

DIS affects the organs internal to body like liver.

CNS can cause encephalitis as it infects the brain and nervous system. The child who is suffering from CNS herpes feed poorly, have tremors, seizures, irritability and lethargy and may have their fontanelle bulge. Morbidity is highest in the case of CNS herpes and mortality is highest in the case of DIS herpes. All the three forms of neonatal herpes are not dependent but may overlap with each other, if the SEM is not treated then it may spreading to internal organs of body.

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