Materiały źródłowe

• #1 Neonatal herpes (herpes in a baby)

  https://www.nhs.uk/conditions/neonatal-herpes/

  Neonatal herpes is a herpes infection in a young baby. The younger the baby, the more vulnerable they are to the harmful effects of infection. […] Herpes can be very serious for a young baby, whose immune system will not have fully developed to fight off the virus. […] A baby is most at risk of getting a herpes infection in the first 4 weeks after birth. […] Very often the baby will not have any specific herpes symptoms, such as a rash. […] Neonatal herpes is usually treated with antiviral medicines given directly into the baby’s vein (intravenously). […] You can breastfeed your baby while they’re receiving treatment, unless you have herpes sores around your nipples. […] Sometimes neonatal herpes will only affect the baby’s eyes, mouth or skin. […] But the condition is much more serious if it has spread to the baby’s organs.

• #1 Neonatal herpes simplex virus infection: maternal risk stratification and management of at-risk neonates | Article | Infant journal

  https://www.infantjournal.co.uk/journal_article.html?id=7269

  Neonatal herpes simplex virus (HSV) infection is rare, with an estimated incidence of 10 cases per 100,000 live births worldwide. It is associated with significant morbidity and mortality with a mortality rate of up to 26%. […] Identification of and stratified management of mothers whose infants are at risk of perinatal infection is recommended in the UK, guided by a combination of maternal and obstetric considerations. […] Neonatal infection with HSV is a potentially devastating complication of maternal genital herpes. It is rare but is associated with considerable morbidity and mortality. The majority (85%) of neonatal herpes infections occur from exposure to HSV-1 or HSV-2 shed in the genital tract during delivery. […] The risk of neonatal herpes infection is considerably greater for primary maternal infections close to term, as in our hypothetical case, when the virus is shed from the genital tract but maternal IgG antibodies have yet to be produced.

• #1 Prevention and management of neonatal herpes simplex virus infections

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4028647/

  Human herpes simplex virus (HSV) infection in neonates can result in devastating outcomes, including mortality and significant morbidity. All infants are potentially at risk for neonatal HSV infection. […] Recommendations for managing newborns known to have been exposed intrapartum to HSV are based on expert opinion because a randomized trial to compare management options is not feasible. […] Guidance is provided for the empirical management of infants with suspected clinical sepsis, including those who do not respond to antibacterial therapy. […] The most common and important category of NHSV acquisition is intrapartum. Even for HSV-1, 75% of cases of NHSV are acquired during delivery from genital disease that is often newly acquired and asymptomatic. […] Newborns may also acquire HSV infection through in utero or postnatal transmission.

• #1 Neonatal herpes (Neonatal HSV) | Bliss

  https://www.bliss.org.uk/parents/about-your-baby/medical-conditions/neonatal-herpes

  Herpes simplex virus (HSV) infection in a newborn baby is called neonatal herpes or neonatal HSV. […] In young or premature babies who have immature immune systems, HSV infections can spread rapidly if left untreated, causing irreversible cell damage which can lead to permanent disability or death. […] Early recognition and prompt treatment with antiviral medication is essential to save the baby’s life. Even if treated, a baby could suffer permanent brain damage or die if they are not treated quickly enough. […] Babies can become infected in two main ways: During a vaginal birth (perinatal): through contact with HSV in the birth canal. This is the most common source of infection. […] Infection after birth usually occurs following contact with an active cold sore, HSV-infected broken skin or HSV blisters on the fingers (herpetic whitlow).

• #1 Prevention and management of neonatal herpes simplex virus infections | Canadian Paediatric Society

  https://cps.ca/documents/position/prevention-management-neonatal-herpes-simplex-virus-infections

  All infants, therefore, must be considered to be potentially at risk for NHSV infection. […] The category of maternal infection at time of delivery influences the likelihood of NHSV acquisition, presumably because mothers who have had an HSV infection transmit HSV-neutralizing antibodies to their infant across the placenta, provided that their infant is not born before 32 weeks gestation. […] Thus, infants born to mothers who have a first-episode primary infection at time of delivery are at the highest risk for acquiring HSV, with transmission rates of up to 60%, because their mother had no pre-existing neutralizing antibodies to transmit. […] Delivery by elective Cesarean section markedly reduces but does not eliminate the risk for newborn infection. […] Obstetrical procedures that can cause scalp abrasions or a break in the infants skin during labour and delivery may increase risk of NHSV transmission to a newborn infant.

• #1 #26: Neonatal HSV – Plain and Simplex – The Curbsiders

  https://thecurbsiders.com/cribsiders-podcast/26

  There are three well defined manifestations of postnatal HSV: mucocutaneous disease (Skin, eye, mouth disease), encephalitis, and disseminated HSV disease. […] HSV infection is treated with 20mg/kg acyclovir IV every 8 hours. For SEM disease, treatment course is 14 days. For disseminated disease or meningoencephalitis, treat for 21 days. […] The consequences of perinatal HSV can be devastating. It is important to be vigilant for these infections. […] The first 30 days of life are a uniquely vulnerable time as neonates have a developing immune system. Neonates exposed to HSV during the first 30 days of life are at high risk of developing infection, however the infection acquired at this time can present up to about 6 weeks of age. […] If the pregnant patient has active lesions at the time of delivery, this is an indication for c-section for both primary and recurrent infection. The risk for vertical transmission of HSV is about 40-60% in primary infections and <5% in recurrent infection with active lesions.

• #1 Neonatal herpes – Wikipedia

  https://en.wikipedia.org/wiki/Neonatal_herpes

  Neonatal herpes simplex, or simply neonatal herpes, is a herpes infection in a newborn baby, caused by the herpes simplex virus (HSV). It occurs mostly as a result of vertical transmission of the HSV from an affected mother to her baby. Types include skin, eye, and mouth herpes (SEM), disseminated herpes (DIS), and central nervous system herpes (CNS). Depending on the type, symptoms vary from a fever to small blisters, irritability, low body temperature, lethargy, breathing difficulty, and a large abdomen due to ascites or large liver. There may be red streaming eyes or no symptoms. […] The cause is HSV 1 and 2. It can infect the unborn baby, but more often passes to the baby during childbirth. Onset is typically in the first six weeks after birth. The baby is at greater risk of being affected if the mother contracts HSV in later pregnancy. In such scenarios a prolonged rupture of membranes or childbirth trauma may increase the risk further.

• #1 Herpes Simplex Virus (HSV) Infection in Newborns – Children’s Health Issues – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/children-s-health-issues/infections-in-newborns/herpes-simplex-virus-hsv-infection-in-newborns

  Herpes simplex virus infection usually causes only annoying, recurring blisters in healthy adults but can cause severe infection in newborns. […] Newborns may become infected during delivery or after birth. […] The main symptom is a rash of blisters. […] Newborns with herpes simplex virus infection are given the antiviral medication acyclovir. […] This infection is fatal in many untreated children. […] To prevent spreading the infection, infected pregnant people may be given antiviral medications at the end of pregnancy and may have a cesarean delivery (c-section). […] In newborns, HSV infection can lead to chronic health problems or even be fatal. […] Symptoms of herpes simplex virus infection usually start between the first and third weeks of life but rarely may not appear until the fourth week. The first symptom is usually a rash of small, fluid-filled blisters.

• #1 Neonatal Herpes Encephalitis: A Rare Cause of Neonatal Refractory Seizures and Challenge for Neonatologist – MedCrave online

  https://medcraveonline.com/JPNC/neonatal-herpes-encephalitis-a-rare-cause-of-neonatal-refractory-seizures-and-challenge-for-neonatologist.html

  Neonatal HSV present in three forms SEM disease (Skin Eye and mucosal), CNS disease and Disseminated Disease. […] This accounts for approximately 30% of cases of neonatal herpes. Neonate may present with lethargy, poor feeding, irritability, temperature instability or seizures. […] Diagnosis is made by brain MRI and Lumber puncture. […] Even with treatment, there is a 4% to 14% mortality rate and the majority of survivors will have long-term neurologic sequelae. […] The incidence of disseminated disease has decreased to approximately 25% of all neonatal herpes because of effective antiviral therapy. […] The current recommendations are to treat all neonates with HSV disease parenteral with acyclovir given at 60 mg/kg/d divided every 8 hours. […] Duration of treatment is 14 days for infants with SEM disease and 21 days for neonates with CNS and disseminated disease presentations.

• #1 Neonatal Herpes Simplex Virus (HSV) Infection – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/infections-in-neonates/neonatal-herpes-simplex-virus-hsv-infection

  Neonates with disseminated disease and visceral organ involvement have hepatitis, pneumonitis, disseminated intravascular coagulation, or a combination, with or without encephalitis or skin disease. […] Acyclovir should be started immediately and presumptively in suspected cases while awaiting confirmatory diagnostic tests. […] For localized disease (skin, mouth, or conjunctivae), treatment is acyclovir for 14 days. […] The mortality rate of untreated disseminated herpes simplex disease is 85%; among neonates with untreated encephalitis, it is approximately 50%. […] Death is uncommon in neonates with local disease limited to the skin, eyes, or mouth. However, without treatment, many of these neonates progress to disseminated disease or CNS disease that may be unrecognized. […] To prevent neonatal herpes infection, pregnant patients with a history of genital herpes should be offered suppressive viral therapy at or beyond 36 weeks gestation.

• #1 NEONATAL HSV INFECTION

  https://guidelines.stief.org.nz/herpes-neonatal-hsv-infection

  About 6080% of infants with neonatal HSV disease are born to women with unrecognised infection. […] The risk is greatest when a previously seronegative woman acquires genital herpes (HSV-1 or HSV-2) at or near the time of delivery. […] The usual age of symptom onset in neonatal HSV infection is between 5 and 21 days, but there may be a delay in diagnosis if the significance of the symptoms is not initially recognised. […] Physicians caring for sick infants in the first 6 weeks of life should always be aware that neonatal HSV infection remains a possibility, even when no parental history of HSV infection is given. […] There is no clear pattern of signs and symptoms that identifies babies with neonatal HSV disease, meaning that a high index of suspicion is required. […] Presenting symptoms include fever, lethargy, seizures and respiratory distress, although fever may be absent initially.

• #1 Herpes Simplex Virus in the Newborn

  https://www.health.ny.gov/diseases/communicable/herpes/newborns/fact_sheet.htm

  Herpes simplex virus (HSV) is a virus that usually causes skin infections. […] HSV infection in newborn babies can be very severe and can even cause death. This is because newborns’ immune systems are not fully developed. […] Most HSV infections in newborns are caused by HSV-2 that the infant catches from the mother’s birth canal. […] Infected newborns may have mild symptoms at first, such as low grade fever (100.4 degrees F., or more, rectally), poor feeding, or one or more small skin blisters. […] Newborns with HSV require hospitalization for intravenous antiviral medication for 21 days. Even with this treatment, some newborns can suffer death or brain damage from HSV infection. […] If you are pregnant and have a history or signs and symptoms of genital HSV-2 infection, tell your doctor as soon as possible. A C-section delivery is recommended if a mother has an HSV-2 outbreak near the time of birth.

• #1 Prevention and management of neonatal herpes simplex virus infections

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4028647/

  The absence of skin lesions does not negate the possibility of an NHSV diagnosis. […] NHSV infection should be considered in neonates with sepsis syndrome, particularly when this condition is accompanied by liver dysfunction and even when there is no known history of maternal HSV and the infant has no skin vesicles. […] Infants who present with disseminated disease are less likely to survive than infants with SEM or CNS disease. […] Early therapy with intravenous (IV) ACV improves the prognosis for all three presentations of NHSV. Therefore, infants should be started on IV ACV before laboratory confirmation of NHSV, as soon as the infection is suspected clinically. […] Follow-up is necessary to detect and manage adverse effects related to suppressive ACV treatment as well as for the neurodevelopmental sequelae of NHSV.

• #1 Neonatal Herpes Infection: A Review – Page 3

  https://www.medscape.com/viewarticle/472408_3

  Due to the increasing incidence of neonatal herpes infection and the exceptionally high mortality and morbidity of this disease, a high index of suspicion is imperative in all clinicians caring for neonatal patients. […] The clinical presentation of neonatal herpes may be very nonspecific, therefore a high index of suspicion must be present to reduce the mortality and morbidity associated with a delay in diagnosis. […] Not only is neonatal herpes infection of concern for those clinicians caring for infants in the newborn nursery or neonatal intensive care unit, those infants who are considered well newborns and have been discharged home are also at risk of infection. […] Any delay in the diagnosis of neonatal HSV infection can have disastrous consequences.

• #1 Neonatal herpes – Don’t Forget the Bubbles

  https://dontforgetthebubbles.com/neonatal-herpes/

  The standard diagnosis of neonatal herpes is by PCR (on both HSV types), performed on swabs (cutaneous, nasopharyngeal mucosa, ocular, rectal), serum, and liquor. […] Whether a mother has had a previous genital infection (i.e. a recurrence) or not (a primary infection) helps direct obstetric management. […] A baby born around a primary infection is not protected against HSV because there is no protective antibody response. […] Women with primary herpes during the first or second trimester of pregnancy should be treated with aciclovir during this episode, with oral aciclovir started again after 36 weeks of gestation to minimise the chance of erupting lesions during delivery. […] Treatment is best done in consultation with a paediatric infectious disease expert. […] Babies born vaginally during or after primary infection in the third trimester should be started prophylactically on intravenous aciclovir.

• #1 #26: Neonatal HSV – Plain and Simplex – The Curbsiders

  https://thecurbsiders.com/cribsiders-podcast/26

  In laboring patients with active lesions during delivery (either vaginal or c-sections), obstetricians should get a swab of the lesion for either PCR or culture assay. […] If the parent did not have a history of HSV prior to pregnancy, we obtain serologies for HSV1 and HSV2 to help us determine if this is a recurrent or a primary infection. Then (even if asymptomatic), at 24 hours, the baby gets cultures, blood PCR, CSF analysis, serum transaminase analysis. We start the baby on antiviral treatment with acyclovir. […] Disease does not always occur in the immediate newborn period! The average onset of neonatal HSV disease (both SEM and disseminated disease) is 10-12 days. The average onset of HSV encephalitis is 16-19 days of age. […] In the case of a symptomatic infant (trouble latching, hypothermic, irritable) prior to 24 hours of life: start evaluation for HSV and for bacterial infections.

• #1 Prevention and management of neonatal herpes simplex virus infections | Canadian Paediatric Society

  https://cps.ca/documents/position/prevention-management-neonatal-herpes-simplex-virus-infections

  The absence of skin lesions does not negate the possibility of an NHSV diagnosis. […] NHSV infection should be considered in neonates with sepsis syndrome, particularly when this condition is accompanied by liver dysfunction and even when there is no known history of maternal HSV and the infant has no skin vesicles. […] Infants who present with disseminated disease are less likely to survive than infants with SEM or CNS disease. […] Early therapy with intravenous (IV) ACV improves the prognosis for all three presentations of NHSV. Therefore, infants should be started on IV ACV before laboratory confirmation of NHSV, as soon as the infection is suspected clinically. […] The dose is 60 mg/kg/day in three divided doses administered every 8 h, assuming that renal function is normal. […] Treatment duration should be 14 days if the disease is limited to the skin, eyes or mouth, and a minimum of 21 days if the infection involves the CNS or is disseminated. […] Follow-up is necessary to detect and manage adverse effects related to suppressive ACV treatment as well as for the neurodevelopmental sequelae of NHSV.

• #1 Neonatal Herpes: Can You Be Born With Herpes?

  https://my.clevelandclinic.org/health/diseases/neonatal-herpes-simplex

  If healthcare providers suspect your baby has neonatal herpes, it’s very likely that your baby will be admitted to the hospital for treatment. […] Providers use an antiviral medication called acyclovir to treat neonatal herpes. Your baby will receive this treatment through an IV and then by mouth (as a liquid). […] If your baby has skin, eye and mouth (SEM) disease, they’ll need IV treatment for 14 days. Then, they’ll complete a six-month course of oral medication. This lowers the risk of the skin blisters returning. […] If your baby has central nervous system (CNS) or disseminated disease, they’ll need IV treatment for 21 days. After completing IV treatment, your baby will need to take oral medications for six months. This supports your baby’s neurologic development and lowers the risk of long-term effects on their brain. […] If your baby has any signs of neonatal herpes, contact a healthcare provider right away. Neonatal herpes needs quick treatment. The sooner your baby gets treatment, the better their chances of survival and of recovery with minimal or no long-term effects.

• #1 #26: Neonatal HSV – Plain and Simplex – The Curbsiders

  https://thecurbsiders.com/cribsiders-podcast/26

  HSV infection is treated with 20mg/kg acyclovir IV every 8 hours. For SEM disease (negative CSF, AST/ALT), treatment course is 14 days. For disseminated disease or meningoencephalitis, treat for 21 days. […] If you have HSV on the differential, in Dr. Golden’s expert opinion you should initiate treatment—there is evidence that delayed treatment of HSV infection increases the risk of in-hospital mortality. […] Acyclovir prophylaxis for 6 months improves the neurodevelopmental outcomes of children who had neonatal HSV infection. […] While neonatal HSV is not as common as other conditions in the newborn, the consequences can be devastating. It is important to be vigilant for these infections.

• #1 Neonatal herpes simplex virus (HSV) infection: Management and prevention – UpToDate

  https://www.uptodate.com/contents/neonatal-herpes-simplex-virus-hsv-infection-management-and-prevention

  Neonates can acquire HSV infection by intrauterine, perinatal, or postnatal transmission of the virus. Neonatal HSV infection causes serious morbidity and mortality and leaves many survivors with permanent sequelae. Strong clinical suspicion, timely diagnosis, and early antiviral treatment are critical to improving outcome. […] The management and prevention of neonatal HSV infection will be reviewed here. […] Supportive measures for the critically ill neonate with disseminated or central nervous system (CNS) disease include: Fluid and electrolyte maintenance and avoidance of hypoglycemia. Management of hepatic and kidney failure, if present.

• #1 Prevention and Treatment of Neonatal Herpes Simplex Virus Infection

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8713303/

  Herpes simplex virus (HSV) infection occurs infrequently in neonates despite the ubiquitous nature of the virus in adults. […] Early diagnosis is imperative when evaluating neonatal HSV infection in order to prevent further disease progression, neurological complications, and even death. […] Both HSV-1 and HSV-2 can cause neonatal HSV disease, and to improve overall outcome in infants diagnosed with neonatal HSV disease, early diagnosis and initiation of treatment is imperative. […] The treatment of neonatal HSV disease has significantly improved over the last 40 years with the advancements in antiviral therapy. […] Acyclovir, an acyclic guanine nucleoside analog, is the only antiviral agent recommended for treatment and for suppressive therapy in neonatal HSV disease. […] Cesarean sections in women presenting with active genital lesions at time of delivery has reduced the transmission of herpes from mother to infant. […] The use of suppressive therapy in pregnant females with a history of genital herpes has reduced the chance of having active lesions at time of delivery and decreased periods of subclinical viral shedding.

• #1 Neonatal herpes (herpes in a baby)

  https://www.nhs.uk/conditions/neonatal-herpes/

  If widespread herpes is not treated immediately, there’s a high chance the baby will die. […] If you’re pregnant and have a history of genital herpes, tell your doctor or midwife. […] Delivery by caesarean section is recommended if the genital herpes has occurred for the first time in the last 6 weeks of your pregnancy.

• #1 Neonatal Herpes Simplex Virus (HSV) Infection – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/infections-in-neonates/neonatal-herpes-simplex-virus-hsv-infection

  Cesarean delivery is recommended for pregnant patients with active genital herpes simplex lesions or prodromal symptoms at the time of delivery. […] Neonatal herpes infection may be localized to the skin, eyes, or mouth, the central nervous system, or may be disseminated. […] Encephalitis and disseminated disease have a high mortality rate, and neurologic sequelae are common among survivors. […] In suspected cases, presumptive therapy and rapid diagnosis by HSV PCR of cerebrospinal fluid, blood, or lesions are essential to optimize outcomes. […] Give parenteral acyclovir for both localized and disseminated disease.

• #1 Neonatal herpes information and advice | Kit Tarka Foundation

  https://www.kittarkafoundation.org/neonatal-herpes-info-and-advice

  If you are concerned your baby has an infection, seek medical assistance as soon as possible and always ask 'Could it be herpes?’. […] An antiviral medication is administered into the baby’s blood stream (intravenously) typically for 14-21 days. […] Treatment must be given promptly in order to be successful. Babies who are not given antiviral medication quickly may very sadly die. […] Some babies make a full recovery if they have been given early treatment but, even with treatment, if the infection has spread to the baby’s organs it may result in permanent disability or death. […] If you are pregnant and have ever had genital herpes, let your doctor/midwife know. […] If you develop genital herpes for the first time during your last trimester then a caesarean birth may be recommended which significantly reduces the risk of transmission during delivery. […] If you have a cold sore, blister on the fingers (herpetic whitlow) or infected broken skin, you should try and avoid direct contact with newborn babies who are not yours to avoid putting them at risk. […] Regular and thorough hand washing is essential.

• #1 Neonatal herpes (Neonatal HSV) | Bliss

  https://www.bliss.org.uk/parents/about-your-baby/medical-conditions/neonatal-herpes

  If you develop genital herpes for the first time during your last trimester, then a caesarean birth may be recommended which significantly reduces the risk of transmission during delivery. […] If you develop lesions on your breast or nipples you should stop feeding from that breast immediately and arrange to see your GP as soon as possible. […] You should try and avoid direct contact with newborn babies who are not yours to avoid putting them at risk. […] As people can 'shed’ the virus with no symptoms, everyone should wash their hands carefully before holding a young baby. Regular and thorough hand washing is essential.

• #1 Neonatal Herpes Simplex Virus Infections | AAFP

  https://www.aafp.org/pubs/afp/issues/2002/0315/p1138.html

  The HSV-exposed neonate should be monitored closely for any signs of infection. Initial cultures should be performed at 24 to 48 hours, then weekly cultures of conjunctiva, nose, mouth, urine and rectum for HSV-1 or HSV-2 have been suggested. […] Any exposed infant with clinical signs of HSV should be cultured (conjunctiva, nose, mouth, urine, rectum, CSF, blood buffy coat), CSF should be sent for PCR analysis, and the infant should be immediately started on intravenous acyclovir therapy. […] Infants born to women with active genital HSV lesions should be managed with contact precautions and be kept in a private room.

• #1 Herpes Simplex Virus in the Newborn

  https://www.health.ny.gov/diseases/communicable/herpes/newborns/fact_sheet.htm

  Contact your doctor immediately if there are any signs of HSV infection. These include low grade fever (100.4 degrees F., or more, rectally), poor feeding, irritability, and skin rash in the form of pimples or blisters, seizures or other similar symptoms that may develop within six weeks following birth. […] All newborns should be seen by their health care provider between the first and third week of life.

• #1 Herpes Simplex Virus and Breastfeeding | Breastfeeding special circumstances | CDC

  https://www.cdc.gov/breastfeeding-special-circumstances/hcp/illnesses-conditions/herpes.html

  Herpes simplex virus (HSV) infections in infants can be severe. Mothers with HSV can continue to breastfeed if there are no lesions on the breasts, and if lesions elsewhere on the body are carefully and fully covered. […] Women with herpes lesions may transmit HSV to their infants by direct or indirect contact with the lesions. For mothers with active lesions, breastfeeding is acceptable if: No lesions are present on the breasts, and, Active lesions elsewhere on the mother are carefully and fully covered. […] Mothers with active lesions on the breast should temporarily stop breastfeeding from the affected breast. She should not feed expressed breast milk from the affected breast. She should discard expressed breast milk from the affected side until the lesions have healed. […] A mother may breastfeed her infant from the unaffected breast but should ensure that the lesions on the affected breast are completely covered to avoid transmission.

• #1 Herpes Simplex Virus and Breastfeeding | Breastfeeding special circumstances | CDC

  https://www.cdc.gov/breastfeeding-special-circumstances/hcp/illnesses-conditions/herpes.html

  While breast lesions are healing, some mothers may need additional support to maintain their milk production. […] Mothers should consult with their health care provider to determine if their lesions have healed. […] It is not safe for a mother to give her infant hand-expressed or pumped breast milk from an affected breast if she has active herpes lesions on her breast. […] Mothers with herpes lesions should discard expressed breast milk from the affected breast until the lesions have healed. […] Mothers can safely feed their child expressed breast milk from the unaffected breast as long as the lesions on the affected breast are completely covered to avoid transmission.

• #1 Neonatal HSV – WikEM

  https://wikem.org/wiki/Neonatal_HSV

  Many recommend acyclovir empirically in ill-appearing neonates with fever (including hypothermia) or aspetic meningitis until results of work-up are known. […] Any neonate with suspected HSV (especially if CSF pleocytosis) should be treated and admitted. […] Mortality high with CNS (4%) or disseminated (29%) disease even with treatment.

• #1 Birth-Acquired Herpes: Causes, Symptoms, Picture, and Prevention

  https://www.healthline.com/health/birth-acquired-herpes

  Infants with birth-acquired herpes might also appear extremely tired and have trouble feeding. […] The systemic form of congenital herpes, or disseminated herpes infection, occurs when the entire body becomes infected with herpes. It affects more than just the baby’s skin and can cause serious complications, such as eye inflammation, blindness, seizures and seizure disorders, respiratory illnesses. […] The herpes virus can be treated, but not cured. This means the virus will remain in your child’s body throughout their life. However, the symptoms can be managed. […] Your child’s pediatrician will likely treat the infection with antiviral medications given through an IV, a needle or tube that goes into a vein. […] Acyclovir (Zovrax) is the most commonly used antiviral medication for birth-acquired herpes. Treatment usually spans a few weeks and may include other medications to control seizures or treat shock.

• #1 Neonatal Herpes Simplex Virus Infections | AAFP

  https://www.aafp.org/pubs/afp/issues/2002/0315/p1138.html

  Neonatal herpes simplex virus infections can result in serious morbidity and mortality. […] The diagnosis of neonatal HSV can be difficult, but it should be suspected in any newborn with irritability, lethargy, fever or poor feeding at one week of age. Diagnosis is made by culturing the blood, cerebrospinal fluid, urine and fluid from eyes, nose and mucous membranes. All newborns suspected to have or who are diagnosed with HSV infection should be treated with parenteral acyclovir. […] A neonatal HSV infection can be devastating to an infant. […] The diagnosis of neonatal HSV can be difficult initially. The presentation is nonspecific, with signs and symptoms such as irritability, lethargy, fever or failure to feed at about one week of age. […] All infants suspected to have or who are diagnosed with an HSV infection should be treated with parenteral antiviral therapy.

• #1 Neonatal Herpes: Can You Be Born With Herpes?

  https://my.clevelandclinic.org/health/diseases/neonatal-herpes-simplex

  Neonatal herpes is a serious infection that affects newborns. Fluid-filled blisters on your baby’s skin, around their eyes and in their mouth are the most obvious signs. The infection can harm your baby’s brain and other major organs, leading to life-threatening complications. Urgent treatment is necessary. […] Neonatal herpes is a type of herpes infection that develops in a baby during their first six weeks of life. It typically occurs when the herpes simplex virus (HSV) passes from you to your baby, most commonly during delivery. […] In newborns, HSV is dangerous and potentially life-threatening. It can cause a widespread infection that affects your baby’s major organs, including their brain. Prompt treatment gives your baby the best chance at a good outcome. […] Fluid-filled blisters affecting your baby’s skin, eye area and mouth are the most obvious sign. But not all babies with neonatal herpes develop these blisters. It depends on the type of neonatal herpes they have.

• #1 Neonatal HSV – WikEM

  https://wikem.org/wiki/Neonatal_HSV

  Causative agent: HSV-1 or HSV-2. […] Definition infection acquired peri-natally or postnatally without clinical manifestations at birth or in the first 24 hours of life but with subsequent clinical manifestations in the neonatal period (age less than 29 days). […] Risk associated with age 3 weeks, primary maternal HSV infection at delivery. […] May be well appearing – maintain high clinical suspicion. […] Always consider neonatal HSV and perform appropriate work-up and treatment if: Evidence of vesicular rash (even if minor), Keratoconjunctivitis, Seizure, Poor feeding, Lethargy, Irritability, Respiratory distress, Sepsis, Temperature instability, CSF pleocytosis, Thrombocytopenia, Transaminitis, Working up for serious bacterial illness. […] Acyclovir if Proven HSV disease, Suspected HSV disease (see clinical features) pending studies, At risk due to exposure (active genital lesions in mother or history of cold sores in a contact).

• #1 NEONATAL HSV INFECTION

  https://guidelines.stief.org.nz/herpes-neonatal-hsv-infection

  The mortality rate is highest in neonates with altered consciousness, seizures, disseminated intravascular coagulation, and prematurity. […] Treatment with intravenous aciclovir decreases the mortality and morbidity associated with neonatal HSV infections. […] Starting treatment early improves neurological outcomes. […] Infants with neonatal HSV disease should be managed using contact precautions throughout the course of their illness. […] Long-term follow-up in survivors of neonatal HSV infection is important to monitor for longer-term sequelae. […] A diagnosis of neonatal HSV infection causes considerable stress for families, and many couples go on to separate.

• #1 Subclinical Herpes Simplex Virus in Neonates: What to Do? – Pediatrics Nationwide

  https://pediatricsnationwide.org/2024/11/25/subclinical-herpes-simplex-virus-in-neonates-what-to-do/

  Neonates can test positive for HSV without having visible lesions or other classic symptoms, leaving clinical uncertainty regarding appropriate antiviral treatment and testing protocols. […] The urgency of initiating treatment leads many clinicians to start antiviral therapy with acyclovir in advance of known results — provided the infant has classic HSV symptoms or there was confirmed intrapartum HSV disease in the mother. However, in the absence of mucosal lesions, skin vesicles, liver disease, seizures or other typical signs of HSV infection or risk factors, empiric acyclovir treatment is unclear. […] At present, little is known about the true incidence of HSV infection in neonates, in part because of the difficulty many centers have with timely testing. Estimates range from 1 in every 3,000 to 1 in 20,000 live births. Left untreated, it can be deadly, and even with treatment, some babies sustain long-term neurodevelopmental delays, blindness and significant organ damage.

• #2 Neonatal Herpes: Can You Be Born With Herpes?

  https://my.clevelandclinic.org/health/diseases/neonatal-herpes-simplex

  Neonatal herpes is a serious infection that affects newborns. Fluid-filled blisters on your baby’s skin, around their eyes and in their mouth are the most obvious signs. The infection can harm your baby’s brain and other major organs, leading to life-threatening complications. Urgent treatment is necessary. […] Neonatal herpes is a type of herpes infection that develops in a baby during their first six weeks of life. It typically occurs when the herpes simplex virus (HSV) passes from you to your baby, most commonly during delivery. […] In newborns, HSV is dangerous and potentially life-threatening. It can cause a widespread infection that affects your baby’s major organs, including their brain. Prompt treatment gives your baby the best chance at a good outcome. […] Fluid-filled blisters affecting your baby’s skin, eye area and mouth are the most obvious sign. But not all babies with neonatal herpes develop these blisters. It depends on the type of neonatal herpes they have.

• #2 Characteristics of neonatal herpes simplex virus infections in Germany: results of a 2-year prospective nationwide surveillance study | ADC Fetal & Neonatal Edition

  https://fn.bmj.com/content/107/2/188

  Objective To assess incidence and burden of neonatal herpes simplex virus (HSV) infections and to explore possible transmission routes. […] Neonatal herpes simplex virus (HSV) infections are rare. […] The 2-year incidence of neonatal HSV infections was 2.35 per 100000 live births (95% CI 1.69 to 3.02) and disease-specific mortality was 0.13 per 100000 live births (95%CI 0.04 to 0.21). […] Neonatal HSV infections are rare in Germany. Most infants have a benign clinical course, but some infants are severely affected. […] An active maternal genital HSV infection was reported in 3 cases. […] Neonates treated for asymptomatic or skin/mucous membrane HSV infections have a favourable outcome, while neonates presenting with disseminated disease or eye infection are at high risk for sequelae.

• #2 Prevention and management of neonatal herpes simplex virus infections | Canadian Paediatric Society

  https://cps.ca/documents/position/prevention-management-neonatal-herpes-simplex-virus-infections

  Human herpes simplex virus (HSV) infection in neonates can result in devastating outcomes, including mortality and significant morbidity. […] All infants are potentially at risk for neonatal HSV infection. […] Recommendations for managing newborns known to have been exposed intrapartum to HSV are based on expert opinion because a randomized trial to compare management options is not feasible. […] The most common and important category of NHSV acquisition is intrapartum. Even for HSV-1, 75% of cases of NHSV are acquired during delivery from genital disease that is often newly acquired and asymptomatic. […] Newborns may also acquire HSV infection through in utero or postnatal transmission. […] In most cases of NHSV infection, there is no known history of maternal genital HSV because mothers have never had or have never noticed external genital lesions.

• #2 How to protect your baby from herpes infection | Your Pregnancy Matters | UT Southwestern Medical Center

  https://utswmed.org/medblog/herpes-simplex-pregnancy-baby/

  The herpes simplex viruses that cause cold sores or genital sores in adults can cause significant infections in newborns. […] When a newborn is infected with herpes, serious and sometimes fatal complications can occur. […] Herpes infection occurs in less than 1 percent of births, and the development of meningitis from HSV-1 infection is incredibly rare. However, herpes infection in newborns is always a concern. […] A study published in January 2017 in The Lancet Global Health states that 85 percent of herpes-infected newborns contract the disease from their mothers during delivery. […] For HSV-1, or oral herpes, infection typically happens through contact from an infected person’s lesion to a membrane area of the baby’s body, such as the eyes or mouth. […] Herpes symptoms in infants can be vague, such as difficulty breathing, bleeding easily, or feeding poorly.

• #2 THINK hands and no kisses: preventing Neonatal Herpes – Maternity & Midwifery Forum %

  https://maternityandmidwifery.co.uk/think-hands-and-no-kisses-preventing-neonatal-herpes/

  Neonatal herpes is a serious infection, which, in some cases, can be fatal. […] Neonatal herpes is a rare, and potentially fatal, disease which usually occurs in the the first four week of a babys life. […] Most neonatal herpes infections are transmitted from mothers and birthing parents with active genital herpes to their babies during delivery, however, a substantial proportion are contracted after birth from someone with an active herpes infection e.g. cold sore or herpetic whitlow on the finger. […] 60% of new and expectant parents dont know that herpes infections in young babies can be fatal. […] More than 1 in 6 parents would allow a person they dont know well to touch their baby without washing their hands. […] 1/3 of parents would not ask friends and family to wash their hands before holding their young baby.

• #2 Genital Herpes and Pregnancy

  https://www.ashasexualhealth.org/herpes-and-pregnancy/

  Babies are most at risk for neonatal herpes if the mother contracts genital herpes late in pregnancy. This is because a newly infected mother does not have antibodies against the virus, so there is no natural protection for the baby during birth. In addition, a new herpes infection is frequently active, so there is an increased possibility the virus will be present in the birth canal during delivery. […] Women who have genital herpes before they become pregnant have a very low risk of transmitting the virus to their babies. This is because their immune systems make antibodies that are temporarily passed to the baby through the placenta. Even if herpes is active in the birth canal during delivery, the antibodies help protect the baby. In addition, if a mother knows she has genital herpes, her doctor or midwife can take steps to protect the baby.

• #2 Neonatal herpes – Don’t Forget the Bubbles

  https://dontforgetthebubbles.com/neonatal-herpes/

  Neonatal herpes can present with various symptoms, and diagnosis can be challenging. […] Neonatal herpes acquired peri- or post-partum causes three different types of disease entities which are not entirely mutually exclusive: […] Skin Eye Mouth (SEM) disease is a local infection affecting the skin and mucosa without the involvement of visceral organs. […] Central nervous system (CNS) involvement, with incubation of up to six weeks, can occur with or without skin symptoms. […] Disseminated infection in which skin, mucosa, as well as other organs (such as lungs, liver, adrenal glands) are affected. […] In addition, HSV can cause in-utero disease, which is rare but has severe sequelae. […] Neonatal herpes can predispose to dermal recurrences in the future, for which prophylaxis may be necessary.

• #2 Neonatal Herpes and the Urgency for Change

  https://herpescureadvocacy.com/neonatal-herpes-and-the-urgency-for-change/

  Neonatal herpes (nHSV), is a genital herpes infection that impacts newborns and is a serious health condition with devastating health outcomes. […] While neonatal herpes causes painful skin, eye, and/or mouth lesions, it also has severe and lasting neurological impacts, and it can be fatal 60% of the time. […] Neonatal herpes manifests in three ways, skin/eyes/mouth, disseminated disease, or a brain (or CNS) infection. […] 45% of neonatal herpes cases are an SEM infection. In an SEM infection, no internal organs are affected and the disease is limited to the skin, eyes, and mouth with virtually no mortality. […] Most infants who survive with SEM herpes, however, do suffer considerable morbidity as a result of the skin disease recurrences. […] 25% of neonatal herpes cases are disseminated disease where the infection reaches internal organs. […] When neonatal herpes reaches the internal organs or brain it is more serious and has a higher fatality rate and risk of lasting permanent brain injury. […] Some signs of the disseminated disease include respiratory distress and seizures, which are incredibly dangerous for neonates.

• #2 Neonatal Herpes and the Urgency for Change

  https://herpescureadvocacy.com/neonatal-herpes-and-the-urgency-for-change/

  And most dangerous, accounting for 30% of all cases, another clinical outcome of neonatal herpes is localized brain or CNS infection, which is characterized by inflammation affecting the brain and spinal cord, which often is fatal and leads to long-term health conditions. […] Consequences for surviving infants can be dire and the most fatal manifestation of the disease. Infants surviving neonatal herpes often have permanent brain damage that can inhibit the basic physiological functions needed for a normal life. […] Current guidelines that recommend against testing for herpes simplex virus or genital herpes in pregnant mothers are putting infants and families at risk. […] With only 10-15% of women aware of their seropositive status, we have a dangerous loophole for occurrences of neonatal herpes. […] Furthermore, in terms of testing, infants who are suspected of having herpes, are recommended to be tested via diagnostic polymerase chain reaction (PCR) tests. […] Guidance needs to evolve urgently, to recommend screening that protects newborn babies and alleviates these tragic outcomes. […] Considering the dire impact on these lives proves that more robust treatment and prevention strategies are essential and long overdue.

• #2 Birth-Acquired Herpes: Causes, Symptoms, Picture, and Prevention

  https://www.healthline.com/health/birth-acquired-herpes

  Infants with birth-acquired herpes might also appear extremely tired and have trouble feeding. […] The systemic form of congenital herpes, or disseminated herpes infection, occurs when the entire body becomes infected with herpes. It affects more than just the baby’s skin and can cause serious complications, such as eye inflammation, blindness, seizures and seizure disorders, respiratory illnesses. […] The herpes virus can be treated, but not cured. This means the virus will remain in your child’s body throughout their life. However, the symptoms can be managed. […] Your child’s pediatrician will likely treat the infection with antiviral medications given through an IV, a needle or tube that goes into a vein. […] Acyclovir (Zovrax) is the most commonly used antiviral medication for birth-acquired herpes. Treatment usually spans a few weeks and may include other medications to control seizures or treat shock.

• #2 #26: Neonatal HSV – Plain and Simplex – The Curbsiders

  https://thecurbsiders.com/cribsiders-podcast/26

  In laboring patients with active lesions during delivery (either vaginal or c-sections), obstetricians should get a swab of the lesion for either PCR or culture assay. […] If the parent did not have a history of HSV prior to pregnancy, we obtain serologies for HSV1 and HSV2 to help us determine if this is a recurrent or a primary infection. Then (even if asymptomatic), at 24 hours, the baby gets cultures, blood PCR, CSF analysis, serum transaminase analysis. We start the baby on antiviral treatment with acyclovir. […] Disease does not always occur in the immediate newborn period! The average onset of neonatal HSV disease (both SEM and disseminated disease) is 10-12 days. The average onset of HSV encephalitis is 16-19 days of age. […] In the case of a symptomatic infant (trouble latching, hypothermic, irritable) prior to 24 hours of life: start evaluation for HSV and for bacterial infections.

• #2 What Are the Causes of Neonatal HSV Infection?

  https://www.icliniq.com/articles/infectious-diseases/neonatal-herpes-simplex-infection

  Signs and symptoms of neonatal herpes simplex infection in babies may include: Fever: A baby with neonatal herpes simplex infection may have a fever that does not go away or worsens despite treatment. Skin Rash: Some babies will develop a blistering or ulcerated rash on the skin or mouth. The rash may spread and become more severe over time. Lethargy or Irritation: A baby with neonatal herpes simplex infection may be exhausted, lazy, or weak. Vomiting and Diarrhea: These symptoms can also be present in babies with neonatal herpes simplex infection. Eye Discharge: Babies may also experience a discharge from their eyes. Respiratory Difficulties: Babies with neonatal herpes simplex infection may have difficulty breathing, or they may have a cough or rapid breathing. Cyanosis: Bluetongue and skin. Has difficulty waking up from sleep. Baby is unable to feed properly.

• #2 Prevention and management of neonatal herpes simplex virus infections | Canadian Paediatric Society

  https://cps.ca/documents/position/prevention-management-neonatal-herpes-simplex-virus-infections

  The absence of skin lesions does not negate the possibility of an NHSV diagnosis. […] NHSV infection should be considered in neonates with sepsis syndrome, particularly when this condition is accompanied by liver dysfunction and even when there is no known history of maternal HSV and the infant has no skin vesicles. […] Infants who present with disseminated disease are less likely to survive than infants with SEM or CNS disease. […] Early therapy with intravenous (IV) ACV improves the prognosis for all three presentations of NHSV. Therefore, infants should be started on IV ACV before laboratory confirmation of NHSV, as soon as the infection is suspected clinically. […] The dose is 60 mg/kg/day in three divided doses administered every 8 h, assuming that renal function is normal. […] Treatment duration should be 14 days if the disease is limited to the skin, eyes or mouth, and a minimum of 21 days if the infection involves the CNS or is disseminated. […] Follow-up is necessary to detect and manage adverse effects related to suppressive ACV treatment as well as for the neurodevelopmental sequelae of NHSV.

• #2 Neonatal Herpes Simplex Virus Infections | AAFP

  https://www.aafp.org/pubs/afp/issues/2002/0315/p1138.html

  Neonatal herpes simplex virus infections can result in serious morbidity and mortality. […] The diagnosis of neonatal HSV can be difficult, but it should be suspected in any newborn with irritability, lethargy, fever or poor feeding at one week of age. Diagnosis is made by culturing the blood, cerebrospinal fluid, urine and fluid from eyes, nose and mucous membranes. All newborns suspected to have or who are diagnosed with HSV infection should be treated with parenteral acyclovir. […] A neonatal HSV infection can be devastating to an infant. […] The diagnosis of neonatal HSV can be difficult initially. The presentation is nonspecific, with signs and symptoms such as irritability, lethargy, fever or failure to feed at about one week of age. […] All infants suspected to have or who are diagnosed with an HSV infection should be treated with parenteral antiviral therapy.

• #2 #26: Neonatal HSV – Plain and Simplex – The Curbsiders

  https://thecurbsiders.com/cribsiders-podcast/26

  HSV infection is treated with 20mg/kg acyclovir IV every 8 hours. For SEM disease (negative CSF, AST/ALT), treatment course is 14 days. For disseminated disease or meningoencephalitis, treat for 21 days. […] If you have HSV on the differential, in Dr. Golden’s expert opinion you should initiate treatment—there is evidence that delayed treatment of HSV infection increases the risk of in-hospital mortality. […] Acyclovir prophylaxis for 6 months improves the neurodevelopmental outcomes of children who had neonatal HSV infection. […] While neonatal HSV is not as common as other conditions in the newborn, the consequences can be devastating. It is important to be vigilant for these infections.

• #2 Neonatal Herpes Simplex Virus (HSV) Infection – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/infections-in-neonates/neonatal-herpes-simplex-virus-hsv-infection

  Neonates with disseminated disease and visceral organ involvement have hepatitis, pneumonitis, disseminated intravascular coagulation, or a combination, with or without encephalitis or skin disease. […] Acyclovir should be started immediately and presumptively in suspected cases while awaiting confirmatory diagnostic tests. […] For localized disease (skin, mouth, or conjunctivae), treatment is acyclovir for 14 days. […] The mortality rate of untreated disseminated herpes simplex disease is 85%; among neonates with untreated encephalitis, it is approximately 50%. […] Death is uncommon in neonates with local disease limited to the skin, eyes, or mouth. However, without treatment, many of these neonates progress to disseminated disease or CNS disease that may be unrecognized. […] To prevent neonatal herpes infection, pregnant patients with a history of genital herpes should be offered suppressive viral therapy at or beyond 36 weeks gestation.

• #2 Neonatal herpes simplex virus (HSV) infection: Management and prevention – UpToDate

  https://www.uptodate.com/contents/neonatal-herpes-simplex-virus-infection-management-and-prevention

  Neonatal herpes simplex virus (HSV) infection causes serious morbidity and mortality and leaves many survivors with permanent sequelae. Strong clinical suspicion, timely diagnosis, and early antiviral treatment are critical to improving outcome. […] The management and prevention of neonatal HSV infection will be reviewed here. […] Supportive measures for the critically ill neonate with disseminated or central nervous system (CNS) disease include: Fluid and electrolyte maintenance and avoidance of hypoglycemia. […] Management of hepatic and kidney failure, if present.

• #2 NEONATAL HSV INFECTION

  https://guidelines.stief.org.nz/herpes-neonatal-hsv-infection

  The mortality rate is highest in neonates with altered consciousness, seizures, disseminated intravascular coagulation, and prematurity. […] Treatment with intravenous aciclovir decreases the mortality and morbidity associated with neonatal HSV infections. […] Starting treatment early improves neurological outcomes. […] Infants with neonatal HSV disease should be managed using contact precautions throughout the course of their illness. […] Long-term follow-up in survivors of neonatal HSV infection is important to monitor for longer-term sequelae. […] A diagnosis of neonatal HSV infection causes considerable stress for families, and many couples go on to separate.

• #2 Herpes infection in newborn babies (neonatal herpes)

  https://www2.hse.ie/conditions/neonatal-herpes/

  Neonatal herpes infection is caused by the cold sore virus. It is very uncommon in newborn babies. […] Babies are most at risk of herpes if their mother develops genital herpes in the last 6 weeks of pregnancy. […] Neonatal herpes can be very serious or even fatal for young babies. It can affect their internal organs including the brain and the lungs. Their immune systems are not developed enough to fight the infection. The risk is highest in the first 4 to 6 weeks after birth. […] Your baby can become unwell very quickly, so you need to act fast. […] They will need tests and treatment. […] Your baby will usually be given antiviral medicine if they have neonatal herpes. This is given through a drip into a vein. […] If the virus spreads to a baby’s organs, the infection is life-threatening. […] If you’re pregnant and have genital herpes, tell your GP, obstetrician or midwife. […] Talk to your GP if you have herpes blisters on your breast or around your nipple. You may not be able to breastfeed from that breast.

• #2 Neonatal herpes – Don’t Forget the Bubbles

  https://dontforgetthebubbles.com/neonatal-herpes/

  The standard diagnosis of neonatal herpes is by PCR (on both HSV types), performed on swabs (cutaneous, nasopharyngeal mucosa, ocular, rectal), serum, and liquor. […] Whether a mother has had a previous genital infection (i.e. a recurrence) or not (a primary infection) helps direct obstetric management. […] A baby born around a primary infection is not protected against HSV because there is no protective antibody response. […] Women with primary herpes during the first or second trimester of pregnancy should be treated with aciclovir during this episode, with oral aciclovir started again after 36 weeks of gestation to minimise the chance of erupting lesions during delivery. […] Treatment is best done in consultation with a paediatric infectious disease expert. […] Babies born vaginally during or after primary infection in the third trimester should be started prophylactically on intravenous aciclovir.

• #2 Genital herpes

  https://www.nhs.uk/conditions/genital-herpes/

  Women who have had genital herpes before pregnancy can usually expect to have a healthy baby and a vaginal delivery. […] However, if you have a herpes outbreak when you give birth, or you get genital herpes for the first time during pregnancy, there’s a risk your baby could develop a serious illness called neonatal herpes. You’ll be offered medicine from around 32 weeks of pregnancy to reduce this risk. […] Neonatal herpes can be fatal, but most babies recover with treatment. […] The risk of your baby getting neonatal herpes is low if you’ve had genital herpes before. […] It’s higher if you get genital herpes for the first time within the last 6 weeks of your pregnancy. […] See your midwife or a GP if you think you have genital herpes in pregnancy. […] You may be offered antiviral treatment: to treat outbreaks in pregnancy, from week 32 of pregnancy to reduce the chance of an outbreak during birth, from diagnosis until the birth if you first get herpes after week 28 of pregnancy. […] Many women with genital herpes have a vaginal delivery. You may be offered a caesarean, depending on your circumstances.

• #2 Pregnancy and herpes Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/pregnancy-and-herpes

  Newborn infants can become infected with herpes simplex virus (HSV) during pregnancy, during labor or delivery, or after birth. […] If the mother has an active outbreak of genital herpes at the time of delivery, the baby is more likely to become infected during birth. Some mothers may not know they have HSV sores inside the vagina. […] HSV infection in infants is generally treated with antiviral medicine given through a vein (intravenous). The baby may need to be on the medicine for several weeks. […] If your baby has any symptoms of birth-acquired herpes, including skin blisters with no other symptoms, have the baby seen by your provider right away. […] People with cold sores should not come in contact with newborn infants. To prevent transmitting the virus, caregivers who have a cold sore should wear a mask and wash their hands carefully before coming in contact with an infant.

• #2 Neonatal Herpes Encephalitis | ABC Law Centers: Birth Injury Lawyers

  https://www.abclawcenters.com/practice-areas/neonatal-herpes-encephalitis/

  Failure to promptly diagnose neonatal herpes greatly increases the seriousness of the disease and increases the chance of herpes encephalitis, permanent brain injury, and death. […] All babies with suspected or diagnosed HSV must be treated immediately with intravenous (IV) acyclovir (Zovirax). Prompt treatment is crucial, especially in cases of disseminated infections. […] Identifying pregnant patients who have (or are at risk of having) HSV is a critical component of preventing transmission to a baby. […] Newborns born to patients with active genital lesions, with a confirmed or suspected HSV infection, should be isolated and managed with contact precautions, closely monitored, and immediately treated with IV acyclovir. […] If the baby is at risk of infection, they must be monitored closely after delivery, and if any signs of HSV are present, the baby must be treated and tested for the infection. Failure to promptly treat an infant with HSV and failure to follow the standards of care listed above constitute negligence. If this negligence leads to injury in the baby, it is medical malpractice.

• #2 Genital Herpes and Pregnancy

  https://www.ashasexualhealth.org/herpes-and-pregnancy/

  If you have an active outbreak at the time of delivery, the safest course is a Cesarean section to prevent the baby from coming into contact with virus in the birth canal. If you do not have an active outbreak, you can have a vaginal delivery. […] After birth, watch the baby closely for about three weeks. Symptoms of neonatal herpes may include a skin rash, fever, crankiness, or lack of appetite. While these can be symptoms of several mild illnesses, dont wait to see if your baby will get better. Take him or her to the pediatrician at once. Be sure to tell the pediatrician you have genital herpes.

• #2 Neonatal herpes (herpes in a baby)

  https://www.nhs.uk/conditions/neonatal-herpes/

  Neonatal herpes is a herpes infection in a young baby. The younger the baby, the more vulnerable they are to the harmful effects of infection. […] Herpes can be very serious for a young baby, whose immune system will not have fully developed to fight off the virus. […] A baby is most at risk of getting a herpes infection in the first 4 weeks after birth. […] Very often the baby will not have any specific herpes symptoms, such as a rash. […] Neonatal herpes is usually treated with antiviral medicines given directly into the baby’s vein (intravenously). […] You can breastfeed your baby while they’re receiving treatment, unless you have herpes sores around your nipples. […] Sometimes neonatal herpes will only affect the baby’s eyes, mouth or skin. […] But the condition is much more serious if it has spread to the baby’s organs.

• #2 Herpes and Breastfeeding – Breastfeeding Support

  https://breastfeeding.support/herpes-and-breastfeeding/

  If a mother has herpes simplex virus, she can usually still breastfeed with the following precautions: […] Herpes can be very dangerous and life threatening for a newborn baby up to three weeks of age. A mother should speak to her healthcare provider for the latest recommendations and precautions if she has a very young baby and suspects she has herpes or has recurrent herpes. […] If active herpes sores are on a breast or nipple, mothers are advised not to breastfeed from that breast until the lesions have dried. […] The breast milk from a breast with an active herpes lesion will need to be expressed to maintain the mothers milk supply and prevent engorgement or mastitis. […] Although transmission of HSV to the breast is rare, if a breastfed toddler has oral herpes there is a risk of transferring HSV-1 from the childs mouth to the mothers nipples by breastfeeding.

• #2 Neonatal herpes (Neonatal HSV) | Bliss

  https://www.bliss.org.uk/parents/about-your-baby/medical-conditions/neonatal-herpes

  If you develop genital herpes for the first time during your last trimester, then a caesarean birth may be recommended which significantly reduces the risk of transmission during delivery. […] If you develop lesions on your breast or nipples you should stop feeding from that breast immediately and arrange to see your GP as soon as possible. […] You should try and avoid direct contact with newborn babies who are not yours to avoid putting them at risk. […] As people can 'shed’ the virus with no symptoms, everyone should wash their hands carefully before holding a young baby. Regular and thorough hand washing is essential.

• 2″>1

  #2 Herpes Simplex Virus and Breastfeeding | Breastfeeding special circumstances | CDC

  https://www.cdc.gov/breastfeeding-special-circumstances/hcp/illnesses-conditions/herpes.html

• #2 Herpes Simplex Virus and Breastfeeding | Breastfeeding special circumstances | CDC

  https://www.cdc.gov/breastfeeding-special-circumstances/hcp/illnesses-conditions/herpes.html

  While breast lesions are healing, some mothers may need additional support to maintain their milk production. […] Mothers should consult with their health care provider to determine if their lesions have healed. […] It is not safe for a mother to give her infant hand-expressed or pumped breast milk from an affected breast if she has active herpes lesions on her breast. […] Mothers with herpes lesions should discard expressed breast milk from the affected breast until the lesions have healed. […] Mothers can safely feed their child expressed breast milk from the unaffected breast as long as the lesions on the affected breast are completely covered to avoid transmission.

• #2 Breastfeeding with Herpes Simplex Virus ~ Birth Aims

  https://birthaims.com.au/breastfeeding-with-herpes/

  Likewise, the Academy of Breastfeeding Medicine in their protocol on nipple pain and management recommend oral antiviral therapy for treating primary or recurrent infections, preventing infant contact with lesions and avoiding breastfeeding or feeding expressed breastmilk to infants from an affected breast/nipple until lesions are healed to prevent neonatal herpes infection. […] It is recommended that the mother wash her hands with hot, soapy water before contact with the infant and especially after contact with any herpetic lesions. […] If not able to breastfeed because of active herpetic lesions that cannot be covered sufficiently then it is recommended that the mother feed on the unaffected breast if able, and express milk from the affected breast.

• #2 Herpes Simplex Virus (HSV) Infection in Newborns – Children’s Health Issues – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/children-s-health-issues/infections-in-newborns/herpes-simplex-virus-hsv-infection-in-newborns

  If herpes simplex virus infection of the newborn is not treated, it usually progresses to severe problems. The infection is fatal in approximately 85% of babies with untreated widespread infection and in approximately 50% of newborns with untreated brain infection. […] Appropriate treatment with antiviral medications decreases the fatality rate and significantly increases the likelihood of normal development. […] If pregnant people have active genital herpes lesions or symptoms that indicate the infection is going to become active (such as tingling, discomfort, or itching) at the time of delivery, cesarean delivery (c-section) is recommended to decrease the risk of transmitting the infection to the newborn.

• #2 Birth-Acquired Herpes: Causes, Symptoms, Picture, and Prevention

  https://www.healthline.com/health/birth-acquired-herpes

  If you’re pregnant and you or your partner have herpes or have had it in the past, discuss your situation with your doctor well before your due date. […] You may also be able to have a cesarean delivery if you have active genital lesions. A cesarean delivery can lower the risk of passing herpes on to your baby. […] Babies with systemic herpes infections may not even respond to treatment and can possibly face several additional health risks. Disseminated birth-acquired herpes may be life-threatening and can cause neurological problems or coma.

• #2 Neonatal herpes – Don’t Forget the Bubbles

  https://dontforgetthebubbles.com/neonatal-herpes/

  If positive, the duration of aciclovir treatment is generally 14 days in SEM and at least 21 days in disseminated or CNS disease. […] After treatment, it is important to ensure adequate follow-up, especially in cases of CNS disease and/or disseminated disease, as morbidity can be significant. […] Neonatal herpes is rare, but its consequences can be devastating; awareness of the disease and its varying presentations, and testing when you suspect it, is therefore essential.

• #2 Neonatal herpes information and advice | Kit Tarka Foundation

  https://www.kittarkafoundation.org/neonatal-herpes-info-and-advice

  Neonatal herpes simplex virus (HSV) disease, also called 'neonatal herpes’ or 'neonatal HSV’, is a rare, but potentially fatal, disease which usually occurs in the first four weeks of a baby’s life. […] Early recognition and treatment of the virus has been shown to significantly improve babies’ chances of making a full recovery. […] In young babies who have immature immune systems; HSV infections can spread rapidly if left untreated, causing irreversible cell damage which can lead to permanent disability or death. […] Early recognition and prompt treatment with antiviral medication is essential to save the baby’s life. Even if treated, a baby may suffer permanent brain damage or die. […] Signs of infection in a baby include lethargy/extreme tiredness, irritability, high-pitched or abnormal cry, poor feeding, abnormally high or low temperature, floppiness, grunting or difficulty breathing, and rash or sores on the skin, eye or inside the mouth.

• #2 Neonatal Herpes: When a Baby Catches the Infection

  https://flo.health/being-a-mom/your-baby/baby-health-and-safety/neonatal-herpes

  To protect yourself and your baby, you may want to take some of the following steps: Let your doctor know if you have a history of genital herpes. Get yourself familiar with the symptoms of HSV and neonatal herpes. Refrain from kissing your baby if you have cold sores or ulcers. Wash your hands before feeding your baby. Stop breastfeeding your baby if you notice the symptoms of HSV around your breasts. Consult your pediatrician for an alternative way of feeding your baby if necessary. […] The majority of women with active HSV infection during the six weeks before birth undergo a cesarean section. Medical experts consider this procedure the safest way to prevent spreading the infection. […] In many cases, neonatal herpes doesnt show any symptoms. Neither infected babies nor their mothers show neonatal herpes symptoms during the first stage of the disease. The best tactic might be to get yourself familiar with the disease and do necessary exams if you notice something unusual. You may want to combine your knowledge and intuition to take proper action so you can feel confident that you are doing your best to take care of your child.

• #3 #26: Neonatal HSV – Plain and Simplex – The Curbsiders

  https://thecurbsiders.com/cribsiders-podcast/26

  There are three well defined manifestations of postnatal HSV: mucocutaneous disease (Skin, eye, mouth disease), encephalitis, and disseminated HSV disease. […] HSV infection is treated with 20mg/kg acyclovir IV every 8 hours. For SEM disease, treatment course is 14 days. For disseminated disease or meningoencephalitis, treat for 21 days. […] The consequences of perinatal HSV can be devastating. It is important to be vigilant for these infections. […] The first 30 days of life are a uniquely vulnerable time as neonates have a developing immune system. Neonates exposed to HSV during the first 30 days of life are at high risk of developing infection, however the infection acquired at this time can present up to about 6 weeks of age. […] If the pregnant patient has active lesions at the time of delivery, this is an indication for c-section for both primary and recurrent infection. The risk for vertical transmission of HSV is about 40-60% in primary infections and <5% in recurrent infection with active lesions.

• #3 Neonatal herpes information and advice | Kit Tarka Foundation

  https://www.kittarkafoundation.org/neonatal-herpes-info-and-advice

  Neonatal herpes simplex virus (HSV) disease, also called 'neonatal herpes’ or 'neonatal HSV’, is a rare, but potentially fatal, disease which usually occurs in the first four weeks of a baby’s life. […] Early recognition and treatment of the virus has been shown to significantly improve babies’ chances of making a full recovery. […] In young babies who have immature immune systems; HSV infections can spread rapidly if left untreated, causing irreversible cell damage which can lead to permanent disability or death. […] Early recognition and prompt treatment with antiviral medication is essential to save the baby’s life. Even if treated, a baby may suffer permanent brain damage or die. […] Signs of infection in a baby include lethargy/extreme tiredness, irritability, high-pitched or abnormal cry, poor feeding, abnormally high or low temperature, floppiness, grunting or difficulty breathing, and rash or sores on the skin, eye or inside the mouth.

• #3 Neonatal Herpes Simplex Virus Infections | AAFP

  https://www.aafp.org/pubs/afp/issues/2002/0315/p1138.html

  The HSV-exposed neonate should be monitored closely for any signs of infection. Initial cultures should be performed at 24 to 48 hours, then weekly cultures of conjunctiva, nose, mouth, urine and rectum for HSV-1 or HSV-2 have been suggested. […] Any exposed infant with clinical signs of HSV should be cultured (conjunctiva, nose, mouth, urine, rectum, CSF, blood buffy coat), CSF should be sent for PCR analysis, and the infant should be immediately started on intravenous acyclovir therapy. […] Infants born to women with active genital HSV lesions should be managed with contact precautions and be kept in a private room.

• #3 Neonatal herpes – Don’t Forget the Bubbles

  https://dontforgetthebubbles.com/neonatal-herpes/

  If positive, the duration of aciclovir treatment is generally 14 days in SEM and at least 21 days in disseminated or CNS disease. […] After treatment, it is important to ensure adequate follow-up, especially in cases of CNS disease and/or disseminated disease, as morbidity can be significant. […] Neonatal herpes is rare, but its consequences can be devastating; awareness of the disease and its varying presentations, and testing when you suspect it, is therefore essential.

• #3 Neonatal Herpes Encephalitis | ABC Law Centers: Birth Injury Lawyers

  https://www.abclawcenters.com/practice-areas/neonatal-herpes-encephalitis/

  Herpes simplex virus (HSV) can cause two types of infection, HSV-1–the common cause of cold sores–or HSV-2, more commonly known as genital herpes. When a pregnant person has either type of infection, their baby is also at risk for infection. […] Failure to take the necessary precautions to prevent neonatal herpes is negligence and can have devastating effects on the baby, including neonatal herpes encephalitis, which can result in permanent brain damage. […] Most neonatal infections result from exposure to HSV in the birth parent’s genital tract during birth, although occasionally the baby may become infected earlier in pregnancy or after birth. […] If neonatal herpes is suspected, doctors should look for: irritability, lethargy, respiratory problems (e.g. grunting, rapid breathing, apnea), feeding problems, blue appearance (Cyanosis), yellowing of skin and eyes (Jaundice), bleeding easily, fever, soft spot protruding from the baby’s head (Bulging fontanelle), abnormal movements/positioning, seizures, hepatitis, pneumonia, disseminated intravascular coagulation (DIC).