Materiały źródłowe

• #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 and initiation of treatment is imperative. Early initiation of therapy prevents further disease progression. […] 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, was licensed for use against herpes virus infections and quickly became the drug of choice for treatment of neonatal HSV disease due to its more favorable toxicity profile. […] Duration of therapy with intravenous acyclovir is determined by the disease classification. Infants with SEM disease are treated for a total of 14 days with intravenous acyclovir, whereas infants with CNS or disseminated disease are treated with at least 21 days of therapy. […] After completion of the recommended 14- or 21-day treatment course with intravenous acyclovir, patients are transitioned to oral acyclovir to complete a 6-month course of suppressive therapy. […] Currently, acyclovir is the only recommended antiviral agent for treatment of neonatal HSV disease.

• #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. […] Early recognition and prompt treatment with antiviral medication is essential to save the baby’s life. […] An antiviral medication is administered into the baby’s blood stream (intravenously) typically for 14-21 days. […] The most commonly used medication is called acyclovir. […] 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.

• #3 Neonatal herpes (Neonatal HSV) | Bliss

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

  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. […] An antiviral medication is given by injection into a medical drip (a thin tube inserted into a vein), typically for 14-21 days, although some babies may require longer treatment. The most commonly used medication is called 'acyclovir (pronounced assey-clove-eeyer). […] Treatment must be given promptly in order to be successful. Babies who are not given antiviral medication quickly may become extremely unwell. […] Many babies make a full recovery but, even with treatment, if the infection has spread to the baby’s organs it may result in permanent disability or death.

• #4 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 and initiation of treatment is imperative. Early initiation of therapy prevents further disease progression. […] 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, was licensed for use against herpes virus infections and quickly became the drug of choice for treatment of neonatal HSV disease due to its more favorable toxicity profile. […] Duration of therapy with intravenous acyclovir is determined by the disease classification. Infants with SEM disease are treated for a total of 14 days with intravenous acyclovir, whereas infants with CNS or disseminated disease are treated with at least 21 days of therapy. […] After completion of the recommended 14- or 21-day treatment course with intravenous acyclovir, patients are transitioned to oral acyclovir to complete a 6-month course of suppressive therapy. […] Currently, acyclovir is the only recommended antiviral agent for treatment of neonatal HSV disease.

• #5 Congenital Herpes Simplex – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507897/

  Congenital herpes simplex is a rare but potentially devastating viral infection that occurs in newborns and is transmitted from mother to baby during childbirth. […] The most common treatment for congenital HSV infection is parenteral acyclovir, which should be administered to all neonates with HSV disease, regardless of the specific manifestations and clinical findings. […] Parenteral acyclovir is the standard of care in treating congenital HSV infection. This treatment should be administered to all neonates with HSV disease, regardless of the specific manifestations and clinical findings. The recommended dosage of acyclovir is 60 mg/kg per day in 3 divided doses (ie, 20 mg/kg per dose); however, the duration of treatment depends on the type of HSV present. For infants with SEM disease, acyclovir should be given intravenously for 14 days. Infants with CNS disease or disseminated disease should be given acyclovir intravenously for a minimum of 21 days. […] Oral acyclovir suppressive therapy for the 6 months following treatment of acute congenital HSV disease improves neurodevelopmental outcomes in infants with HSV CNS disease and prevents skin recurrences in infants with any disease classification of congenital HSV.

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

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

  Intravenous acyclovir is the treatment of choice for treating NHSV. The dose is 60 mg/kg/day in three divided doses administered every 8 h, assuming that renal function is normal. The duration of therapy is dictated by the category of disease. For SEM disease, the duration of therapy is 14 days, while for disseminated or CNS disease, the minimum duration of treatment is 21 days. Oral ACV has limited bioavailability, resulting in inadequate drug levels for treatment; consequently, parenteral therapy is required. […] 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. […] For infants with CNS disease, CSF should be sampled near the end of a 21-day course of therapy. If the PCR remains positive, treatment should be extended with weekly CSF sampling and ACV stopped when a negative result is obtained. […] Suppressive therapy with oral ACV (300 mg/m2 per dose administered three times per day) should be given for six months to infants with CNS disease. Data are less convincing for SEM or disseminated disease, but suppressive therapy may still be offered.

• #7 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. […] All primary episodes of HSV and secondary episodes near term or at the time of delivery should be treated with antiviral therapy. […] If active HSV infection is present at the time of delivery, cesarean section should be performed. […] All newborns suspected to have or who are diagnosed with HSV infection should be treated with parenteral acyclovir. […] All primary episodes of genital HSV infections should be treated with antiviral medications, including primary episodes occurring in pregnant women. […] Acyclovir should be given to all pregnant women with active genital HSV infection near term or at the time of delivery. […] All infants suspected to have or who are diagnosed with an HSV infection should be treated with parenteral antiviral therapy. The duration of disease before antiviral therapy is initiated is significantly correlated with morbidity and mortality. Currently, suggested therapy is acyclovir 60 mg per kg per day in three divided doses intravenously for 14 days for disease limited to skin, eyes and mucous membranes, and 21 days for central nervous system or disseminated disease.

• #8 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. […] All primary episodes of HSV and secondary episodes near term or at the time of delivery should be treated with antiviral therapy. […] If active HSV infection is present at the time of delivery, cesarean section should be performed. […] All newborns suspected to have or who are diagnosed with HSV infection should be treated with parenteral acyclovir. […] All primary episodes of genital HSV infections should be treated with antiviral medications, including primary episodes occurring in pregnant women. […] Acyclovir should be given to all pregnant women with active genital HSV infection near term or at the time of delivery. […] All infants suspected to have or who are diagnosed with an HSV infection should be treated with parenteral antiviral therapy. The duration of disease before antiviral therapy is initiated is significantly correlated with morbidity and mortality. Currently, suggested therapy is acyclovir 60 mg per kg per day in three divided doses intravenously for 14 days for disease limited to skin, eyes and mucous membranes, and 21 days for central nervous system or disseminated disease.

• #9 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

  Neonatal herpes simplex virus infection is usually transmitted during delivery. Treatment is with high-dose parenteral acyclovir and supportive care. […] Acyclovir should be started immediately and presumptively in suspected cases while awaiting confirmatory diagnostic tests. Infants with disseminated and/or CNS disease are given acyclovir for 21 days. After this regimen, infants with any form of HSV disease are given oral acyclovir for 6 months; this long-term regimen improves neurodevelopmental outcomes at 1 year of age but may cause neutropenia. […] For localized disease (skin, mouth, or conjunctivae), treatment is acyclovir for 14 days. […] Give parenteral acyclovir for both localized and disseminated disease.

• #10 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. Urgent treatment is necessary. […] Prompt treatment gives your baby the best chance at a good outcome. […] If healthcare providers suspect your baby has neonatal herpes, its 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, theyll need IV treatment for 14 days. Then, theyll complete a six-month course of oral medication. […] If your baby has central nervous system (CNS) or disseminated disease, theyll need IV treatment for 21 days. After completing IV treatment, your baby will need to take oral medications for six months.

• #11 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

  Neonatal herpes simplex virus infection is usually transmitted during delivery. Treatment is with high-dose parenteral acyclovir and supportive care. […] Acyclovir should be started immediately and presumptively in suspected cases while awaiting confirmatory diagnostic tests. Infants with disseminated and/or CNS disease are given acyclovir for 21 days. After this regimen, infants with any form of HSV disease are given oral acyclovir for 6 months; this long-term regimen improves neurodevelopmental outcomes at 1 year of age but may cause neutropenia. […] For localized disease (skin, mouth, or conjunctivae), treatment is acyclovir for 14 days. […] Give parenteral acyclovir for both localized and disseminated disease.

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

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

  Intravenous acyclovir is the treatment of choice for treating NHSV. The dose is 60 mg/kg/day in three divided doses administered every 8 h, assuming that renal function is normal. The duration of therapy is dictated by the category of disease. For SEM disease, the duration of therapy is 14 days, while for disseminated or CNS disease, the minimum duration of treatment is 21 days. Oral ACV has limited bioavailability, resulting in inadequate drug levels for treatment; consequently, parenteral therapy is required. […] 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. […] For infants with CNS disease, CSF should be sampled near the end of a 21-day course of therapy. If the PCR remains positive, treatment should be extended with weekly CSF sampling and ACV stopped when a negative result is obtained. […] Suppressive therapy with oral ACV (300 mg/m2 per dose administered three times per day) should be given for six months to infants with CNS disease. Data are less convincing for SEM or disseminated disease, but suppressive therapy may still be offered.

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

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

  Its important to know that some babies with CNS involvement need IV treatment for longer than 21 days. […] Neonatal herpes is a serious condition because it can harm your babys organs, including their brain. […] The sooner your baby gets treatment, the better their chances of survival and of recovery with minimal or no long-term effects.

• #14 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 and initiation of treatment is imperative. Early initiation of therapy prevents further disease progression. […] 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, was licensed for use against herpes virus infections and quickly became the drug of choice for treatment of neonatal HSV disease due to its more favorable toxicity profile. […] Duration of therapy with intravenous acyclovir is determined by the disease classification. Infants with SEM disease are treated for a total of 14 days with intravenous acyclovir, whereas infants with CNS or disseminated disease are treated with at least 21 days of therapy. […] After completion of the recommended 14- or 21-day treatment course with intravenous acyclovir, patients are transitioned to oral acyclovir to complete a 6-month course of suppressive therapy. […] Currently, acyclovir is the only recommended antiviral agent for treatment of neonatal HSV disease.

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

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

  Intravenous acyclovir is the treatment of choice for treating NHSV. The dose is 60 mg/kg/day in three divided doses administered every 8 h, assuming that renal function is normal. The duration of therapy is dictated by the category of disease. For SEM disease, the duration of therapy is 14 days, while for disseminated or CNS disease, the minimum duration of treatment is 21 days. Oral ACV has limited bioavailability, resulting in inadequate drug levels for treatment; consequently, parenteral therapy is required. […] 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. […] For infants with CNS disease, CSF should be sampled near the end of a 21-day course of therapy. If the PCR remains positive, treatment should be extended with weekly CSF sampling and ACV stopped when a negative result is obtained. […] Suppressive therapy with oral ACV (300 mg/m2 per dose administered three times per day) should be given for six months to infants with CNS disease. Data are less convincing for SEM or disseminated disease, but suppressive therapy may still be offered.

• #16 Congenital Herpes Simplex – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507897/

  Congenital herpes simplex is a rare but potentially devastating viral infection that occurs in newborns and is transmitted from mother to baby during childbirth. […] The most common treatment for congenital HSV infection is parenteral acyclovir, which should be administered to all neonates with HSV disease, regardless of the specific manifestations and clinical findings. […] Parenteral acyclovir is the standard of care in treating congenital HSV infection. This treatment should be administered to all neonates with HSV disease, regardless of the specific manifestations and clinical findings. The recommended dosage of acyclovir is 60 mg/kg per day in 3 divided doses (ie, 20 mg/kg per dose); however, the duration of treatment depends on the type of HSV present. For infants with SEM disease, acyclovir should be given intravenously for 14 days. Infants with CNS disease or disseminated disease should be given acyclovir intravenously for a minimum of 21 days. […] Oral acyclovir suppressive therapy for the 6 months following treatment of acute congenital HSV disease improves neurodevelopmental outcomes in infants with HSV CNS disease and prevents skin recurrences in infants with any disease classification of congenital HSV.

• #17 Improving Neurodevelopmental Outcomes After Neonatal Herpes Simplex Virus Infection | Journal of Perinatology

  https://www.nature.com/articles/7211236

  Approximately 1500 newborns acquire herpes simplex virus (HSV) infections annually. […] Over the past 20 years, the evolution of antiviral therapy (vidarabine to high-dose acyclovir) and the use of polymerase chain reaction (PCR) to detect HSV DNA have greatly improved our ability to diagnose and manage neonatal herpes infections. […] In this issue of the Journal, Tiffany et al. describe favorable neurodevelopmental outcomes in a small cohort of infants receiving long-term, high-dose acyclovir after initial treatment for either disseminated or CNS HSV infection. […] The current study extends the rationale for long-term suppression by quantifying improved neurological outcome in patients with the most severe forms of neonatal HSV. […] Should we institute suppressive acyclovir therapy routinely after the standard 14- or 21-day treatment course for neonatal HSV?

• #18 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

  Newborns with herpes simplex virus infection are given the antiviral medication acyclovir.Newborns with herpes simplex virus infection are given the antiviral medication acyclovir. […] Newborns who have a widespread infection are given the antiviral medication acyclovir by vein (intravenously) for 3 weeks and then by mouth for 6 months. Newborns who have a localized infection are given acyclovir intravenously for 2 weeks. This medication does not cure the infection but helps keep it from spreading and limits the symptoms. […] Eye infections also are treated with eye drops that contain another antiviral medication called trifluridine or with an eye gel that contains another antiviral medication called ganciclovir.Eye infections also are treated with eye drops that contain another antiviral medication called trifluridine or with an eye gel that contains another antiviral medication called ganciclovir. […] Appropriate treatment with antiviral medications decreases the fatality rate and significantly increases the likelihood of normal development.

• #19 Neonatal Herpes Simplex Virus Disease | Infectious Diseases Management Program at UCSF

  https://idmp.ucsf.edu/content/neonatal-herpes-simplex-virus-disease

  Neonatal herpes simplex disease – disseminated, CNS/encephalitis, or mucocutaneous (skin/eye/mouth) (including young infants 3 months old) […] Acyclovir 20 mg/kg/dose IV q8h […] All infants with neonatal HSV disease should receive suppressive therapy following completion of above treatment course, for a minimum 6 months: […] Acyclovir 300 mg/m2/dose enterally tid […] All infants with suspected or proven neonatal HSV disease should have a full evaluation with LP, CSF HSV PCR, plasma HSV PCR, cultures or PCR of conjunctivae, mouth, nasopharynx, and rectum […] Ocular HSV requires addition of topical antivirals (trifluridine or ganciclovir gel) and ophthalmology co-management […] Duration: Skin/eye/mouth disease: 14 days […] CNS disease: Minimum of 21 days (repeat LP near end of therapy, duration extended if HSV still detected in CSF) […] Disseminated disease: 21 days.

• #20 Neonatal Herpes Simplex Virus Disease | Infectious Diseases Management Program at UCSF

  https://idmp.ucsf.edu/content/neonatal-herpes-simplex-virus-disease

  Neonatal herpes simplex disease – disseminated, CNS/encephalitis, or mucocutaneous (skin/eye/mouth) (including young infants 3 months old) […] Acyclovir 20 mg/kg/dose IV q8h […] All infants with neonatal HSV disease should receive suppressive therapy following completion of above treatment course, for a minimum 6 months: […] Acyclovir 300 mg/m2/dose enterally tid […] All infants with suspected or proven neonatal HSV disease should have a full evaluation with LP, CSF HSV PCR, plasma HSV PCR, cultures or PCR of conjunctivae, mouth, nasopharynx, and rectum […] Ocular HSV requires addition of topical antivirals (trifluridine or ganciclovir gel) and ophthalmology co-management […] Duration: Skin/eye/mouth disease: 14 days […] CNS disease: Minimum of 21 days (repeat LP near end of therapy, duration extended if HSV still detected in CSF) […] Disseminated disease: 21 days.

• #21 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.

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

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

  In addition to antiviral medications, supportive care is essential in treating neonatal herpes simplex infections. They may include providing fluids, nutrition, antibiotics, and oxygen therapy. In severe cases, babies may require hospitalization, intravenous fluids, and mechanical ventilation if needed.

• #23 Pediatric Herpes Simplex Virus Infections: An Evidence-Based Approach To Treatment

  https://www.ebmedicine.net/topics/infectious-disease/pediatric-herpes

  Herpes simplex virus is a common virus that causes a variety of clinical presentations ranging from mild to life-threatening. […] Neonatal herpes is a rare disorder, but prompt recognition and initiation of antiviral therapy is imperative, as the morbidity and mortality of the disease is high. […] The presence of pustules on an infant does not necessarily mean the patient has HSV. […] If suspicion is high for neonatal herpes infection, infants require the following testing: (1) CSF for indices; (2) HSV PCR and bacterial culture; (3) viral culture swabs from the base of any vesicles as well as swabs from the mouth, conjunctiva, nasopharynx, and rectum; (4) HSV PCR on whole blood; and (5) LFTs. […] Elevation of serum aspartate transaminase levels 10 times normal have been associated with increased mortality in neonates with disseminated herpes.

• #24 Fifteen minute consultation: Managing neonatal and childhood herpes encephalitis | ADC Education & Practice Edition

  https://ep.bmj.com/content/100/2/58

  Herpes simplex encephalitis (HSE) is the most common single cause of viral encephalitis in infants and children. Treated or untreated, it can be associated with considerable morbidity and mortality, and its presentation is usually insidious and non-specific. […] A term baby presented on day 15 of life with poor feeding, fever and lethargy. His transaminases were raised and there was disseminated intravascular coagulation. High-dose intravenous cefotaxime and intravenous aciclovir (20mg/m2 TDS) were initiated immediately. […] High-dose intravenous aciclovir is most effective when started early. Following disease relapses in early aciclovir studies in neonates, the standard of care became high-dose intravenous aciclovir given for 21 days for neonatal HSE. […] Prophylaxis with aciclovir has been shown to reduce HSV relapse. While 12 months of antiviral prophylaxis is adequate for some children following neonatal HSE, late central or dermal flares may indicate that longer-term or even lifelong prophylaxis may be required.

• #25 Efficacy of Antiviral Suppression Therapy After Neonatal HSV Infection of the Central Nervous System | Pediatric Trials Network

  https://pediatrictrials.org/efficacy-of-antiviral-suppression-therapy-after-neonatal-hsv-infection-of-the-central-nervous-system/

  Neonatal herpes simplex virus (HSV) occurs in 1 in 3000 births in the United States. It most often results from exposure at delivery and can manifest as: 1) disseminated disease (25%); 2) central nervous system (CNS, 30%) disease; or 3) skin, eye, mouth (SEM, 45%) disease. Untreated neonatal HSV carries a mortality rate of 6080%. […] Institution of high-dose acyclovir therapy (60 mg/kg/day) for 21 days has reduced neonatal HSV mortality from 57% to 31% for disseminated disease and from 20% to 614% for CNS disease. […] Despite the common use of high-dose acyclovir in infants admitted to the neonatal intensive care unit, safety, efficacy and pharmacokinetic (PK) studies to define optimal dosing are lacking. […] To provide the FDA with additional safety data to support labeling of high-dose acyclovir for the treatment of neonatal HSV, we will assess the safety of high-dose acyclovir in infants with HSV via a review of the Pediatrix Medical Group database and a retrospective chart review of infants with HSV treated at 3 medical centers.

• #26 Herpes in a baby (neonatal herpes) | nidirect

  https://www.nidirect.gov.uk/conditions/herpes-baby-neonatal-herpes

  Neonatal herpes is usually treated with antiviral drugs given directly into the baby’s vein (intravenously). This treatment may be needed for several weeks. […] Any related complications, such as fits (seizures), will also need to be treated. […] The baby can be breastfed while receiving treatment, unless the mother has herpes sores around her nipples. […] Sometimes neonatal herpes will only affect the baby’s eyes, mouth or skin. […] In these cases, most babies will make a complete recovery with antiviral treatment. […] But the condition is much more serious if it’s spread to the baby’s organs. Nearly a third of infants with this type of neonatal herpes will die, even after they have been treated. […] If widespread herpes isn’t treated immediately, there’s a high chance the baby will die.

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

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

  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. […] Following the initial acyclovir therapy, infants may need additional oral acyclovir suppressive therapy for six months. […] When treated promptly, babies with HSV have very good outcomes. […] Antiviral treatment has also improved outcomes for surviving neonates with disseminated herpes. Surviving infants have an 80% chance of normal brain development as opposed to the 50% chance they had before wide-spread antiviral treatment.

• #28

  https://111.wales.nhs.uk/encyclopaedia/n/article/neonatalherpes

  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. […] Neonatal herpes is usually treated with antiviral medicines given directly into the baby’s vein (intravenously). This treatment may be needed for several weeks. […] Any related complications, such as fits (seizures), will also need to be treated. […] Sometimes neonatal herpes will only affect the baby’s eyes, mouth or skin. In these cases, most babies will make a complete recovery with antiviral treatment. […] But the condition is much more serious if it has spread to the baby’s organs. Many infants with this type of neonatal herpes will die, even after they have been treated. […] If widespread herpes is not treated immediately, there’s a high chance the baby will die.

• #29 Neonatal herpes (Neonatal HSV) | Bliss

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

  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. […] An antiviral medication is given by injection into a medical drip (a thin tube inserted into a vein), typically for 14-21 days, although some babies may require longer treatment. The most commonly used medication is called 'acyclovir (pronounced assey-clove-eeyer). […] Treatment must be given promptly in order to be successful. Babies who are not given antiviral medication quickly may become extremely unwell. […] Many babies make a full recovery but, even with treatment, if the infection has spread to the baby’s organs it may result in permanent disability or death.

• #30 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. […] Early recognition and prompt treatment with antiviral medication is essential to save the baby’s life. […] An antiviral medication is administered into the baby’s blood stream (intravenously) typically for 14-21 days. […] The most commonly used medication is called acyclovir. […] 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.

• #31 Neonatal Herpes Simplex Virus Infections | AAFP

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

  Prophylactic acyclovir should be considered in the third trimester for women at especially high risk of having an active HSV infection at the time of labor. […] Antiviral therapy with acyclovir should be given to pregnant women who have a primary episode of genital HSV. […] 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.

• #32 Neonatal Herpes Simplex Virus Infections | AAFP

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

  Prophylactic acyclovir should be considered in the third trimester for women at especially high risk of having an active HSV infection at the time of labor. […] Antiviral therapy with acyclovir should be given to pregnant women who have a primary episode of genital HSV. […] 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.

• #33 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. […] All primary episodes of HSV and secondary episodes near term or at the time of delivery should be treated with antiviral therapy. […] If active HSV infection is present at the time of delivery, cesarean section should be performed. […] All newborns suspected to have or who are diagnosed with HSV infection should be treated with parenteral acyclovir. […] All primary episodes of genital HSV infections should be treated with antiviral medications, including primary episodes occurring in pregnant women. […] Acyclovir should be given to all pregnant women with active genital HSV infection near term or at the time of delivery. […] All infants suspected to have or who are diagnosed with an HSV infection should be treated with parenteral antiviral therapy. The duration of disease before antiviral therapy is initiated is significantly correlated with morbidity and mortality. Currently, suggested therapy is acyclovir 60 mg per kg per day in three divided doses intravenously for 14 days for disease limited to skin, eyes and mucous membranes, and 21 days for central nervous system or disseminated disease.

• #34 Neonatal Herpes Simplex Virus Infections | AAFP

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

  Prophylactic acyclovir should be considered in the third trimester for women at especially high risk of having an active HSV infection at the time of labor. […] Antiviral therapy with acyclovir should be given to pregnant women who have a primary episode of genital HSV. […] 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.

• #35 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. […] All primary episodes of HSV and secondary episodes near term or at the time of delivery should be treated with antiviral therapy. […] If active HSV infection is present at the time of delivery, cesarean section should be performed. […] All newborns suspected to have or who are diagnosed with HSV infection should be treated with parenteral acyclovir. […] All primary episodes of genital HSV infections should be treated with antiviral medications, including primary episodes occurring in pregnant women. […] Acyclovir should be given to all pregnant women with active genital HSV infection near term or at the time of delivery. […] All infants suspected to have or who are diagnosed with an HSV infection should be treated with parenteral antiviral therapy. The duration of disease before antiviral therapy is initiated is significantly correlated with morbidity and mortality. Currently, suggested therapy is acyclovir 60 mg per kg per day in three divided doses intravenously for 14 days for disease limited to skin, eyes and mucous membranes, and 21 days for central nervous system or disseminated disease.

• #36 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. […] Reductions in morbidity and mortality are due to the use of antiviral treatments such as vidarabine and acyclovir. However, morbidity and mortality still remain high due to diagnosis of DIS and CNS herpes coming too late for effective antiviral administration; early diagnosis is difficult in the 20-40% of infected neonates that have no visible lesions. […] Harrison’s Principles of Internal Medicine recommends that pregnant women with active genital herpes lesions at the time of labor be delivered by caesarean section. Women whose herpes is not active can be managed with acyclovir. The current practice is to deliver women with primary or first episode non-primary infection via caesarean section, and those with recurrent infection vaginally (even in the presence of lesions) because of the low risk (13%) of vertical transmission associated with recurrent herpes.

• #37 Neonatal herpes (herpes in a baby)

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

  Neonatal herpes is usually treated with antiviral medicines given directly into the baby’s vein (intravenously). […] This treatment may be needed for several weeks. […] Any related complications, such as fits (seizures), will also need to be treated. […] You can breastfeed your baby while they’re receiving treatment, unless you have herpes sores around your nipples. […] If you are taking antiviral treatment too, this can be excreted in your breast milk, but is not thought to cause any harm to your baby. […] Sometimes neonatal herpes will only affect the baby’s eyes, mouth or skin. […] In these cases, most babies will make a complete recovery with antiviral treatment. […] But the condition is much more serious if it has spread to the baby’s organs. […] Many infants with this type of neonatal herpes will die, even after they have been treated. […] If widespread herpes is not treated immediately, there’s a high chance the baby will die.

• #38 Herpes in a baby (neonatal herpes) | nidirect

  https://www.nidirect.gov.uk/conditions/herpes-baby-neonatal-herpes

  Neonatal herpes is usually treated with antiviral drugs given directly into the baby’s vein (intravenously). This treatment may be needed for several weeks. […] Any related complications, such as fits (seizures), will also need to be treated. […] The baby can be breastfed while receiving treatment, unless the mother has herpes sores around her nipples. […] Sometimes neonatal herpes will only affect the baby’s eyes, mouth or skin. […] In these cases, most babies will make a complete recovery with antiviral treatment. […] But the condition is much more serious if it’s spread to the baby’s organs. Nearly a third of infants with this type of neonatal herpes will die, even after they have been treated. […] If widespread herpes isn’t treated immediately, there’s a high chance the baby will die.

• #39 Neonatal herpes (herpes in a baby)

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

  Neonatal herpes is usually treated with antiviral medicines given directly into the baby’s vein (intravenously). […] This treatment may be needed for several weeks. […] Any related complications, such as fits (seizures), will also need to be treated. […] You can breastfeed your baby while they’re receiving treatment, unless you have herpes sores around your nipples. […] If you are taking antiviral treatment too, this can be excreted in your breast milk, but is not thought to cause any harm to your baby. […] Sometimes neonatal herpes will only affect the baby’s eyes, mouth or skin. […] In these cases, most babies will make a complete recovery with antiviral treatment. […] But the condition is much more serious if it has spread to the baby’s organs. […] Many infants with this type of neonatal herpes will die, even after they have been treated. […] If widespread herpes is not treated immediately, there’s a high chance the baby will die.

• #40 Neonatal herpes (herpes in a baby) | NICS Well

  https://www.nicswell.co.uk/conditions-and-treatments/neonatal-herpes-herpes-in-a-baby

  Neonatal herpes is usually treated with antiviral drugs given directly into the baby’s vein (intravenously). […] This treatment may be needed for several weeks. […] Any related complications, such as fits (seizures), will also need to be treated. […] The baby can be breastfed while receiving treatment, unless the mother has herpes sores around her nipples. […] If the mother is taking antiviral treatment too, this can be excreted in her breast milk, but is not thought to cause any harm to the baby. […] Sometimes neonatal herpes will only affect the baby’s eyes, mouth or skin. […] In these cases, most babies will make a complete recovery with antiviral treatment. […] But the condition is much more serious if it’s spread to the baby’s organs. […] Nearly a third of infants with this type of neonatal herpes will die, even after they have been treated. […] If widespread herpes is not treated immediately, there’s a high chance the baby will die.

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

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

  If a mom presents to Labor and Delivery in labor or for a scheduled induction, we will do a thorough examination of the perineum to look for lesions and a speculum exam to look for lesions on the cervix. […] To reduce the risk of having an outbreak near delivery, we prescribe antiviral medications such as acyclovir (Valtrex) to pregnant women who have a history of herpes, starting around 36 weeks. […] After delivery, your pediatrician may order extra testing on the newborn. If the baby is thought to be at extremely high risk for HSV infection, we test the blood right away for evidence of viral infection, and we may consider treating the baby with antiviral medications even before the results of those tests are reported. […] Whether or not you have herpes yourself, insist that everyone who wants to hold or touch your newborn wash their hands first. […] Do not allow anyone with a cold sore, or anyone who you know has had a cold sore in the previous week, to hold or kiss your baby. […] Once people are infected with herpes, they’re infected for life, even when symptoms aren’t present.

• #42 Facts on having genital herpes HSV-2 during pregnancy and while parenting

  https://www.herpes.org.nz/living-with-herpes/pregnancy-and-parenting

  If a pregnant person gets a new genital HSV infection during the last 6 weeks of pregnancy, a caesarean delivery is recommended, even if no outbreak is present, as there is a greater than 50% risk of neonatal HSV. […] Due to the potential seriousness of a primary episode of genital herpes for the baby and the relative safety of valaciclovir/aciclovir, it is now recommended that valaciclovir/aciclovir are used for treating a first episode of genital herpes or severe recurrent herpes in the last trimester of pregnancy. It is believed that the benefit of using these antivirals, by reducing the risk of transmission of herpes to the baby, outweighs the risk of not using it. […] HSV can cause neonatal herpes (babies up to 28 days old, infected by herpes), a rare but life-threatening infection. Neonatal herpes can cause eye or throat infections, damage to the central nervous system, mental retardation, or death. Medication may help prevent or reduce lasting damage if it is given early. […] The best way to protect your baby from neonatal herpes is to prevent contracting genital HSV during late pregnancy, especially during the last 6 weeks.

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

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

  If a mom presents to Labor and Delivery in labor or for a scheduled induction, we will do a thorough examination of the perineum to look for lesions and a speculum exam to look for lesions on the cervix. […] To reduce the risk of having an outbreak near delivery, we prescribe antiviral medications such as acyclovir (Valtrex) to pregnant women who have a history of herpes, starting around 36 weeks. […] After delivery, your pediatrician may order extra testing on the newborn. If the baby is thought to be at extremely high risk for HSV infection, we test the blood right away for evidence of viral infection, and we may consider treating the baby with antiviral medications even before the results of those tests are reported. […] Whether or not you have herpes yourself, insist that everyone who wants to hold or touch your newborn wash their hands first. […] Do not allow anyone with a cold sore, or anyone who you know has had a cold sore in the previous week, to hold or kiss your baby. […] Once people are infected with herpes, they’re infected for life, even when symptoms aren’t present.

• #44 Reddit – The heart of the internet

  https://www.reddit.com/r/NewParents/comments/16m0g5u/i_gave_my_baby_daughter_herpes_hsv1_by_kissing/

  They told us that she will need at least a week of IV antiviral as she is too young to take oral antiviral. […] I am also glad that our baby was healthy on seemingly all account prior to this incident because it would likely affect her worse had there been other compromising factors. […] We were discharged from the hospital four days ago and provided with enough oral antiviral medication for one week. […] I do intend on discussing management of the virus with my doctor soon to see what methods may be available, safe, and effective for me in my efforts to reduce the risk of spreading the virus. […] Once infected, the HSV-1 virus remains within the body for life. […] I deeply regret kissing my daughter when I did (while she was a baby and while having sores present on my lips) and where I did (semi-exposed skin), but I did not know that transmission through skin on any part of the body was possible. […] What happened has affected us greatly the last couple of weeks and may continue to affect us, and we do not want others to go through what we have or worse.

• #45 Fifteen minute consultation: Managing neonatal and childhood herpes encephalitis | ADC Education & Practice Edition

  https://ep.bmj.com/content/100/2/58

  In recurrent HSV infection, the risks are less, but if active lesions are present at delivery then delivery by caesarean section may be considered. For vaginally delivered babies, there are little data to guide initiation of aciclovir, and there is variable practice. We would recommend minimising the risk of a devastating illness by treating all infants born to mothers with active lesions. […] HSE is a highly destructive neurotrophic virus; early diagnosis with early and optimal treatment offers the best chance to ameliorate the otherwise poor outcome. In neonates, the outcomes can be particularly severe so in any febrile neonate presenting with possible sepsis, neonatal HSE should be considered; where there are other clues to the diagnosis such as deranged liver function tests or skin lesions, babies should be commenced on aciclovir unless an alternative diagnosis is apparent.

• #46 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

  Continue IV aciclovir for a minimum of 10 days (as in the hypothetical case described). […] If the result of a diagnostic evaluation is positive, continue IV aciclovir for 14 days in SEM disease or at least 21 days in CNS disease or disseminated disease. […] After completion of parenteral therapy for CNS, disseminated, or SEM disease, administer a suppressive course of oral aciclovir at a dose of 300mg/m2/dose three times a day for six months. […] The introduction of aciclovir as an effective non-toxic antiviral treatment in the 1980s has improved the outcome of neonatal HSV and management of high-risk cases awaiting results. […] Although neonatal HSV is a treatable disease, recognition and initiation of treatment can sometimes take time. […] Maternal antiviral medication should be prescribed to treat primary infection in pregnancy.

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