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. […] To improve overall outcome in infants diagnosed with neonatal HSV disease, early diagnosis and initiation of treatment is imperative. Early initiation of therapy prevents further disease progression. […] As a result of the severity of the disease in neonates, measures aimed at preventing transmission have become of great importance. These measures include performing cesarean delivery for mothers with active genital lesions at time of delivery, decreasing contact exposure to persons with active herpes labialis or gingivostomatitis, reducing the use of fetal scalp electrodes, and implementing suppressive therapy in pregnant women with a history of genital herpes.

• #2

  https://www.who.int/news-room/fact-sheets/detail/herpes-simplex-virus

  Neonatal herpes can occur when an infant is exposed to HSV during delivery. Neonatal herpes is rare, occurring in an estimated 10 out of every 100,000 births globally. However, it is a serious condition that can lead to lasting neurologic disability or death. The risk for neonatal herpes is greatest when a mother acquires HSV for the first time in late pregnancy. […] Pregnant women with symptoms of genital herpes should inform their health care providers. Preventing acquisition of HSV-2 infection is particularly important for women in late pregnancy when the risk for neonatal herpes is greatest.

• #3 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. […] To improve overall outcome in infants diagnosed with neonatal HSV disease, early diagnosis and initiation of treatment is imperative. Early initiation of therapy prevents further disease progression. […] As a result of the severity of the disease in neonates, measures aimed at preventing transmission have become of great importance. These measures include performing cesarean delivery for mothers with active genital lesions at time of delivery, decreasing contact exposure to persons with active herpes labialis or gingivostomatitis, reducing the use of fetal scalp electrodes, and implementing suppressive therapy in pregnant women with a history of genital herpes.

• #4 NEONATAL HSV INFECTION

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

  Several factors influence the risk of a newborn acquiring HSV infection, the most important of which is whether the mother has newly acquired or recurrent genital disease. […] The risk is greatest when a previously seronegative woman acquires genital herpes (HSV-1 or HSV-2) at or near the time of delivery. […] High maternal titres of type-specific neutralising antibody are associated with a substantially lower risk and severity of neonatal infection, while risk factors for neonatal infection include the use of invasive obstetric procedures (e.g. foetal scalp electrodes), method of delivery, and prolonged rupture of membranes. […] Anticipatory aciclovir therapy should be started. […] Anticipatory aciclovir therapy can be discontinued if the neonate remains well, HSV PCR and molecular diagnostic testing have not identified HSV, and the CSF studies (including PCR results) are normal.

• #5 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. […] If you’re pregnant and have genital herpes, tell your GP, obstetrician or midwife. They may prescribe an antiviral medicine for you to take in the last month of pregnancy to prevent an outbreak of vaginal sores during labour. […] If you get genital herpes during the last 6 weeks of your pregnancy, you might have a caesarean birth. Your doctor or midwife may talk to you about this. […] If you have a cold sore or feel you are getting one: do not kiss your baby, wash your hands properly before contact with your baby, cover up any cold sores before breastfeeding if you feel it might lessen the risk of spreading the virus.

• #6 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.

• #7 Herpes – STI Treatment Guidelines

  https://www.cdc.gov/std/treatment-guidelines/herpes.htm

  Prevention of neonatal herpes depends both on preventing acquisition of genital herpes during late pregnancy and avoiding exposure of the neonate to herpetic lesions and viral shedding during delivery. […] The risk for transmission to the neonate from an infected mother is high (30%50%) among women who acquire genital herpes near the time of delivery and low (1%) among women with prenatal histories of recurrent herpes or who acquire genital herpes during the first half of pregnancy. […] All pregnant women should be asked whether they have a history of genital herpes or genital symptoms concerning for HSV infection. […] Women with recurrent genital herpetic lesions at the onset of labor should have a cesarean delivery to reduce the risk for neonatal HSV infection. […] Acyclovir can be administered orally to pregnant women with first-episode genital herpes or recurrent herpes and should be administered IV to pregnant women with severe HSV.

• #8 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.

• #9 Herpes – STI Treatment Guidelines

  https://www.cdc.gov/std/treatment-guidelines/herpes.htm

  Prevention of neonatal herpes depends both on preventing acquisition of genital herpes during late pregnancy and avoiding exposure of the neonate to herpetic lesions and viral shedding during delivery. […] The risk for transmission to the neonate from an infected mother is high (30%50%) among women who acquire genital herpes near the time of delivery and low (1%) among women with prenatal histories of recurrent herpes or who acquire genital herpes during the first half of pregnancy. […] All pregnant women should be asked whether they have a history of genital herpes or genital symptoms concerning for HSV infection. […] Women with recurrent genital herpetic lesions at the onset of labor should have a cesarean delivery to reduce the risk for neonatal HSV infection. […] Acyclovir can be administered orally to pregnant women with first-episode genital herpes or recurrent herpes and should be administered IV to pregnant women with severe HSV.

• #10 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.

• #11 Maternal Antibodies Offer Protection Against Herpes in Newborns

  https://www.contagionlive.com/view/maternal-antibodies-offer-protection-against-herpes-in-newborns

  Pregnant women who have been infected by herpes simplex virus type 1 (HSV-1) in the past, maintain active antibodies that protect against the virus, according to the press release. […] The findings suggest that the key to preventing serious brain disease related to these conditions in fetuses and newborns lies in immunizing pregnant women against HSV, according senior study author David A Leib, PhD, professor of microbiology and immunology at Geisel School of Medicine. […] Maternal antibodies have a potent protective role in the neonatal nervous system against HSV. […] If that baby should be infected during delivery, it will be protected because the mothers antibodies get into the nervous system before birth. […] However, if a woman who is already pregnant gets infected by the virus, the newborn has a 50% risk of having severe complications.

• #12 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. […] A history of HSV in a pregnant woman and her partner should be obtained at the first prenatal visit. […] Women with a negative personal history of HSV (especially those with a positive history in the male partner) should be counseled on ways to avoid infection, especially during the third trimester. […] Prophylactic use of acyclovir in the third trimester should be considered in women with frequent HSV infection outbreaks.

• #13 Herpes – STI Treatment Guidelines

  https://www.cdc.gov/std/treatment-guidelines/herpes.htm

  Prevention of neonatal herpes depends both on preventing acquisition of genital herpes during late pregnancy and avoiding exposure of the neonate to herpetic lesions and viral shedding during delivery. […] The risk for transmission to the neonate from an infected mother is high (30%50%) among women who acquire genital herpes near the time of delivery and low (1%) among women with prenatal histories of recurrent herpes or who acquire genital herpes during the first half of pregnancy. […] All pregnant women should be asked whether they have a history of genital herpes or genital symptoms concerning for HSV infection. […] Women with recurrent genital herpetic lesions at the onset of labor should have a cesarean delivery to reduce the risk for neonatal HSV infection. […] Acyclovir can be administered orally to pregnant women with first-episode genital herpes or recurrent herpes and should be administered IV to pregnant women with severe HSV.

• #14 Neonatal herpes (herpes in a baby)

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

  Neonatal herpes can be prevented by following some simple advice. […] If you’re pregnant and have a history of genital herpes, tell your doctor or midwife. […] You may need to take medicine during the last month of pregnancy to prevent an outbreak of vaginal sores during labour. […] Delivery by caesarean section is recommended if the genital herpes has occurred for the first time in the last 6 weeks of your pregnancy. […] If you develop a cold sore or have any signs of a herpes infection, take these precautions: do not kiss any babies, wash your hands before contact with a baby, wash your hands before breastfeeding, cover up any cold sores, lesions or signs of a herpes infection anywhere on your body to avoid passing on the virus.

• #15 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. […] A history of HSV in a pregnant woman and her partner should be obtained at the first prenatal visit. […] Women with a negative personal history of HSV (especially those with a positive history in the male partner) should be counseled on ways to avoid infection, especially during the third trimester. […] Prophylactic use of acyclovir in the third trimester should be considered in women with frequent HSV infection outbreaks.

• #16

  https://www.healio.com/news/pediatrics/20120331/optimal-guidelines-needed-for-preventing-neonatal-herpes-simplex-virus

  They advocated that the following proposed strategies be evaluated further to determine their efficacy: Counseling all women to avoid unprotected sexual intercourse and oralgenital contact during late pregnancy. […] Performing serologic testing among pregnant women to determine those at risk for HSV. […] Performing serological testing in pregnant women and their partners to determine discordant results that may put an uninfected mother at risk. […] Treating pregnant women with recently acquired HSV with an antiviral to reduce the risk for morbidity. Proposed regimens include a 400-mg dose of oral acyclovir (Zovirax, GlaxoSmithKline) three times daily or 500 mg of oral valacyclovir (Valtrex, GlaxoSmithKline) twice a day for seven to 10 days. […] Using rapid polymerase chain reaction assays to detect viral shedding at delivery, followed by early antiviral therapy for at-risk infants.

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

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

  If your partner has genital herpes and you have never been infected, I recommend abstaining from sex the last few weeks of pregnancy. […] 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. […] 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. […] As parents and providers, we must do all we can to safeguard our babies from herpes infection.

• #18 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. […] Delivery by elective Cesarean section markedly reduces but does not eliminate the risk for newborn infection. Women with recurrent genital HSV are commonly prophylaxed with acyclovir (ACV) or valacyclovir from 36 weeks gestation until delivery. […] 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. […] Strategies to prevent NHSV, including the identification of high-risk pregnancies, Caesarean delivery, maternal antiviral therapy, and anticipatory guidance for prospective mothers and partners, are largely beyond the scope of this statement.

• #19 Herpes – STI Treatment Guidelines

  https://www.cdc.gov/std/treatment-guidelines/herpes.htm

  Suppressive acyclovir treatment starting at 36 weeks gestation reduces the frequency of cesarean delivery among women who have recurrent genital herpes by diminishing the frequency of recurrences at term. […] Newborn infants exposed to HSV during birth, as documented by virologic testing of maternal lesions at delivery or presumed by observation of maternal lesions, should be followed clinically in consultation with a pediatric infectious disease specialist. […] Administration of acyclovir might be considered for neonates born to women who acquired HSV near term because the risk for neonatal herpes is high for these newborn infants.

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

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

  Daily suppressive antiviral therapy for women with a history of genital herpes can aid in the reduction of recurrent episodes and subclinical viral shedding, and has been recommended for all pregnant women with recurrent genital herpes starting at 36 weeks gestation. […] 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.

• #21 Genital Herpes: A Review | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0601/p928.html

  Antiviral prophylaxis with acyclovir is recommended from 36 weeks of gestation until delivery in women with a history of genital herpes to minimize active recurrence at the time of delivery. […] Elective cesarean delivery should be performed in laboring patients with active lesions to decrease the risk of HSV transmission. […] One in five pregnant women is seropositive for HSV-2, and more than 60% of pregnant women are positive for HSV-1. Yet, neonatal herpes is uncommon, occurring once in 3,200 live births. However, maternal primary infection with HSV-1 or HSV-2 at the time of delivery carries a 60% risk of neonatal herpes.

• #22 Herpes – STI Treatment Guidelines

  https://www.cdc.gov/std/treatment-guidelines/herpes.htm

  Suppressive acyclovir treatment starting at 36 weeks gestation reduces the frequency of cesarean delivery among women who have recurrent genital herpes by diminishing the frequency of recurrences at term. […] Newborn infants exposed to HSV during birth, as documented by virologic testing of maternal lesions at delivery or presumed by observation of maternal lesions, should be followed clinically in consultation with a pediatric infectious disease specialist. […] Administration of acyclovir might be considered for neonates born to women who acquired HSV near term because the risk for neonatal herpes is high for these newborn infants.

• #23

  https://www.healio.com/news/pediatrics/20120331/optimal-guidelines-needed-for-preventing-neonatal-herpes-simplex-virus

  They advocated that the following proposed strategies be evaluated further to determine their efficacy: Counseling all women to avoid unprotected sexual intercourse and oralgenital contact during late pregnancy. […] Performing serologic testing among pregnant women to determine those at risk for HSV. […] Performing serological testing in pregnant women and their partners to determine discordant results that may put an uninfected mother at risk. […] Treating pregnant women with recently acquired HSV with an antiviral to reduce the risk for morbidity. Proposed regimens include a 400-mg dose of oral acyclovir (Zovirax, GlaxoSmithKline) three times daily or 500 mg of oral valacyclovir (Valtrex, GlaxoSmithKline) twice a day for seven to 10 days. […] Using rapid polymerase chain reaction assays to detect viral shedding at delivery, followed by early antiviral therapy for at-risk infants.

• #24 Herpes – STI Treatment Guidelines

  https://www.cdc.gov/std/treatment-guidelines/herpes.htm

  Suppressive acyclovir treatment starting at 36 weeks gestation reduces the frequency of cesarean delivery among women who have recurrent genital herpes by diminishing the frequency of recurrences at term. […] Newborn infants exposed to HSV during birth, as documented by virologic testing of maternal lesions at delivery or presumed by observation of maternal lesions, should be followed clinically in consultation with a pediatric infectious disease specialist. […] Administration of acyclovir might be considered for neonates born to women who acquired HSV near term because the risk for neonatal herpes is high for these newborn infants.

• #25 Neonatal Herpes Simplex Virus Infections | AAFP

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

  Acyclovir should be given to all pregnant women with active genital HSV infection near term or at the time of delivery. […] All women presenting in labor should be asked about symptoms of HSV infections. […] All laboring women with active genital HSV infections should be delivered by cesarean section. […] Cesarean section alone does not completely remove the risk of transmission of HSV to the infant. […] The HSV-exposed neonate should be monitored closely for any signs of infection. […] Empiric acyclovir may be instituted in infants born to mothers with suspected primary HSV infection because the risk of infection in the infant is 33 to 50 percent. […] Any exposed infant with clinical signs of HSV should be cultured, and the infant should be immediately started on intravenous acyclovir therapy. […] Postpartum women, family members and nursery personnel with active herpetic lesions of the mouth or skin should be instructed to use contact precautions with the infant.

• #26 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. […] 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. Cesarean delivery is recommended for pregnant patients with active genital herpes simplex lesions or prodromal symptoms at the time of delivery. […] Neonates born to people with active genital lesions at the time of vaginal delivery should be evaluated and tested for HSV infection.

• #27 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. […] Delivery by elective Cesarean section markedly reduces but does not eliminate the risk for newborn infection. Women with recurrent genital HSV are commonly prophylaxed with acyclovir (ACV) or valacyclovir from 36 weeks gestation until delivery. […] 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. […] Strategies to prevent NHSV, including the identification of high-risk pregnancies, Caesarean delivery, maternal antiviral therapy, and anticipatory guidance for prospective mothers and partners, are largely beyond the scope of this statement.

• #28 Neonatal Herpes Simplex Virus Infections | AAFP

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

  Acyclovir should be given to all pregnant women with active genital HSV infection near term or at the time of delivery. […] All women presenting in labor should be asked about symptoms of HSV infections. […] All laboring women with active genital HSV infections should be delivered by cesarean section. […] Cesarean section alone does not completely remove the risk of transmission of HSV to the infant. […] The HSV-exposed neonate should be monitored closely for any signs of infection. […] Empiric acyclovir may be instituted in infants born to mothers with suspected primary HSV infection because the risk of infection in the infant is 33 to 50 percent. […] Any exposed infant with clinical signs of HSV should be cultured, and the infant should be immediately started on intravenous acyclovir therapy. […] Postpartum women, family members and nursery personnel with active herpetic lesions of the mouth or skin should be instructed to use contact precautions with the infant.

• #29 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. […] Early recognition and prompt treatment with antiviral medication is essential to save the baby’s life. […] If there is a known first episode of genital herpes in late pregnancy, birth parents may be advised to have a caesarean section (also called a 'C-section’) to minimise the risk of transmission to their baby. […] If you are pregnant, if you have ever had genital herpes (ulcers/blisters/sores) in the past or develop symptoms during your pregnancy, tell your doctor or midwife. They may prescribe oral antiviral medication. […] 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.

• #30 NEONATAL HSV INFECTION

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

  Given the social stigma of sexually transmitted infections, parents may be unable to initiate a conversation with healthcare providers or ask the questions that are worrying them. […] Elective Caesarean section significantly reduces the risk of transmission and is recommended for pregnant people who have a known or presumed first episode of genital herpes within 6 weeks of delivery, even if receiving suppressive antiviral therapy.

• #31 Neonatal Herpes Simplex Virus Infections | AAFP

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

  Acyclovir should be given to all pregnant women with active genital HSV infection near term or at the time of delivery. […] All women presenting in labor should be asked about symptoms of HSV infections. […] All laboring women with active genital HSV infections should be delivered by cesarean section. […] Cesarean section alone does not completely remove the risk of transmission of HSV to the infant. […] The HSV-exposed neonate should be monitored closely for any signs of infection. […] Empiric acyclovir may be instituted in infants born to mothers with suspected primary HSV infection because the risk of infection in the infant is 33 to 50 percent. […] Any exposed infant with clinical signs of HSV should be cultured, and the infant should be immediately started on intravenous acyclovir therapy. […] Postpartum women, family members and nursery personnel with active herpetic lesions of the mouth or skin should be instructed to use contact precautions with the infant.

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

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

  If your partner has genital herpes and you have never been infected, I recommend abstaining from sex the last few weeks of pregnancy. […] 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. […] 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. […] As parents and providers, we must do all we can to safeguard our babies from herpes infection.

• #33 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. […] Delivery by elective Cesarean section markedly reduces but does not eliminate the risk for newborn infection. Women with recurrent genital HSV are commonly prophylaxed with acyclovir (ACV) or valacyclovir from 36 weeks gestation until delivery. […] 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. […] Strategies to prevent NHSV, including the identification of high-risk pregnancies, Caesarean delivery, maternal antiviral therapy, and anticipatory guidance for prospective mothers and partners, are largely beyond the scope of this statement.

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

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

  Neonates with HSV infection should be managed using contact precautions when mucocutaneous lesions are present and until lesions have crusted. Asymptomatic neonates whose mothers have active HSV lesions should be managed using contact precautions until the end of the incubation period (day 14) or until samples from the infant taken after the first 24 h of life are negative. […] Mothers with herpes labialis should wear a disposable mask when caring for their infant 6 weeks of age, until lesions are healed (crusted and dried). Advise these mothers not to kiss their infant. There is no contraindication to breastfeeding unless there are herpetic lesions on the breast.

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

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

  Neonates with HSV infection should be managed using contact precautions when mucocutaneous lesions are present and until lesions have crusted. Asymptomatic neonates whose mothers have active HSV lesions should be managed using contact precautions until the end of the incubation period (day 14) or until samples from the infant taken after the first 24 h of life are negative. […] Mothers with herpes labialis should wear a disposable mask when caring for their infant 6 weeks of age, until lesions are healed (crusted and dried). Advise these mothers not to kiss their infant. There is no contraindication to breastfeeding unless there are herpetic lesions on the breast.

• #36 Herpes – STI Treatment Guidelines

  https://www.cdc.gov/std/treatment-guidelines/herpes.htm

  Suppressive acyclovir treatment starting at 36 weeks gestation reduces the frequency of cesarean delivery among women who have recurrent genital herpes by diminishing the frequency of recurrences at term. […] Newborn infants exposed to HSV during birth, as documented by virologic testing of maternal lesions at delivery or presumed by observation of maternal lesions, should be followed clinically in consultation with a pediatric infectious disease specialist. […] Administration of acyclovir might be considered for neonates born to women who acquired HSV near term because the risk for neonatal herpes is high for these newborn infants.

• #37 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. […] 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. Cesarean delivery is recommended for pregnant patients with active genital herpes simplex lesions or prodromal symptoms at the time of delivery. […] Neonates born to people with active genital lesions at the time of vaginal delivery should be evaluated and tested for HSV infection.

• #38 Herpes – STI Treatment Guidelines

  https://www.cdc.gov/std/treatment-guidelines/herpes.htm

  Suppressive acyclovir treatment starting at 36 weeks gestation reduces the frequency of cesarean delivery among women who have recurrent genital herpes by diminishing the frequency of recurrences at term. […] Newborn infants exposed to HSV during birth, as documented by virologic testing of maternal lesions at delivery or presumed by observation of maternal lesions, should be followed clinically in consultation with a pediatric infectious disease specialist. […] Administration of acyclovir might be considered for neonates born to women who acquired HSV near term because the risk for neonatal herpes is high for these newborn infants.

• #39 Neonatal Herpes Simplex Virus Infections | AAFP

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

  Acyclovir should be given to all pregnant women with active genital HSV infection near term or at the time of delivery. […] All women presenting in labor should be asked about symptoms of HSV infections. […] All laboring women with active genital HSV infections should be delivered by cesarean section. […] Cesarean section alone does not completely remove the risk of transmission of HSV to the infant. […] The HSV-exposed neonate should be monitored closely for any signs of infection. […] Empiric acyclovir may be instituted in infants born to mothers with suspected primary HSV infection because the risk of infection in the infant is 33 to 50 percent. […] Any exposed infant with clinical signs of HSV should be cultured, and the infant should be immediately started on intravenous acyclovir therapy. […] Postpartum women, family members and nursery personnel with active herpetic lesions of the mouth or skin should be instructed to use contact precautions with the infant.

• #40 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. […] Last week we launched our THANKS: Think Hands And No Kisses campaign to highlight the importance of good hygiene around young babies and we are seeking the support of midwives and other health professionals to help spread the word. […] 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. […] As a response to these findings, we launched a new campaign to remind anyone coming into contact with a young baby to remember their THANKS: Think Hands And No Kisses. […] We are seeking support from midwives and other health professionals to remind new parents of the importance of good hygiene around young babies.

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

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

  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. […] Everyone coming into contact with a newborn baby: 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. […] Nobody other than the parents should kiss a newborn baby especially if they have a cold sore. Even parents with a cold sore should not kiss their infants until the lesion has healed over.

• #42 Neonatal herpes (Neonatal HSV) | Bliss

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

  If your partner has active lesions, you should avoid sexual activity in late pregnancy to reduce the risk of catching HSV. […] 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. […] 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. […] Nobody other than the parents should kiss a newborn baby especially if they have a cold sore.

• #43 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. […] Newborns can sometimes get HSV-1 from close contact with someone who is shedding HSV-1 virus in their saliva or has an active HSV-1 outbreak (cold sores). […] 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. […] Everyone should wash their hands before touching the newborn. […] Do not kiss your baby or let others kiss your baby if you or they have cold sores on the mouth or lips.

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

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

  Neonates with HSV infection should be managed using contact precautions when mucocutaneous lesions are present and until lesions have crusted. Asymptomatic neonates whose mothers have active HSV lesions should be managed using contact precautions until the end of the incubation period (day 14) or until samples from the infant taken after the first 24 h of life are negative. […] Mothers with herpes labialis should wear a disposable mask when caring for their infant 6 weeks of age, until lesions are healed (crusted and dried). Advise these mothers not to kiss their infant. There is no contraindication to breastfeeding unless there are herpetic lesions on the breast.

• #45 Neonatal herpes (Neonatal HSV) | Bliss

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

  If your partner has active lesions, you should avoid sexual activity in late pregnancy to reduce the risk of catching HSV. […] 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. […] 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. […] Nobody other than the parents should kiss a newborn baby especially if they have a cold sore.

• #46 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. […] Every precaution must be taken to prevent infants from being exposed to the herpes virus. Women with HSV should follow appropriate hand hygiene before holding the infant. […] 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.

• #47 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. […] Every precaution must be taken to prevent infants from being exposed to the herpes virus. Women with HSV should follow appropriate hand hygiene before holding the infant. […] 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.

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

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

  Mothers should consult with their health care provider to determine if their lesions have healed. […] If the test result is positive, acyclovir (safe to use while breastfeeding) should be administered quickly, and breastfeeding should be discontinued until the lesion has 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.

• #49 #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. […] After initial treatment, neurodevelopmental outcomes are improved if children are placed on long-term HSV prophylaxis to prevent recurrent disease. […] The consequences of perinatal HSV can be devastating. It is important to be vigilant for these infections. […] 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. [...] Acyclovir prophylaxis for 6 months improves the neurodevelopmental outcomes of children who had neonatal HSV infection. [...] Prophylaxis (not treatment!) can be with oral acyclovir.

• #50 Unexpected neonatal herpes simplex virus infection in a premature newborn baby | Article | Infant journal

  https://www.infantjournal.co.uk/journal_article.html?id=7367

  In this article, we describe a case of neonatal herpes simplex virus infection with CNS involvement in an extremely premature infant delivered to a COVID-19 positive mother who had no history or symptoms of genital herpes infection. […] Prophylaxis was resumed and continues at 24 months of age with several subsequent skin outbreaks. […] HSV infection in a newborn baby can be associated with significant morbidity and mortality. […] HSV infection should be considered in a sick neonate, even when an alternative diagnosis is made. When appropriate, an investigation for HSV and prompt treatment should be instigated. […] Appropriate diagnosis and treatment with antiviral therapy can significantly improve the outcome of these infants. […] Infants with neonatal HSV disease should receive at least six months of oral acyclovir suppressive therapy.

• #51 #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. […] After initial treatment, neurodevelopmental outcomes are improved if children are placed on long-term HSV prophylaxis to prevent recurrent disease. […] The consequences of perinatal HSV can be devastating. It is important to be vigilant for these infections. […] 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. [...] Acyclovir prophylaxis for 6 months improves the neurodevelopmental outcomes of children who had neonatal HSV infection. [...] Prophylaxis (not treatment!) can be with oral acyclovir.

• #52 Unexpected neonatal herpes simplex virus infection in a premature newborn baby | Article | Infant journal

  https://www.infantjournal.co.uk/journal_article.html?id=7367

  In this article, we describe a case of neonatal herpes simplex virus infection with CNS involvement in an extremely premature infant delivered to a COVID-19 positive mother who had no history or symptoms of genital herpes infection. […] Prophylaxis was resumed and continues at 24 months of age with several subsequent skin outbreaks. […] HSV infection in a newborn baby can be associated with significant morbidity and mortality. […] HSV infection should be considered in a sick neonate, even when an alternative diagnosis is made. When appropriate, an investigation for HSV and prompt treatment should be instigated. […] Appropriate diagnosis and treatment with antiviral therapy can significantly improve the outcome of these infants. […] Infants with neonatal HSV disease should receive at least six months of oral acyclovir suppressive therapy.

• #53

  https://www.healio.com/news/pediatrics/20120331/optimal-guidelines-needed-for-preventing-neonatal-herpes-simplex-virus

  They advocated that the following proposed strategies be evaluated further to determine their efficacy: Counseling all women to avoid unprotected sexual intercourse and oralgenital contact during late pregnancy. […] Performing serologic testing among pregnant women to determine those at risk for HSV. […] Performing serological testing in pregnant women and their partners to determine discordant results that may put an uninfected mother at risk. […] Treating pregnant women with recently acquired HSV with an antiviral to reduce the risk for morbidity. Proposed regimens include a 400-mg dose of oral acyclovir (Zovirax, GlaxoSmithKline) three times daily or 500 mg of oral valacyclovir (Valtrex, GlaxoSmithKline) twice a day for seven to 10 days. […] Using rapid polymerase chain reaction assays to detect viral shedding at delivery, followed by early antiviral therapy for at-risk infants.

• #54

  https://www.healio.com/infectious-disease/stds/news/online/%7Bc11461ff-4449-438b-9e5a-26f0ee99cc72%7D/optimal-guidelines-needed-for-preventing-neonatal-herpes-simplex-virus

  They advocated that the following proposed strategies be evaluated further to determine their efficacy: Counseling all women to avoid unprotected sexual intercourse and oralgenital contact during late pregnancy. […] Performing serologic testing among pregnant women to determine those at risk for HSV. […] Performing serological testing in pregnant women and their partners to determine discordant results that may put an uninfected mother at risk. […] Treating pregnant women with recently acquired HSV with an antiviral to reduce the risk for morbidity. Proposed regimens include a 400-mg dose of oral acyclovir (Zovirax, GlaxoSmithKline) three times daily or 500 mg of oral valacyclovir (Valtrex, GlaxoSmithKline) twice a day for seven to 10 days. […] Using rapid polymerase chain reaction assays to detect viral shedding at delivery, followed by early antiviral therapy for at-risk infants. […] A concentrated effort to conduct studies that may provide guidance for effectively reducing the incidence of neonatal HSV infection is needed and will require an alliance between practitioners and academicians, the researchers wrote.

• #55 Maternal Antibodies Offer Protection Against Herpes in Newborns

  https://www.contagionlive.com/view/maternal-antibodies-offer-protection-against-herpes-in-newborns

  Pregnant women who have been infected by herpes simplex virus type 1 (HSV-1) in the past, maintain active antibodies that protect against the virus, according to the press release. […] The findings suggest that the key to preventing serious brain disease related to these conditions in fetuses and newborns lies in immunizing pregnant women against HSV, according senior study author David A Leib, PhD, professor of microbiology and immunology at Geisel School of Medicine. […] Maternal antibodies have a potent protective role in the neonatal nervous system against HSV. […] If that baby should be infected during delivery, it will be protected because the mothers antibodies get into the nervous system before birth. […] However, if a woman who is already pregnant gets infected by the virus, the newborn has a 50% risk of having severe complications.

• #56 Maternal Antibodies Offer Protection Against Herpes in Newborns

  https://www.contagionlive.com/view/maternal-antibodies-offer-protection-against-herpes-in-newborns

  This finding, that maternal antibodies offer protection to infants, hasnt been noted before, according to lead study author Yike Jiang, MD/PhD student at Geisel School of Medicine. […] Maternal immunization may be an effective strategy to use against other pathogens, such as Zika virus, in newborns, Dr. Leib concluded.

• #57

  https://www.healio.com/news/pediatrics/20120331/optimal-guidelines-needed-for-preventing-neonatal-herpes-simplex-virus

  A concentrated effort to conduct studies that may provide guidance for effectively reducing the incidence of neonatal HSV infection is needed and will require an alliance between practitioners and academicians, the researchers wrote. […] Their call for guidance from professional societies is being answered by the American Academy of Pediatrics, which currently is discussing a suggested approach to the management of neonates delivered to women with active herpetic lesions.

• #58 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. […] To improve overall outcome in infants diagnosed with neonatal HSV disease, early diagnosis and initiation of treatment is imperative. Early initiation of therapy prevents further disease progression. […] As a result of the severity of the disease in neonates, measures aimed at preventing transmission have become of great importance. These measures include performing cesarean delivery for mothers with active genital lesions at time of delivery, decreasing contact exposure to persons with active herpes labialis or gingivostomatitis, reducing the use of fetal scalp electrodes, and implementing suppressive therapy in pregnant women with a history of genital herpes.

• #59 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. […] There are some simple things you can do to help prevent babies from catching herpes infections. These include regular hand washing, covering cold sores and not kissing babies who are not your own. […] Early recognition and prompt treatment with antiviral medication is essential to save the baby’s life. […] If you are pregnant: If you have ever had genital herpes (ulcers/blisters/sores) in the past or develop symptoms during your pregnancy then let your doctor/midwife know. They may prescribe oral antiviral medication. […] 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.

• #60 Herpes simplex virus infection in pregnancy and in neonate: status of art of epidemiology, diagnosis, therapy and prevention | Virology Journal | Full Text

  https://virologyj.biomedcentral.com/articles/10.1186/1743-422X-6-40

  The most effective measure to prevent perinatal herpes infections is to avoid viral exposure to the neonate when primary genital herpes develops in late pregnancy whereas the risk of severe neonatal infection is small in recurrent episodes. […] Prophylactic administration of acyclovir or valacyclovir in the third trimester of pregnancy should be provided to all pregnants with frequent genital herpes outbreaks and with active genital HSV infection near term or at the time of delivery. […] Neonates, born to women with active genital lesions, with a confirmed or suspected HSV infection should be isolated, managed with contact precautions to avoid direct contact with skin and mucosal lesions, excretions, body fluids and immediately treated with intravenous acyclovir.

• #61 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. […] To improve overall outcome in infants diagnosed with neonatal HSV disease, early diagnosis and initiation of treatment is imperative. Early initiation of therapy prevents further disease progression. […] As a result of the severity of the disease in neonates, measures aimed at preventing transmission have become of great importance. These measures include performing cesarean delivery for mothers with active genital lesions at time of delivery, decreasing contact exposure to persons with active herpes labialis or gingivostomatitis, reducing the use of fetal scalp electrodes, and implementing suppressive therapy in pregnant women with a history of genital herpes.

• #62 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. […] There are some simple things you can do to help prevent babies from catching herpes infections. These include regular hand washing, covering cold sores and not kissing babies who are not your own. […] Early recognition and prompt treatment with antiviral medication is essential to save the baby’s life. […] If you are pregnant: If you have ever had genital herpes (ulcers/blisters/sores) in the past or develop symptoms during your pregnancy then let your doctor/midwife know. They may prescribe oral antiviral medication. […] 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.

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