Neonatal Herpes is rare but dangerous
Neonatal herpes is rare but extremely dangerous, the infection is passed from mother to baby when the child is born and comes in contact with infected genital secretions. In the United States about 1 in 3,000 children are infected with neonatal herpes and 1 in 20,000 live births. The risk of transition from mother to newborn is 30-57%.
Neonatal Herpes Treatment – Valacyclovir
Valacyclovir is a nucleoside analog that only inhibit viral replication, they reduce the duration of the painful vesicular lesions and the duration of symptomatic and asymptomatic shedding of the virus. Valacyclovir has a high bioavailability with greater absorption which results in higher plasma levels; valacyclovir has one of the highest bioavailability compared to other herpes medications.
Neonatal Herpes simplex
Neonatal HSV infection is usually caused by vertical transmission of HSV from mother to newborn. 85% of cases occur during birth when the baby comes into contact with infected genital secretions in the birth canal. About 5% are infected in utero and about 10% of cases are acquired postnatally.
Symptoms are vesicles on the body usually on the chest and usually appear in the first or second week of life and even as late as the fourth week.
Neonatal herpes simplex can be fatal to infants infected with the disease and it is very important to treat it at the first sign of the infection.
Neonatal herpes comes in three different forms: skin, eyes and mouth herpes sometimes referred to as localized or SEM. There is also disseminated herpes or DIS, and central nervous system herpes (CNS).
SEM herpes is characterized by external lesions such as bumps and blisters but no internal organ involvement. The lesions most likely appear on trauma sites such as the attachment site of fetal scalp electrodes, forceps or vacuum extractors that are used during delivery.
DIS herpes affect internal organs, the liver in particular. CNS herpes infects the nervous system and the brain and can lead to encephalitis. Symptoms of CNS in infants are seizures, tremors, lethargy and irritability, they also don’t eat well, have unstable temperatures and the soft spot in the skull may bulge.
CNS herpes has the highest morbidity rate and DIS herpes has the highest mortality rate. SEM herpes has the best prognosis of the three infections. If SEM is left untreated it can progress to disseminated or CNS herpes.
Death from neonatal herpes has gone down to 25% in the last few decades as compared to 85% before more medical discoveries. Most infants with neonatal herpes are premature with a gestation less than 38 weeks.
Valacyclovir has been given to infants with neonatal herpes and it seems to help the breakouts occur less often letting the child live a healthy normal life.