Herpes infections are due to a virus that can infect the genital tract. This virus can cause an infection in the genital tract of both men and women. The infection can occur in newborns and can cause severe disease. According to "Nelson's Pediatrics," neonatal herpes occurs in is one out of every 3,000 live births. Women that are aware that they have herpes should take medication in the last trimester of their pregnancy to reduce the chances of spreading infection to her baby.
How Herpes Infects the Newborn
Neonatal herpes infections are caused by the herpes simplex virus 2, abbreviated as HSV-2. An infected mother can spread her infection to an infant; this happens most commonly during delivery. However, transmission of infection has been documented even in cesarean sections. The virus can enter into the infant through the nose, mouth, conjunctiva or through any breaks in the skin. Because neonates have a very frail immune system, the virus can spread throughout the body by traveling through the bloodstream.
Skin, Eye and Mouth
Infection involving the skin, eye and mouth is called a SEM infection. Infants born with herpes may have a variety of skin lesions. These typically occur five to 11 days after birth. They most commonly take the form of vesicles, which are shallow blisters. These can burst and leave small ulcers in the skin. The virus can cause also cause similar ulcerations inside the mouth. In the eye, the virus can cause conjunctivitis in one or both eyes.
Central Nervous System
Herpes encephalitis, a viral brain infection, within eight to 17 days following birth. This infection can occur in the absence of any skin infection. Infected infants are irritable and may have lethargy, poor feeding, floppy limbs, and seizures. Fever usually does not occur. Many of the survivors of this infection have long-term complications.
Disseminated Disease
The disseminated infection is the most severe form of herpes infection. It occurs approximately five to 11 days after birth. Infants may have a fever or may have low temperatures. Common symptoms include jaundice, skin rash, vomiting, irritability and poor feeding. Skin vesicles are seen in most of these patients. Some infants may have difficulty breathing and have cyanosis, a bluish discoloration of the skin which occurs when oxygen levels are very low.
Treatment
Physicians can make a diagnosis based on a DNA test that is specific to the virus. As soon as diagnosis is suspected, doctors should treat infants with antiviral agents. Drugs such as acyclovir should be given by injection. The earlier the treatment is given, the better the outcome. Pregnant women with genital herpes should take acyclovir tablets in the last four weeks of pregnancy as this can reduce the chances of infection the infant.
Complications
Even if treated, herpes simplex infection may be fatal. According to a 2002 article published in "American Family Physician," SEM infection is rarely fatal. However, 15 percent of infants with nervous system infection and more than 50 percent of infants with disseminated disease do not survive their infection. If the infant does survive, a number of long-lasting complications may be seen. Some infants may have seizures, mental retardation or blindness. Infants may also have muscle weakness and rigidity.
References
- "Nelson Textbook of Pediatrics"; Dr. Robert M. Kliegman, et al.; 2008
- "American Family Physician"; Neonatal Herpes Simplex Virus Infections; Caroline M. Rudnick; March 2002
