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Neonatal herpes is a rare but serious condition where the herpes simplex virus is passed from a pregnant woman to her baby during birth. It can cause skin, eye, mouth, central nervous system, and disseminated herpes. Early diagnosis and antiviral drugs can reduce the death rate. Cesarean delivery can help prevent transmission if the mother has contracted herpes during pregnancy.
Neonatal herpes is a rare medical condition in which the herpes simplex virus is passed from a pregnant woman to her baby, usually around the time of birth. Although neonatal herpes is rare, affecting only one newborn in every 3,000 to 20,000 live births, it is a serious and often fatal condition. A newborn baby usually becomes infected with herpes by coming into contact with infected secretions in the birth canal, although five percent of babies with herpes are infected in the womb and ten percent are infected soon after birth. Neonatal herpes is more common when the mother acquires herpes during pregnancy.
There are three different manifestations of neonatal herpes: herpes of the skin, eyes and mouth (SEM), disseminated herpes (DIS), and herpes of the central nervous system (CNS). Herpes SEM has the best prognosis of the three, although if left untreated, it can progress to one of the other more dangerous forms of neonatal herpes. Herpes SEM is characterized by external lesions, especially on the face, and on areas associated with trauma or surgery. Disseminated herpes, on the other hand, affects internal organs, especially the liver. Herpes DIS has the highest mortality rate of all forms of neonatal herpes.
Herpes of the central nervous system is associated with the highest morbidity rate of the three types of neonatal herpes. In CNS herpes, the spinal cord and brain are infected with the herpes virus. This form of neonatal herpes can present with muscle seizures or tremors, lethargy, irritability, and difficulty feeding.
In recent decades, the death rate of herpes simplex in infants has been greatly reduced through the use of antiviral drugs including acyclovir and vidarabine. However, for these drugs to be effective, it is very important that the infection is diagnosed early. Unfortunately, 20 to 40 percent of infected children cannot receive early treatment because they have no visible symptoms. If the mother is known to have contracted herpes during pregnancy, cesarean delivery can help reduce the chance of the baby becoming infected with the herpes simplex virus. A woman with recurrent herpes acquired before pregnancy is very unlikely to pass the infection to her child, so cesarean section is not indicated in these cases.
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