$Unique_ID{BRK03819} $Pretitle{} $Title{Herpes, Neonatal} $Subject{Herpes Neonatal Herpes Simplex Infection of Newborn Herpesvirus Hominis Infection of Newborn } $Volume{} $Log{} Copyright (C) 1987, 1989 National Organization for Rare Disorders, Inc. 353: Herpes, Neonatal ** IMPORTANT ** It is possible the main title of the article (Neonatal Herpes) is not the name you expected. Please check the SYNONYMS listing to find the alternate names and disorder subdivisions covered by this article. Synonyms Herpes Simplex Infection of Newborn Herpesvirus Hominis Infection of Newborn General Discussion ** REMINDER ** The information contained in the Rare Disease Database is provided for educational purposes only. It should not be used for diagnostic or treatment purposes. If you wish to obtain more information about this disorder, please contact your personal physician and/or the agencies listed in the "Resources" section of this report. Neonatal Herpes is a very rare disorder affecting newborn infants infected with the Herpes simplex virus (HSV), also called Herpesvirus hominis. This disorder can vary from mild to severe. In most cases the disorder is transferred by a parent with oral or genital herpes to an offspring before, during, or shortly after birth. In the mild form, Neonatal Herpes is caused by type 2 virus. The skin, eyes, and mouth may become infected, and symptoms may recur for some time. In its severe form, which is caused by type 1 virus, Neonatal Herpes is a serious disease characterized by blistery (vesicular) red lesions of the skin and mucous membranes. Liver, spleen, lungs, brain, kidneys, and adrenal glands may also become infected. Symptoms The mild form of Neonatal Herpes is usually present at birth. It consists of red skin lesions which are flat and not blistery. Eyes and mouth may also be infected, and fever may occur. This form of the disorder may recur during infancy until the child develops antibodies against the virus, usually by one year of age. Onset of the severe form of Neonatal Herpes is usually between the 5th and the 9th day of life. Clustered blistery lesions occur on the skin and mucous membranes, and appetite decreases. Infection of the cornea and the inside of the eyelids (keratoconjunctivitis) is also possible. Ulcerations may appear on the soft palate or the esophagus. The infection may spread to the lungs and cause difficulty breathing (dyspnea). Enlargement of liver and spleen may occur, usually accompanied by jaundice. The temperature of the infant may fluctuate. Lethargy, a reduced muscle tone (hypotonia), and blood coagulation inside the blood vessels are other signs of the more serious form of Neonatal Herpes. The adrenal glands and the kidneys may also be affected. Convulsions and other signs of Central Nervous System involvement may also occur. Causes Neonatal Herpes is caused by an infection of the newborn by the Herpes simplex virus, also called Herpesvirus hominis. The milder form of the disorder is caused by type 2 virus, which is present in the birth canal when the mother has a genital herpes infection. The more severe form is caused by type 1 Herpes simplex virus. The more severe form of Neonatal Herpes occurs less frequently than the milder form and may also be a consequence of maternal genital herpes infection. It is also possible that infection takes place in the uterus during pregnancy. A mother who does not have symptoms of a herpes infection may breast-feed an infant with milk that contains the herpes virus, thus infecting the infant. An attendant at the birthing process may also transfer his or her infection to the newborn child if sterile precautions are not adequate. Neonatal Herpes may also affect babies with immune system deficiencies. Affected Population Neonatal Herpes is a very rare disorder. It affects about 1 in 5,000 to 7,500 live births. During their first year of life, these infants usually develop antibodies against the Herpes virus. Only malnourished infants, those with an impaired immune system, or otherwise weakened infants tend to carry the infection after one year. Infants born to a mother with a first time Herpes infection late in her pregnancy are at higher risk to develop Neonatal Herpes than infants of mothers with recurrent Herpes infection. In the first case the mother has not yet developed antibodies against the virus which would ordinarily protect her baby. Therapies: Standard When a mother shows signs of a genital Herpes infection, delivery by cesarian section is advised. It is important to notify the physician when a pregnant woman or her sexual partner are carrying Herpes virus, because the baby might become infected with the virus during the birth process. A culture of baby and mother may be done at birth. If tests are positive, treatment of the virus can be started immediately after birth. Vidarabine (Ara-A, Vira-A), and acyclovir (Zovirax) are the drugs most commonly used to treat herpes virus infections. If treatment is started early enough, the disorder usually remains restricted to the skin, eyes, and mucous membranes, and does not progress to the more serious form of the disorder. Therapies: Investigational This disease entry is based upon medical information available through September 1989. Since NORD's resources are limited, it is not possible to keep every entry in the Rare Disease Database completely current and accurate. Please check with the agencies listed in the Resources section for the most current information about this disorder. Resources For more information on Neonatal Herpes, please contact: National Organization for Rare Disorders (NORD) P.O. Box 8923 New Fairfield, CT 06812-1783 (203) 746-6518 Centers for Disease Control (CDC) 1600 Clifton Road, NE Atlanta, GA 30333 (404) 639-3534 NIH/National Institute of Allergy and Infectious Diseases 9000 Rockville Pike Bethesda, MD 20892 (301) 496-5717 March of Dimes Birth Defects Foundation 1275 Mamaroneck Avenue White Plains, NY 10605 (914) 428-7100 Alliance of Genetic Support Groups 35 Wisconsin Circle, Suite 440 Chevy Chase, MD 20815 (800) 336-GENE (301) 652-5553 References HERPES AND PREGNANCY: John H. Grossman, and Susan Hilbert; The Helper, Herpes Resource Center (Fall 1985). Pp. 1-5. RESEARCH UPDATE, NEONATAL HERPES: Ann Arvin, and Charles Prober; The Helper, Herpes Resource Center (Summer 1986). Pp. 1-5.