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NEONATAL HERPES

 

Neonatal herpes infection is an extremely problematic condition that has a high mortality rate. This condition is typically caused by transmission during delivery when the maternal genital tract is infected. This condition is caused by the HSV 2 virus in around 80 % of the cases while in 20 % of the cases it is caused by HSV1 virus.

Neonatal herpes quite simply is a condition that is observed in babies before they are born or in a period of the first 6 weeks of their life. Such an infection may be observed when the child is in the womb or the disease may be transferred during delivery as it happens in maximum cases.

Manifestations of neonatal herpes appear in the 1st and 2nd week of the child’s life but it may not be obvious in some cases till the 4th week. In this condition skin vesicles may be observed. In some cases the herpes condition may start off with a red or a purple rash. In many cases mild form of skin rashes may mimic herpes and so it is important to seek the doctor’s opinion before diagnosis of neonatal herpes is made.

In neonatal herpes the herpes blisters or sores may be found on any region on the skin and these include the head of the baby and buttocks as well. In many cases where a baby is born infected with this condition the behavior of the baby may seem less energetic. The child may seem to be lethargic and may stop feeding or become irritable.

In some cases of neonatal herpes the child may not have any sores at all. In disseminated herpes which is found in other parts of the body the herpes infection may appear as early as within the first 7 days of the baby’s life. The symptoms of sluggishness, vomiting and going off feeding are commonly observed among cases of disseminated herpes.


Jaundice may be observed in some cases of neonatal herpes. In some cases the baby may develop pneumonia and may have problems in breathing or may suffer from apnea. In this illness the symptoms manifested may include neurologic findings. In 40 percent of the neonatal cases eye, skin along with mouth involvement may be observed but CNS involvement may not be seen. Brain involvement is seen in 35% of the cases and skin lesions may not be observed.

In case of disseminated neonatal herpes if the condition is left untreated the mortality rate can be as high as 85%. In cases of congenital herpes the signs or symptoms associated with this condition may not be observed at birth. If the pregnant woman has primary infection during delivery then the baby has the highest chance or risk of developing this problem. This condition can be identified by measuring the type specific HSV antibodies in the blood of the pregnant woman.

Where the pregnant woman has new infection at the time of delivery the child has around 30% risk of getting neonatal herpes. Where the woman has known genital herpes the risk of the child getting this condition is as low as 1%. This is because the antibodies in the woman are transported to the fetus to protect it. Such antibodies are normally found where the mother gets the infection before the mid period of pregnancy.

Primarily four factors are responsible for increased risk of the transmission of this infection to the child. These factors include whether the mother has initial or primary infection in the pregnancy period, whether the mother has the HSV antibodies at the time of delivery, whether fetal scalp monitors are used and whether ascending infection is observed.



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