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Herpes infection in a newborn is a potentially life-threatening condition that can have last neurological consequences if not treated adequately in time. Here we will discuss the tell-tale signs of this disease.

Herpes infection in a newborn can be one of the most difficult diagnoses for doctors to make. Oftentimes a mother's history with genital herpes during pregnancy can be enough to arouse suspicion but this may not always be the case. Being able to recognize how the transmitted genital herpes infection affects newborns can save crucial time in providing the child with the appropriate treatment.

But I have never suffered from genital herpes before!

Herpes is an infectious disease caused by the Herpes Simplex Virus (HSV) and is one of the most common sexually transmitted infections especially among women. There are two types, HSV-1 and HSV-2,  and is spread via skin-to-skin contact of sores either during kissing or intercourse. It can be transmitted during pregnancy to the child in the womb or more commonly during delivery when the baby comes in contact with sores in the birth canal. It is important to note that most cases of herpes infection have no symptoms, meaning that you could have contracted the disease and not known it, but the risk of transmission in these cases is very low. [1]

What should I watch out for?

There are two forms by which a genital herpes infection may manifest in a child, as either localized disease where symptoms are confined to one area of the body, or disseminated disease where the baby has symptoms across a range of locations and organs such as the liver, lungs and kidneys. Symptoms most commonly show up between the first and third weeks of life.

Localized symptoms are characterized by two major groups, one group where regions of the mouth, eyes and skin are the only places affected and a second group where the brain is infected, known as encephalitis which results in neurological symptoms, which may also be accompanied by infection of the eyes, mouth and skin. Symptoms seen in the first group consisting of formation of blisters which can lead to red sores on the skin and mouth, and the eyes will be red. 

Disseminated disease is far more serious and results in symptoms such as

  • difficulty breathing (fast breathing, turning blue, prolonged periods where the baby stop breathing),
  • excessive tiredness
  • bleeding easily
  • difficulty feeding
  • yellowing of the skin and the whites of the eyes 

It may be accompanied by symptoms seen in localized disease as well. Shock is one of the riskiest conditions that may affect your child as a result of disseminated disease. This is characterized by a lack of blood flow to the major organs and can result in a coma or even death. [2]

How can I test for it?

Doctors will test for herpes in a newborn by swabbing potential skin lesions, eyes, mouth, throat and rectum between 12 and 24 hours after birth if suspected at the time. Herpes encephalitis is tested by performing a spinal tap, where a needle is inserted into the spinal cord and the fluid is collected. These samples are all examined for the presence of the viral DNA, which if found, confirm our suspicions allowing us to proceed with the appropriate treatment. [3]

How can I treat it?

Acyclovir is most commonly used to treat neonatal herpes. It aims to decrease the creation of viral particles in the child thereby bringing an end to the localized symptoms such as sores. In the case of disseminated disease, admission to the hospital will most likely be warranted due to the severe complications associated with the illness. Unfortunately, it is unable to reverse the damage wrought by the disease and the virus will continue to live on in nerve cells in the child, meaning that there exists a chance that the disease may reoccur when the immune system is weakened. [4]

What are the long-term consequences if not treated in time?

Depending on which form of the disease you baby has acquired, the complications that result depend on which organs have been affected. Following encephalitis, the child may suffer from visual and auditory impairment, learning disabilities, seizures or cerebral palsy, a condition where there is a failure in coordination between the brain and muscles. Following localized infection of the eyes, nose and mouth, scarring can occur in areas where the blisters have healed, and there may be damage to the eye and nerves of the region. Disseminated disease can be fatal depending on the extent and severity of the infection. [5]

What can I do to prevent infection?

Be sure to notify your primary healthcare provider if you notice any symptoms of genital herpes during pregnancy. You may be required to take antiviral medications to help minimize the presence of viral particle in the bloodstream and prevent the outbreak of red sores near the birth canal, which increase the risk of spreading herpes. If they are present at the time of delivery, then a cesarean section will be the best means to proceed with delivery. This is a surgery where the baby is delivered through a cut in the abdomen and uterus. [6]

Make sure that your child avoids contact with people who are suffering from any form of herpes, especially contact between sores and skin. Remember that sores can appear on the mouth or fingers of those who are suffering from a herpes outbreak, and if a mother notices sores on her breast, she should stop breastfeeding on that breast. [7]

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