Congenital Herpes Simplex

Congenital herpes simplex is an infection caused by exposure in the uterus. In most cases, babies contract congenital herpes in the birth canal during delivery, although in rare circumstances, it's possible to be infected in the uterus or immediately after birth.

• Herpes affects about 30 out of every 100,000 babies.
• Most symptoms surface by the end of the baby's first week, while more severe central nervous system problems will not appear until the baby's second week.

In adults and children, herpes simplex virus (HSV) can be transmitted by direct skin-to-skin contact and is also a sexually transmitted disease.

Symptoms of congenital herpes usually appear within the first month of the infant's life. Signs that your baby may have herpes are:

• Irritability
• Seizures
• Trouble breathing, including grunting, blue appearance (cyanosis), rapid breathing, and short periods of no breathing
• Jaundice (yellow skin color)
• Bleeding easily
• Shock

Herpes simplex infections can be divided into three categories, determined by these symptoms:

• Localized skin infection: small, fluid-filled blisters on the skin and around the eyes and mouth that burst, crust over, and heal
• Encephalitis: an inflammation of the brain, which can cause problems with brain and spinal cord function, including seizures
• Disseminated herpes infection: the most dangerous type of herpes infection. The herpes virus is spread throughout the body and can affect multiple organs, including the liver, brain, lungs, and kidney.

If your baby is afflicted with herpes, she may not exhibit all the symptoms of the disease. Most symptoms surface by the end of the baby's first week, while more severe central nervous system problems will not appear until the baby's second week.

If left untreated, encephalitis and disseminated herpes infections are potentially fatal.

Diagnosis is difficult because babies with congenital herpes may not have the characteristic blisters of the disease. In addition, many symptoms of herpes resemble other diseases or disorders. However, the following tests can diagnose congenital herpes:

• Skin culture: taking a sample of the blister by scraping or removing a piece of tissue
• Blood test
• Swab culture: taking a sample with a cotton swab from the nose, throat or rectum
• Urine test
• CT scan or MRI scan of the head.

The mother and baby are usually tested simultaneously if herpes is suspected.

If your baby has congenital herpes, she will be treated with antiviral medications given intravenously (through an IV) over a period of several weeks. The most commonly used treatment for congenital herpes is called acyclovir. Other treatment may be necessary for the various symptoms of herpes.