Neonatal herpes
What is Neonatal herpes?
Neonatal herpes is a viral infection that occurs when a baby gets herpes simplex virus during birth. This happens when the mother has genital herpes and passes the virus to the baby as they move through the birth canal. The condition is rare, affecting about 10 out of every 100,000 births in the United States.
There are two types of herpes simplex virus. HSV-1 usually causes cold sores around the mouth. HSV-2 typically causes genital herpes. Both types can cause neonatal herpes, but HSV-2 accounts for most cases. The virus can affect the baby's skin, eyes, mouth, or central nervous system.
Neonatal herpes is most dangerous when it spreads to the brain or throughout the body. Without treatment, the infection can cause serious health problems or death. Early detection and treatment are critical for protecting newborns from severe complications.
Symptoms
- Blisters or sores on the skin, eyes, or mouth
- Fever or low body temperature
- Difficulty breathing or rapid breathing
- Lethargy or extreme sleepiness
- Poor feeding or refusal to eat
- Seizures or unusual movements
- Jaundice or yellowing of the skin
- Irritability or excessive crying
Symptoms typically appear within the first 4 weeks after birth. Some babies show signs within the first few days, while others may not develop symptoms for several weeks. Early symptoms can be subtle and easy to miss.
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Causes and risk factors
Neonatal herpes occurs when a baby comes into contact with herpes simplex virus during delivery. The risk is highest when a mother has an active genital herpes outbreak at the time of birth. Women who get herpes for the first time late in pregnancy face the greatest risk because their bodies haven't developed antibodies yet. Babies can also get infected if someone with an active cold sore kisses them or touches them after touching a herpes sore.
The virus can enter the baby's body through breaks in the skin or through mucous membranes in the eyes, nose, or mouth. Risk factors include a mother having a first herpes outbreak during pregnancy, visible herpes lesions during labor, invasive monitoring during delivery, and premature birth. Women with a history of genital herpes have a much lower risk of transmission compared to those with new infections.
How it's diagnosed
Doctors diagnose neonatal herpes through physical examination and laboratory tests. They look for characteristic blisters or sores on the skin. Blood tests can detect HSV-2 Type Specific Antibodies, which show whether the mother has been exposed to the virus. Testing the mother during pregnancy helps doctors assess risk and plan delivery.
For babies showing symptoms, doctors may take samples from skin lesions, the mouth, eyes, or spinal fluid. These samples are tested for the presence of herpes virus using PCR testing or viral culture. Talk to your doctor about testing options if you have a history of genital herpes or develop symptoms during pregnancy. Preventive screening can help protect your baby.
Treatment options
- Antiviral medications like acyclovir given intravenously to infected babies
- Cesarean delivery for mothers with active herpes lesions at the time of labor
- Suppressive antiviral therapy for pregnant women with a history of genital herpes
- Isolation of newborns from people with active cold sores or genital herpes
- Hospital monitoring and supportive care for infected infants
- Eye drops or ointments if the infection affects the eyes
- Long-term antiviral therapy for babies who had severe infections
Frequently asked questions
Neonatal herpes is rare, affecting about 10 out of every 100,000 births in the United States. The risk is much higher when a mother gets genital herpes for the first time late in pregnancy. Women with long-standing herpes infections have a much lower risk of passing it to their babies.
Yes, several strategies can prevent neonatal herpes. Pregnant women with active genital herpes lesions at delivery should have a cesarean section. Women with a history of genital herpes may take antiviral medication during the last month of pregnancy. Avoiding exposure to people with active cold sores or genital herpes also protects newborns.
Symptoms typically appear within the first 4 weeks after birth. Some babies show signs within the first few days of life. Others may not develop symptoms until 2 to 4 weeks after delivery. Early symptoms can be subtle and include poor feeding, fever, or skin blisters.
Untreated neonatal herpes can cause serious complications or death. The virus may spread to the brain, causing encephalitis and permanent neurological damage. It can also affect multiple organs throughout the body. Early treatment with antiviral medications greatly improves outcomes and reduces the risk of long-term problems.
Talk to your doctor about herpes testing if you have a history of genital herpes or your partner has herpes. Routine screening is not recommended for all pregnant women. However, testing makes sense if you have symptoms or risk factors. Knowing your status helps your doctor plan the safest delivery for your baby.
Yes, mothers with herpes can usually breastfeed safely. The virus does not spread through breast milk. However, you should not breastfeed if you have herpes sores on your breast. Cover any sores on other parts of your body and wash your hands thoroughly before touching your baby.
The outlook depends on how severe the infection was and how quickly treatment started. Babies with skin, eye, or mouth infections usually recover well with treatment. Those with brain or widespread infections may have lasting neurological problems. Early antiviral treatment significantly improves outcomes for all types of neonatal herpes.
Neonatal herpes is much more dangerous than herpes in adults. Newborns have immature immune systems that cannot fight the virus effectively. The infection can spread quickly to the brain and other organs. Adults with herpes typically have mild symptoms and rarely develop serious complications.
Yes, a baby can get herpes if someone with an active cold sore kisses them. HSV-1, which causes cold sores, can be just as dangerous to newborns as HSV-2. Anyone with visible cold sores should avoid kissing babies or touching them. Always wash hands before handling newborns.
The HSV-2 IgG Type Specific Antibody test detects past exposure to HSV-2, the virus that causes most genital herpes. This blood test can show whether you have been infected before, even without symptoms. Your doctor may order this test if you have risk factors or a history of genital herpes.