Background Neonatal HSV usually quoted as a rare disease. Most cases result from vertical transmission. Worldwide incidence is variable and seen as high as 30/100,000 live births in USA. UK incidence is commonly quoted as around 1–2/100,000¹ but a recent report quoted a rate as high as 17.5/100,000.² nHSV can have serious effects with significant mortality and morbidity in otherwise healthy babies.

Aim To review incidence of diagnosed nHSV infection, age of presentations, outcomes, maternal perinatal illness and outcome, common presentations and follow up in a tertiary neonatal centre in UK.

Methods Retrospective study of all diagnosed cases of nHSV in last 10 years in our centre. Maternal health and HSV status were studied. Survivors were followed for recurrence and development.

Results Total 8 patients with nHSV identified during period of 2004 to 2015 with 67 500 live births. An incidence of 12/ 100,000 live births. There were 2 deaths, both due to HSV 2 with rapidly deteriorating course. Age of presentation varied from 3 to 20 days with non-specific symptoms. 3 patients had disseminated infection, of which two died. In both patients who succumbed Acyclovir was commenced after 22 hours of presentation. Five patients had Acyclovir commenced within 4 hours of presentation. 2 mothers had negative serology. One had genital Herpes. 5 patients were followed, had normal development at 1 year.

Conclusion Neonatal HSV is not so uncommon. Initial symptoms are non-specific and clinicians should be aware as early acyclovir can be life saving. Symptom presentation 3–10 days – HSV should be in differential diagnosis. Survivors have normal 1 year development. A nationally reportable incidence and case definition of neonatal herpes simplex virus is desirable but not yet in effect.

References

1. Genital Herpes in Pregnancy, Management (Green-top Guideline No. 30).

2. The incidence and presentation of neonatal herpes in a single UK tertiary centre, 2006–2013.Arch Dis Child. 2014 Oct; 99(10): 916–21