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The Herpes Simplex Virus, also known as HSV, is a viral infection that causes herpes. Herpes can appear in various parts of the body. Most commonly, herpes type 1, sometimes called fever blisters or cold sores, cause sores around the mouth and lips. HSV-1 can cause genital herpes, but most cases of genital herpes are caused by herpes type 2. In HSV-2, the infected person may have sores around the genitals or rectum.
Neonatal herpes can occur when an infant is exposed to HSV in the genital tract during delivery. Estimates of the incidence of neonatal herpes have varied from 1 in 3,000 to 1 in 20,000 live births. The current estimated rate of occurrence is approximately 1 in 3,200 deliveries (Kimberlin, D. W. (2004). Neonatal Herpes Simplex Infection. Clinical Microbiology Reviews, 17(1), 1–13. http://doi.org/10.1128/CMR.17.1.1-13.2004 The risk for neonatal herpes is greatest when a mother acquires an HSV infection for the first time in late pregnancy.
Any delay in the identification of at risk pregnancies or in the diagnosis of neonatal HSV infection can have disastrous consequences and can lead to permanent disabilities or death.
We need your help to bring this important issue to the attention of our local, provincial and federal health ministers and representatives. We want to see mandatory testing across Canada for all women that become pregnant using the Western Blot Test as it is the most accurate form of testing that leads to less false positive results. We also want to see more funding made available for research to be done on this virus so that better treatment options become available for use.
Since neonatal herpes infection can be seen up until four weeks of age, clinicians caring for newborns in clinics, offices, and emergency rooms must be familiar with the clinical manifestations of this disease process. Thus clinicians must be provided with the most up to date information and clinical education on the risk factors, clinical presentations and treatment options to treat this disease.
Finally we look to the health care system to educate the public on this disease. Many people are unaware they carry the virus because they show no signs or symptoms or they have been misdiagnosed by medical professionals, but this virus has can still be transmitted through asymptomatic shedding (no signs or symptoms). Although rare, a simple kiss, diaper change or breastfeeding from someone who is unaware or shows no signs of the virus can pass on the virus to their infant.
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Clinical symptoms associated with neonatal herpes infection are often nonspecific, and can go unrecognized or be attributed to other disease processes. Neonatal HSV infection can be divided into three clinical groups. Skin, Eyes and Mouth disease (SEM) [a localized infection affecting the skin, eyes, or mouth], Central nervous system (CNS) disease is defined as encephalitis, an inflammation of the brain with or without SEM disease], and Disseminated or widespread disease involving infection in multiple organ systems. Skin lesions can be seen in all types and disseminated disease may occur with or without the presence of CNS disease. While the presence of SEM infection is associated with a 0% mortality rate, without prompt treatment, up to 70% of infants with SEM disease will progress to either CNS or disseminated disease (Kimberlin, D. W. (2004). Neonatal Herpes Simplex Infection. Clinical Microbiology Reviews, 17(1), 1–13. http://doi.org/10.1128/CMR.17.1.1-13.2004
The incubation period for neonatal herpes infection is 4 to 21 days after delivery. Infants typically begin to exhibit signs between 6 and 21 days, with 30 to 40% of infants becoming symptomatic within the first week of life. Signs are often consistent with those of bacterial sepsis and include fever, temperature instability, lethargy, poor feeding, respiratory distress, and cyanosis, and as the infection progresses, disseminated intravascular coagulation which is the formation of blood clots forming throughout the body blocking small blood vessels( DIC), hepatitis, pneumonitis, and seizures. Approximately 68% of neonatal herpes infection will present with lesions and 17 to 39% of infants with confirmed herpes infection will never exhibit evidence of lesions during their illness. Since these signs may be initially mistaken for those associated with bacterial infection, treatment is often delayed until progression of the disease process occurs, leading to a dramatic increase in mortality and morbidity.
Infants with CNS disease present with acute symptoms of meningitis, an acute inflammation of the protective membranes covering the brain and spinal cord, including a bulging fontanel, irritability, abnormal movements or positioning, and most commonly generalized or localized seizure activity.
Infants presenting with disseminated herpes typically present with symptoms very similar to those associated with bacterial infection. Disseminated herpes disease may often be distinguishable from bacterial infection by the presence of lesions hepatitis of unknown origin, and DIC. Disseminated herpes infection may have a component of CNS involvement and the infant may therefore exhibit symptoms consistent with encephalitis or meningitis (Kimberlin, D. W. (2004). Neonatal Herpes Simplex Infection. Clinical Microbiology Reviews, 17(1), 1–13. http://doi.org/10.1128/CMR.17.1.1-13.2004
Although infants with a positive maternal history of herpes infection are often considered at risk for the development of neonatal herpes infection, these infants actually carry the lowest risk of infection. The most serious neonatal infections are due to a primary infection in the mother. However, 60 to 80% of those primary infections are asymptomatic, and there may be no history of maternal herpes infection. Therefore, the presence of a negative maternal and/or paternal history cannot reduce the level of suspicion related to neonatal herpes infection should not be considered inconsequential.
A recent study from the United Kingdom shows that genital HSV in pregnancy doubles the risk of autism in children.
Babies who get circumcised can get the virus. It's known to be a ritual in the some Religious communies has that the blood be sucked from the incision and the person preforming the procedure does not need to be tested for the virus.
HSV is considered a sexually transmitted disease (STD) even though it is transmitted in more ways than sexual contact; therefore, people need to become more aware and educated regarding the seriousness of this problem. We believe there is a component of stigma surrounding the topic that must be eradicated before serious consideration and work can be done to help prevent this disease in infants.
The following are just a few of many unfortunate stories.
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