Neonatal herpes: what have we learned.

Area of Science:

• Virology
• Neonatal Medicine
• Infectious Diseases

Background:

• Neonatal herpes simplex virus (HSV) infection is typically acquired during birth from an infected mother.
• The disease can manifest as disseminated infection, central nervous system disease, or SEM (skin, eyes, mouth) disease.
• Despite advances in diagnostics and treatment, the time from symptom onset to therapy initiation remains unchanged.

Purpose of the Study:

• To review the current understanding of neonatal HSV disease, including its transmission, manifestations, diagnosis, and treatment.
• To highlight the persistent challenges in timely diagnosis and treatment initiation.
• To emphasize the importance of increased awareness and future diagnostic developments for improved infant outcomes.

Main Methods:

• Review of recent advances in diagnostic technologies, particularly polymerase chain reaction (PCR).
• Analysis of treatment outcomes with intravenous acyclovir.
• Discussion of current therapeutic timelines and potential future diagnostic strategies.

Main Results:

• Intravenous acyclovir has significantly improved survival rates for neonatal HSV disease.
• Neurologic morbidity remains a common sequela, especially in central nervous system disease cases.
• Diagnostic PCR technology has advanced, but treatment initiation delays persist.

Conclusions:

• Increased awareness of neonatal HSV disease is essential for earlier diagnosis and prompt antiviral therapy, leading to rapid improvements in outcomes.
• Development of rapid, bedside nucleic acid detection kits for maternal screening could identify at-risk infants prenatally.
• Further research and implementation of advanced diagnostics are needed to reduce long-term morbidity in affected infants.