Birth-acquired herpes is an infection that develops in utero, or during or shortly after birth. Babies with birth-acquired herpes contract the infection from mothers that are infected with genital herpes. Birth-acquired herpes is sometimes also called “congenital herpes.” The word “congenital” refers to any condition that is present from birth.
Infants born with herpes may have a skin infection, a system-wide infection (called “systemic herpes”), or both. Systemic herpes is more dangerous to the child, and can cause a variety of serious issues. Brain damage, breathing problems, and seizures are among infants with systemic birth-acquired herpes.
This condition occurs in approximately 30 of every 100,000 births (Boston Children’s Hospital). It is a serious condition, and is potentially life threatening if it leads to encephalitis or disseminated herpes infection.
The herpes simplex virus causes birth-acquired herpes. The virus lies dormant in a person’s body for long periods of time before it flares up and symptoms appear. When the virus flares, it is called an active infection. Women who have active herpes infections are most likely to pass the virus on to their babies during a vaginal birth. The infant comes into contact with herpes blisters in the birth canal, which can cause them to become infected.
Mothers who have herpes but do not have an active infection at the time of delivery can also transmit herpes to their child, according to the National Institutes of Health (NIH, 2010). The chances of giving an infant birth-acquired herpes from a non-active infection are lower, however.
Although not directly related to birth-acquired herpes, you should note that infants can also contract herpes through contact with cold sores. Cold sores on the lips and around the mouth are caused by another form of the herpes simplex virus. A person that has a cold sore can pass the virus to others through kissing and other close personal contact.
The symptoms of birth-acquired herpes usually appear within the first few weeks of the child’s life if they are not present at birth. The skin infection form of the condition is perhaps easiest to identify. The baby may have clusters of fluid-filled blisters on their torso or around the eyes. The blisters, called vesicles, are the same type of blister that appears on the genital regions of adults with herpes. The vesicles may burst and crust over before healing. An infant may be born with the blisters or may develop the sores in the first week of life.
The systemic form of congenital herpes affects more than just the baby’s skin, and can be very serious. The herpes simplex virus can cause encephalitis, a dangerous inflammation of the brain. Encephalitis can cause brain damage and spinal cord injuries. The virus can further attack the body, causing a condition called disseminated herpes infection. In this case, the disease might affect the baby’s vital organs, including:
- lungs, causing breathing difficulties and interruption in breathing
- liver, causing jaundice
- central nervous system, causing seizures, shock, and hypothermia
Infants with birth-acquired herpes might also appear extremely lethargic and have trouble feeding.
Doctors will take samples of the blisters and spinal cord fluid to determine if herpes is the cause of illness. Further diagnostic testing includes magnetic resonance imaging (MRI) scans of the baby’s head to check for brain swelling.
The herpes virus can be treated, but not eliminated. In other words, the virus will be present in the child’s body throughout his or her life, but the symptoms can be managed. Your child’s pediatrician will most likely treat the infection with intravenous antiviral medications. Acyclovir is the most commonly used antiviral for birth-acquired herpes (NIH, 2010). Treatment usually spans a few weeks, and may include other medications to control seizures or treat shock.
Prevention of birth-acquired herpes is a two-fold proposition:
The first step in prevention is for adults of both genders to practice safe sex. Condoms can prevent exposure to an active herpes outbreak, thus preventing transmission of the virus. Talk to your partner about their sexual history as well to keep yourself healthy and safe.
The second step is to limit the risk of passing along herpes if you know you have the infection. If you are an expectant mother that has herpes, discuss your situation with your doctor well before your due date. One option that can reduce your risk of giving your baby herpes is to give birth via C-section. Infants born through C-section bypass the birth canal, eliminating exposure to an active genital herpes infection.
Babies with systemic herpes infections face several additional health risks. Eye inflammation, blindness, seizure disorders, and respiratory illnesses are common complications associated with birth-acquired herpes. Neurological problems, coma, and even death can be possible outcomes of disseminated birth-acquired herpes.
Life with birth-acquired herpes will require vigilance on the part of the child’s parents and caretakers, and, when old enough, the child himself. The infection is not curable. Children who have congenital skin infections may see recurrences of the vesicles throughout their lives. Each outbreak of sores must be treated with antiviral drugs. According to NIH, the outbreaks also increase the risk of learning disabilities in the child (NIH, 2010).