Herpes Simplex Virus

 

Reviewed by Clinical practice Committee
April 2014
 
Clinical Guidelines Back Newborn Services Home Page

 

Herpes Simplex Virus

Only 30% of mothers whose infants have neonatal herpes have a history of symptomatic genital herpes. Any infant with vesicular lesion(s) must have investigations performed and have aciclovir treatment commenced regardless of maternal history.

Investigations

NB: If these are on a baby with suspected HSV disease then swabs of skin lesions and other sites should be for PCR, not culture. If doing surveillance of a non-symptomatic baby born to a mother with HSV, then culture is sufficient.

  1. Skin vesicles: swab for HSV PCR.
  2. Swabs from eyes, mouth / nasopharynx for HSV PCR
  3. WBCs (CPD or EDTA tube) for HSV PCR.
  4. CSF - cells, protein, glucose, culture, HSV PCR.
  5. FBC, LFTs
  6. Head MRI or EEG may assist in localizing disease but 40 % of babies with disseminated disease will not have CNS involvement so indication depends on individual cases
  7. Ophthalmology consultation.
  8. Consult Paediatric Infectious Disease Team

Isolation

Contact isolation required, especially if skin lesions present.
Isolate infants born vaginally to mothers with active genital infection for four weeks. Room-in with mother in isolation if possible. Advise mother re handwashing.

Observation / Serveillance

Known exposed infants require careful observation.

Resource

1 Guidance on management of asymptomatic neonates born to women with active genital herpes lesions. Kimberlin DW, Baley J; Committee on Infectious Diseases; Committee on Fetus and Newborn. Pediatrics. 2013 Feb;131(2):383-6. doi: 10.1542/peds.2012-3217