Neonatal herpes prevention: a minor public health problem in some communities

Abstract

Background: Neonatal herpes is a condition with high morbidity and mortality. The greatest risk occurs when the mother acquires herpes simplex virus (HSV) towards the end of pregnancy. A study from Seattle has suggested that the risk of acquisition of HSV during pregnancy was 3.7%. In Australia, HSV-2 infection is less common in pregnant women than in the United States. Consequently we conducted a study to establish HSV seroprevalence and the rate of HSV seroconversion in this population. Methods: The study was conducted at Westmead Hospital, Sydney, between June 1995 and April 1998. Women completed a questionnaire covering risk factors for the acquisition of genital herpes. A serum sample during pregnancy and a specimen of cord blood were obtained and tested for antibodies to HSV-2 using a type specific indirect enzyme linked immunosorbent assay (ELISA). Equivocal results were resolved by western blot. A subset of the paired sera was tested for antibodies to HSV-1. The data were analysed using SPSS. Results: 326 of the 2616 (12.5%) women were HSV-2 seropositive. Three women (0.15%) acquired HSV-2 infection during pregnancy. None of the three babies of these mothers developed neonatal herpes. 416 maternal cord pairs were tested for HSV-1 antibodies and 330 (79.3%) were positive. No HSV-1 seroconversions occurred. Conclusions: In this population, HSV acquisition was uncommon (0.34% per year) and neonatal herpes was rare. A cost eVective analysis suggested that type specific serology to screen pregnant women and their partners in low prevalence communities was not cost eVective. (Sex Transm Inf 2000;76:287-291)

Transmission of Herpes Simplex Virus Types 1 and 2 in a Prospective Cohort of HIV‐Negative Gay Men: The Health in Men Study

“…Increasing age, a higher number of lifetime sex partners, a history of STDs, and a lower education level have all been reported as risk factors for both prevalent HSV-1 and prevalent HSV-2 infection [16,17,[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36]. In addition, studies of homosexual men have also reported that receptive UAI is a risk factor for HSV-2 [19,20].…”

Strategies for the prevention of neonatal herpes: just a matter of opinion?

“…Type-specific serology did not appear to be cost-effective in a low prevalence Australian community, and was also questioned in a recent study from the US [3,15]. One study suggested that testing women for HSV-1 antibodies dcould provide some public health benefitsT [16].…”

“…More detailed information may help determine risk behaviour and establish reasonable control strategies [3]. One important question that urgently needs to be answered, especially in the light of the growing importance of HSV-1 as the cause of neonatal herpes, is whether or not pregnant women, towards the end of pregnancy (i.e.…”

“…seem to differ widely. This almost certainly has to do with, geographically determined, differences in disease burden [3].…”

Herpes simplex virus infection – survey on knowledge of herpes virus infection among people aged 18–35

“…Częstość występowania opryszczki u noworodków na świecie jest zróżnicowana, co ma związek z różną serokonwersją w poszczególnych regionach geograficznych i różnych populacjach [27,28]. Wzrost liczby zakażeń noworodków na świecie, wysoka śmiertelność i ciężki przebieg choroby powinny zwrócić uwagę na potrzebę edukacji nie tylko wśród lekarzy, lecz także pacjentów co do przebiegu i terapii tego zakażenia.…”