Transplacental Infection by Herpes Simplex Virus

Abstract

One of the more common viral infections affecting man is that caused by the herpes simplex virus. Its most common manifestation, the "fever blister," is so familiar to the layman that a medical diagnosis is not sought.However, the manifestations of the herpes virus are so protean that they may range from severe encephalitis, to the moderately severe stomatitis frequently seen in the very young, to the mild "fever blister" just mentioned. The more severe manifestations are due to a primary infection which occurs after an incubation period of three to five days, whereas the "fever blister" is felt to be the result of an upset in an otherwise symbiotic relationship between host and virus. Between 65% and 98% of adults, depending on areas sampled, will show neutralizing antibodies to the herpes simplex virus.Since the initial case report of herpes simplex infection in the newborn by Haas 1 in 1935 it has been recognized that the herpes virus is capable of producing a widespread disseminated disease of the newborn which involves structures of ectodermal origin as well as those of entodermal and mesodermal origin. After this report by Haas, Zuelzer,2 in 1952, reported five infants with pathologi¬ cal evidence of disseminated herpetic infec¬ tion, one of which was proved on culture to have been caused by the herpes simplex virus. This report and subsequent ones have described the disease as being characterized by the onset of a systemic reaction on or about the fifth to seventh day post delivery with fever or hypothermia, increasing icterus, lethargy, respiratory distress, vomiting, dyspnea, cyanosis, and with rapid develop-

A Report of Three Cases and Review of Intrauterine Herpes Simplex Virus Infection

“…10,29 Another 2 cases had confirmation of herpes infection through histopathology on days 2 and 5, respectively, but virus was not isolated in culture until days 10 and 120, respectively. 12,26 In these cases, culture confirmation occurred at a median of 10 days (range, 4 days to 14 months).…”

“…26 Avgil and Ornoy 4 stated that “in utero infection by HSV bears relatively little danger for significant fetal damage ... and has weak teratogenic potential.” While not a common entity, the cases of intrauterine HSV infection reviewed in this work demonstrate HSV is clearly a teratogen.…”

Superficial Keratitis

“…Herpes simplex eye lesions have been described to be present at birth (Hagler et aI., 1969;Pettay et aI., 1972;Hutchison et aI., 1975) or may develop in the neonatal period (Batignani, 1934;Smith et aI., 1941;Pillard et aI., 1950;Zuelzer and Stulberg, 1952;Florman and Mindlin, 1952;Monnet et aI., 1961;Neimann et aI., 1963;Langvad and Voigt, 1963;Mitchell and McCall, 1963;Cogan et aI., 1964;Yen et aI., 1965;Bahrani et aI., 1966;Berkovich and Ressel, 1966;Proto and Tedesco, 1966';May et aI., 1967;Partridge and Millis, 1968;Golden et aI., 1969;Hagler et aI., 1969;Bobo et aI., 1970;Nahmias et ai., 1970;Cibis and Burde, 1971;Nahmias et ai., 1976). About half of these infants were born premature and showed involvement of central nervous system, skin, cornea, conjunctiva, viscera, eyelids, oral cavity and optic neuritis, choreoretinitis, cataracts and microphthalmia in various combinations and severity.…”

Hematogenous Vertical Transmission of Herpes Simplex Virus Type 1 in Mice

“…In the United States, neonatal HSV-2 infection currently occurs around one in every 2,500 births, but rates are increasing (17,39). HSV infection during pregnancy may result in miscarriage, the death of the fetus, congenital fetal infection, and malformations (16,25,27,37,38,45).…”