Birth-acquired herpes is a herpes virus infection that an infant gets while in the womb. The infection can also develop during or shortly after birth. Babies with birth-acquired herpes get the infection from mothers who 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 who are born with herpes may have a skin infection, a system-wide infection (called “systemic herpes”), or both. Systemic herpes is more dangerous and can cause a variety of serious issues. These issues may include brain damage, breathing problems, and seizures.
According to Boston Children’s Hospital, herpes occurs in approximately 30 out of every 100,000 births. It’s a serious condition and can be life-threatening if it leads to encephalitis (brain inflammation) or disseminated herpes (when the entire body becomes infected with herpes).
The herpes simplex virus causes birth-acquired herpes. After someone recovers from herpes, the virus lies dormant in their body for long periods of time before it flares up and symptoms appear. When the virus reactivates, it’s called an active infection. Women who have active herpes infections are more 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 a nonactive herpes infection at the time of delivery can also transmit herpes to their child, according to the Office on Women’s Health. However, the chances of passing it on to the baby are much lower.
You should note that your infant could also get 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. Someone who has a cold sore can pass the virus on 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 and may be present at birth. Birth-acquired herpes is easiest to identify when it appears as a skin infection. The baby may have clusters of fluid-filled blisters on their torso or around their eyes. The blisters, called vesicles, are the same type of blisters that appear on the genital regions of adults with herpes. The vesicles may burst and crust over before healing. An infant can be born with the blisters or develop the sores a week after birth.
The systemic form of congenital herpes affects more than just the baby’s skin and can cause serious complications, such as seizures. The herpes simplex virus can also cause a dangerous condition known as encephalitis, an inflammation of the brain. Encephalitis may lead to brain damage and spinal cord injuries. The herpes simplex virus can further attack the body and cause a disseminated herpes infection. In this case, the disease might affect the baby’s vital organs, including the:
- lungs, causing difficulty breathing and interruption in breathing
- liver, causing jaundice (a yellowish discoloration in the baby’s eyes and skin)
- central nervous system, causing seizures, shock, and hypothermia
Infants with birth-acquired herpes might also appear extremely tired and have trouble feeding.
Your doctor will take samples of the blisters and spinal cord fluid to determine if herpes is the cause of illness. A blood or urine test may also be used. Further diagnostic testing might include MRI scans of the baby’s head to check for brain swelling.
The herpes virus can be treated, but not cured. This means the virus will remain in your child’s body throughout their life. However, the symptoms can be managed. Your child’s pediatrician will likely treat the infection with antiviral medications given through an IV (a needle or tube that goes into a vein). Acyclovir is the most commonly used antiviral medication for birth-acquired herpes. Treatment usually spans a few weeks and may include other medications to control seizures or treat shock.
You can prevent herpes by practicing safe sex. Condoms can minimize exposure to an active herpes outbreak, thus preventing transmission of the virus. You should also talk to your partner about their sexual history and ask if they have ever had herpes. You can further limit your risk by getting tested for herpes.
If you’re pregnant and have herpes or have had it in the past, discuss your situation with your doctor well before your due date. You may be given medicine towards the end of your pregnancy to help reduce the chance of passing on herpes to your baby. You may also be able to have a cesarean delivery, which can lower the risk of passing herpes on to your baby. In a cesarean delivery, the baby is delivered through incisions made in the mother’s abdomen and uterus. This keeps the child from coming into contact with the virus in the birth canal.
Herpes is inactive at times, but it can come back repeatedly even after treatment. Complications associated with birth-acquired herpes include:
- eye inflammation
- seizure disorders
- respiratory illnesses
Babies with systemic herpes infections may not even respond to treatment and can possibly face several additional health risks. Disseminated birth-acquired herpes may be life-threatening and can cause neurological problems or coma.
Since there is no cure for herpes, the virus will stay in the child’s body. Parents and caretakers must watch for signs or symptoms of herpes throughout the child’s life. When the child is old enough, they will need to learn how to prevent spreading the virus to others.