What is birth-acquired herpes?

Birth-acquired herpes is a herpes virus infection that an infant gets during delivery or, less commonly, while still in the womb. The infection can also develop 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’s present from birth.

Infants who are born with herpes may have a skin infection or a system-wide infection called systemic herpes, or both. Systemic herpes is more serious and can cause a variety of issues. These issues may include:

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.

Causes of birth-acquired herpes

The herpes simplex virus (HSV) causes birth-acquired herpes. The highest risk for birth-acquired herpes is during a mother’s first, or primary, infection.

After someone recovers from herpes, the virus lies dormant in their body for long periods before it flares up and symptoms appear or reappear. When the virus reactivates, it’s called a recurrent 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 infection.

Mothers who have a nonactive herpes infection when they deliver can also transmit herpes to their child, particularly if they acquired herpes for the first time during pregnancy.

Most babies with HSV infection are born to mothers with no history of herpes or active infection. This is, in part, because measures are taken to prevent birth-acquired herpes in babies born to mothers who are known to be infected.

You should note that your infant could also get herpes through contact with cold sores. Another form of the HSV causes cold sores on the lips and around the mouth. Someone who has a cold sore can pass the virus on to others through kissing and other close contact. This would be considered neonatal herpes, rather than birth-acquired herpes, and is usually less severe.

Recognizing the symptoms of birth-acquired herpes

The symptoms of birth-acquired herpes usually appear within the first few weeks of the baby’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.

Infants with birth-acquired herpes might also appear extremely tired and have trouble feeding.

Picture of birth-acquired herpes

Complications associated with birth-acquired herpes

The systemic form of congenital herpes, or disseminated herpes infection, occurs when the entire body becomes infected with herpes. It affects more than just the baby’s skin and can cause serious complications, such as:

The disease might also affect the baby’s vital organs, including the:

The HSV can also cause a dangerous condition known as encephalitis, an inflammation of the brain that may lead to brain damage.

Diagnosing birth-acquired herpes

Your doctor will take samples of the blisters (if they are present) 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.

Birth-acquired herpes treatment

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 (Zovrax) 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.

Herpes prevention

You can prevent herpes by practicing safe sex.

Condoms can minimize exposure to an active herpes outbreak and prevent transmission of the virus. You should also talk to your partner about their sexual history and ask if they have herpes.

If you’re pregnant and you or your partner 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 toward 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 if you have active genital lesions. A cesarean delivery 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 will keep your baby from coming into contact with the virus in the birth canal.

Long-term outlook for birth-acquired herpes

Herpes is inactive at times, but it can come back repeatedly even after treatment.

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’s no cure for herpes, the virus will stay in the child’s body. Parents and caretakers must watch for symptoms of herpes throughout the child’s life. When the child is old enough, they’ll need to learn how to prevent spreading the virus to others.