A guide to neonatal herpes (herpes simplex virus)
Neonatal herpes is a rare but serious condition caused by the herpes simplex virus which can be transmitted from mother to baby during childbirth. Prompt diagnosis and treatment are crucial to prevent the virus spreading and causing severe complications.
Recent studies show that the incidence of neonatal herpes in the UK has increased. A study by the British Paediatric Surveillance Unit (BPSU) found that from 2019 to 2022, there were 6.9 cases per 100,000 live births. This is a significant increase compared to earlier studies, which reported 1.65 to 3.6 cases per 100,000 live births between 1991 and 2006.
What is HSV and how can it affect my baby?
Neonatal herpes (HSV) is an infection that occurs in newborns, typically within the first four weeks of life. It is caused primarily by the herpes simplex virus (type 1 or 2) which is also responsible for oral and genital herpes in adults.
Newborns can quickly become very ill from the virus because of their immature immune systems. If not treated promptly, neonatal herpes can have a severe effect on a baby, such as:
- Localised infections: In some cases, the infection may be limited to the skin, eyes, or mouth (SEM disease). With antiviral treatment, most babies with this form of the infection can recover fully.
- Impact on the central nervous system: If the virus spreads to the central nervous system, it can cause encephalitis (inflammation of the brain), leading to symptoms like seizures, lethargy, and irritability. This can result in long-term neurological damage.
- Disseminated infection: This is the most severe form of infection. If the virus spreads to multiple organs, such as the liver, lungs, and brain, it can lead to severe complications and is often life-threatening, even with treatment.
- Long-term effects: Babies who survive severe neonatal herpes may experience long-term health issues such as developmental delays, learning disabilities, and recurrent seizures.
Early recognition and prompt treatment with antiviral medications are crucial to improving outcomes and reducing the risk of severe complications.
How can a newborn contract HSV?
Newborns can contract neonatal herpes in several ways:
- During birth (perinatal): The most common way is through contact with the herpes simplex virus in the birth canal during vaginal delivery if the mother has an active genital herpes infection.
- After birth (postnatal): The virus can also be transmitted through close contact with someone who has an active herpes infection, for example if someone with a cold sore kisses the baby, or if the baby comes into contact with HSV-infected skin or blisters.
- In utero: Although rare, the HSV virus can be transmitted from the mother to the baby through the placenta during pregnancy.
Perinatal HSV is the most common source of infection. Pregnant women with a history of herpes should be closely monitored and preventive measures should be taken to reduce the risk of transmission during childbirth. If the mother has an active genital herpes infection, a caesarean delivery may be considered.
Once diagnosed, prompt antiviral treatment is essential. Antiviral medications can help control the infection, reduce symptoms, and prevent the virus from spreading to other parts of the body. Treatment may be needed for 2-3 weeks, and any related complications such as seizures also need to be treated.
After the initial treatment, some babies may need long-term antiviral therapy to prevent recurrence and manage any ongoing symptoms.
What are the symptoms of HSV in babies?
Symptoms to watch for:
- Lethargy or irritability
- Poor feeding
- High or low body temperature
- Rash or sores on the skin, eyes, or inside the mouth
- Breathing difficulties, such as rapid breathing or grunting
- Floppiness or unresponsiveness
- Bluish skin or lips (cyanosis)
Prompt diagnosis is crucial in managing neonatal herpes. Delays or misdiagnoses can result in the virus spreading and cause severe complications.
Medical negligence claims arising from HSV infection in a newborn
Medical negligence can significantly impact the management and outcomes of HSV in newborns. Negligence might occur because of:
- Failure to screen and diagnose: If a healthcare provider does not properly screen a pregnant woman for HSV, especially if she has risk factors or symptoms, infections can go undiagnosed and untreated.
- Inadequate monitoring: Not closely monitoring a pregnant woman with known HSV or not taking appropriate measures during labour and delivery (e.g., recommending a caesarean section if there is an active infection) can increase the risk of transmission to the newborn.
- Delayed or improper treatment: Delays in diagnosing and treating neonatal HSV can result in severe complications. Prompt administration of antiviral medications is crucial.
- Lack of preventive measures: Not advising on or implementing preventive measures, such as antiviral prophylaxis for the mother during the last weeks of pregnancy, can increase the risk of neonatal infection.
- Failure to educate: Not providing adequate education to the mother about the risks of HSV and how to prevent transmission can also be considered negligence.
These failures in management and treatment can lead to severe outcomes for the newborn, including long-term neurological damage, developmental delays, and even death.
Talk to a member of our team if you have any concerns about an injury to a newborn baby caused by neonatal herpes. Sarah Cunliffe is a specialist in our medical negligence team, with experience in birth injury claims.
Further information about injuries to mothers and babies arising from problems during pregnancy, labour or childbirth can be found on our birth injury claims page.
Disclaimer
This information is for educational purposes only and does not constitute legal advice. It is recommended that specific professional advice is sought before acting on any of the information given. © Shoosmiths LLP 2025
