MEDIA ADVISORY: Interviews are available with those quoted in this release and with experts in various specialties, including obstetrics and gynecology, pediatrics, and public health.

Experts Call for Action in Preventing Herpes Among Newborns

RESEARCH TRIANGLE PARK, NC -- About one in four pregnant women has genital herpes, and as many as 90% are undiagnosed. In most cases, genital herpes is a recurrent infection that rarely causes problems or complications. However, if a newborn contracts the virus at birth (neonatal herpes), untreated infection in newborns can progress to irreversible brain damage, heart and liver damage, and other complications.

An upcoming commentary in the September 2005 issue of the journal Sexually Transmitted Diseases estimates between 460 and 2,800 cases of neonatal herpes occur each year in the United States. Authors of the article point out that even the lowest current estimate of neonatal herpes exceeds the rates of several other conditions. Congenital rubella, HIV infection, syphilis, and gonorrhea in newborns are all less common than neonatal herpes – yet all are reportable diseases in almost all states and tracked by the Centers for Disease Control and Prevention (CDC).

Without treatment, neonatal herpes is fatal in at least half of cases and up to two-thirds of survivors have lifelong disabilities. Yet in the medical field, neonatal herpes gets little attention and is likely under-reported.

“Early diagnosis and treatment of infected infants is critical,” says James R. Allen, MD, MPH, president and CEO of the American Social Health Association. “This article points out that relatively little is known about how frequently this infection occurs in the United States and about the outcomes of the infected babies. We need to increase awareness of this problem by collecting better data and assuring that health care providers have current information.”

“Few conditions can match the havoc caused by neonatal herpes in its impact on affected families,” says H. Hunter Handsfield, MD, lead author of the article. In the wake of neonatal herpes, Handsfield notes, one or both parents may need therapy to work through anxiety or guilt, a parent might have to quit his or her job to care for the child, and marriages often end in divorce.

Among those diagnosed with genital herpes, fear of passing the infection to children is among the leading concerns. And parents of children who have been afflicted with neonatal herpes often advocate for more concerted prevention efforts.

One such parent is Barbara Peabody Beattie, who has worked with ASHA’s Herpes Resource Center to raise awareness of the problem. “Women must be made aware, through education, of the consequences of passing the virus to a newborn, “ says Beatty. “I was not aware I was infected with herpes simplex, and I wasn’t offered testing. I wish my story was the only one out there, but there are many others, and the number of children affected is increasing. We urgently need to figure out how to prevent this from happening.”

One step in addressing neonatal herpes is to urge states and public health agencies including the CDC to include the condition in their list of reportable infections. Only seven states currently mandate reporting of neonatal herpes: Ohio, Florida, North Dakota, Washington, Connecticut, Massachusetts, and Nebraska.

“[Herpes] probably is the most frequent of all serious, yet preventable and treatable, perinatal or congenital infections,” the authors of the new article contend. “However, it is sufficiently uncommon that reporting would pose little incremental administrative burden on healthcare providers or health departments.” Case reporting would provide reliable data on the incidence and impact of the disease to inform prevention efforts, clinical guidelines, and health policies.

Genital and neonatal herpes have long been considered difficult to prevent and difficult to identify. However, significant diagnostic and treatment advances have been made in recent years, and some experts believe it’s time for a more deliberate prevention effort.

Control strategies to date have focused on women with a history or evidence of genital herpes, despite data showing that two-thirds of infected infants are delivered to women with no history or clinical evidence of the disease. Newer FDA-approved serologic tests can aid in identifying women who have herpes but are unaware of it, as well as women at risk of acquiring herpes during pregnancy. Looking ahead, today’s research pipeline also includes a potential vaccine for herpes simplex virus type 2, the cause of most genital herpes.

The report’s other authors are: Zane A. Brown, MD, a professor of obstetrics and gynecology at the University of Washington and an authority on herpes in pregnancy; Lawrence Corey, MD, a herpes and HIV vaccine expert at the Fred Hutchinson Cancer Research Center and University of Washington; Joan L. Drucker, MD, of Medika LLC; Charles W. Ebel, of the American Social Health Association; Peter A. Leone, MD, an associate professor of medicine at the University of North Carolina; Lawrence R. Stanberry, MD, PhD, a professor of pediatrics at the University of Texas Medical Branch in Galveston; Ann Waldo, JD, a lawyer formerly with GlaxoSmithKline; and Richard J. Whitley, MD, a professor of pediatrics and an expert in neonatal herpes at the University of Alabama at Birmingham.