Title: In utero infection of the fetus by herpes simplex virus.

POPLINE Document Number: 018120

Author(s):

Sieber OF Jr
Fulginiti VA
Brazie J
Umlauf HJ Jr

Source citation:

Journal of Pediatrics, 1966 Jul;69(1):30-4.

Abstract:

Case histories are presented of 2 premature infants with herpes simplex virus (HSV) infection occurring in utero, probably as a result of transplacental transfer of the virus. Case 1, a 969 gm girl who died at 71 hours of age, was noted at birth to have vesicles and bullae filled with clear or serosanguineous fluid. Viral cultures of the skin lesions were positive for HSV. A significant amount of immunoglobulin M (IGm) was present in the infant's serum and the neutralizing antibody (NA) titer to HSV was 1:8, suggesting that the fetus produced antibody in utero. The mother's serum contained 240 mg % of IGm, with a NA titer of 1:32. The father's serum NA titer was 1:64. Case 2, a 1960 gm infant, showed small, circumscribed areas of erythema at 1 hour of age. The skin lesions progressed until death on day 11. A diagnosis of generalized HSV was made, and HSV was isolated from the brain at autopsy. This infant's serum did not contain neutralizing antibody to HSV. Neither infant was exposed to an infected mother, father, or hospital worker. Such exposure accounts for 40% of neonatal HSV disease. The presence of lesions at birth in these 2 cases rules out postnatal exposure since HSV has a minimum 4 day incubation period. An animal study has indicated that transplacental transmission of HSV is the route of infection in utero. Maternal viremia associated with subclinical infection may be a significant source of herpes virus. Another possible source of infection is ascent of HSV from the maternal genital tract, particularly when manipulative procedures are attempted during the pregnancy. Treatment of HSV infection in newborns with gamma globulin or convalescent serum is nonspecific and ineffective. Prevention of contact with infected individuals remains the most important factor for control of herpetic infection.

Keywords:

Case Studies
Sexually Transmitted Diseases
Infections
Infant
Maternal-Fetal Exchange
Studies
Research Methodology
Reproductive Tract Infections
Diseases
Youth
Age Factors
Population Characteristics
Demographic Factors
Population
Pregnancy
Reproduction