What You Need to Know about Newborns and HSV Risk

By Jeffrey Seiden, MD, Medical Director of Pediatrics—Virtua Voorhees

Recent news reports about newborns who died from complications related to the herpes simplex virus (HSV)—a contagious virus that causes cold sores and genital herpes—have caused many new parents to worry about HSV infection.

Although HSV is very common, new parents should know that such serious complications are rare. However, it’s important for parents and caregivers of newborns to minimize the risk of HSV infection and learn about the symptoms of HSV so they can seek medical treatment if needed.

What is HSV and how is it spread?

HSV is a common, contagious virus that causes herpes skin infections that usually show up on the mouth or genitals.

There are two types of HSV:

HSV-1 usually causes cold sores (small fluid-filled blisters that appear around the mouth) and mouth ulcers. About two-thirds of adults carry HSV-1.
HSV-2 usually causes herpes sores around the genitals.

Anyone can get HSV-1 and HSV-2—even newborns—and both types of the virus can cause symptoms in other parts of the body.

HSV is spread through person-to-person contact. If an infected person has a cold sore on the mouth, for example, they can pass HSV-1 to a newborn through direct contact such as a kiss.

However, it’s also possible to get HSV-1 from someone who isn’t showing symptoms and doesn’t have a cold sore. That’s because infected people carry HSV-1 inside their body and “shed” the virus in their saliva at different times throughout their life.

Although newborns can catch HSV-1 from close contact with an infected person, most HSV infections in newborns occur when the baby contracts HSV-2 from their mother’s birth canal during a vaginal delivery.

What are the symptoms of HSV in newborns?

In most cases, young children who get HSV only experience skin, eye and mouth symptoms, such as a rash, eye lesions, cold sores or ulcers. Your newborn could also develop other symptoms of HSV infection that include:

Being less active than normal (lethargic or floppy)
Excessive crying or fussiness
Fever higher than 100.4° (taken rectally)
Not waking up to eat
Seizures

Newborns who get HSV can get very sick quickly. If your newborn is experiencing any of these symptoms, call your pediatrician right away.

Depending on your newborn’s symptoms, your doctor may admit your newborn to the hospital to receive antiviral medications. These medications are given through an intravenous (IV) line to reduce the chances that HSV will affect other parts of your newborn’s body and cause other problems.

What are the complications of HSV in newborns?

HSV in older children and adults is rarely serious. However, because a newborn’s immune system isn’t developed fully at birth, some can experience serious problems if HSV isn’t treated. This includes:

Brain infection called encephalitis
Infection of the central nervous system
Infection of the liver, lungs or kidneys
Meningitis, which causes swelling of the membranes around the brain and spinal cord
Seizures
Vision problems and eye disease

These complications can cause brain damage, permanent disability and even death. This is why it’s important to learn about the symptoms so you can get medical treatment as soon as possible.

How can I protect my newborn from HSV?

If you’re expecting and have a history of genital herpes or if you’re having a genital herpes outbreak, let your obstetrician know as soon as possible. You may need to have a Cesarean section (C-section) delivery or take medication to prevent your newborn from getting HSV during a vaginal delivery.

Anyone who has a cold sore should avoid kissing your newborn or having any face-to-face direct contact with the baby. Starting treatment and avoiding close contact at the very first sign of a cold sore can help keep your newborn safe. Everyone (including parents, grandparents and siblings) should wash their hands before touching your newborn.

Regardless of whether your newborn has been exposed to someone with a cold sore, you should call your newborn’s pediatrician right away if he or she begins to experience symptoms of HSV infection. If your newborn has been infected with HSV, getting early treatment can decrease the chances of life-threatening complications.

To learn more about Virtua pediatric services or to schedule an appointment, call 1-888-VIRTUA-3.

Updated January 14, 2022