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Sex Transm Infect 76:287-291 doi:10.1136/sti.76.4.287

Neonatal herpes prevention: a minor public health problem in some communities

  1. A Mindel1,
  2. J Taylor2,
  3. R L Tideman1,
  4. C Seifert2,
  5. G Berry3,
  6. K Wagner1,
  7. J Page1,
  8. C Marks1,
  9. B Trudinger4,
  10. A Cunningham2
  1. 1Academic Unit of Sexual Health Medicine, Sydney, Australia
  2. 2Centre for Virus Research Westmead Institutes of Health Research, Sydney
  3. 3Department of Public Health and Community Medicine, University of Sydney
  4. 4Department of Obstetrics and Gynaecology Westmead, Hospital, Universities of Sydney and New South Wales
  1. Professor Mindel, Academic Unit of Sexual Health Medicine, Level 1, Nightingale Wing, Sydney Hospital, GPO Box 1614, Sydney, NSW 2001, Australia bbeaton{at}mail.usyd.edu.au
  • Accepted 20 March 2000

Abstract

Background: Neonatal herpes is a condition with high morbidity and mortality. The greatest risk occurs when the mother acquires herpes simplex virus (HSV) towards the end of pregnancy. A study from Seattle has suggested that the risk of acquisition of HSV during pregnancy was 3.7%. In Australia, HSV-2 infection is less common in pregnant women than in the United States. Consequently we conducted a study to establish HSV seroprevalence and the rate of HSV seroconversion in this population.

Methods: The study was conducted at Westmead Hospital, Sydney, between June 1995 and April 1998. Women completed a questionnaire covering risk factors for the acquisition of genital herpes. A serum sample during pregnancy and a specimen of cord blood were obtained and tested for antibodies to HSV-2 using a type specific indirect enzyme linked immunosorbent assay (ELISA). Equivocal results were resolved by western blot. A subset of the paired sera was tested for antibodies to HSV-1. The data were analysed using spss.

Results: 326 of the 2616 (12.5%) women were HSV-2 seropositive. Three women (0.15%) acquired HSV-2 infection during pregnancy. None of the three babies of these mothers developed neonatal herpes. 416 maternal cord pairs were tested for HSV-1 antibodies and 330 (79.3%) were positive. No HSV-1 seroconversions occurred.

Conclusions: In this population, HSV acquisition was uncommon (0.34% per year) and neonatal herpes was rare. A cost effective analysis suggested that type specific serology to screen pregnant women and their partners in low prevalence communities was not cost effective.

Footnotes