Asymptomatic neonatal contamination with herpes simplex virus

Abstract

Frequent maternal vaginal and/or lesion cultures for herpes simplex virus (HSV) were obtained from a high-risk maternal population during the course of pregnancy and from oropharyngeal samples of their newborn infants on the first day of life to determine (1) the incidence of asymptomatic neonatal contamination with HSV and (2) the relationship of neonatal with maternal colonization. Four hundred ninety-nine maternal cultures were obtained from 85 patients. The mean number of cultures per patient was six with a range from one to 12. Thirty-three mothers had 41 positive cultures. Fifty-two women had 301 negative cultures. Cord blood HSV-enzyme-linked immunosorbent assay (ELISA) titers were not different in the two groups of infants (geometric mean titer 1152 and 800, respectively). One infant from each maternal group had a positive oropharyngeal HSV culture. Both infants were asymptomatic. One was delivered by elective cesarean section at term to a mother with four positive cultures obtained during pregnancy. Fetal membranes were intact until delivery. The second infant with a positive oropharyngeal culture on the first day of life was born vaginally to a mother with seven negative cultures during pregnancy. Repeat cultures on both infants during the first week of life were negative. These data indicate that asymptomatic neonatal contamination with HSV does occur in oropharyngeal samples obtained on the first day of life. The data also suggest that there is a poor relationship of viral excretion during pregnancy or the mode of delivery with neonatal contamination. Further data are required to determine the incidence of asymptomatic neonatal contamination and the relationship of maternal with neonatal cultures.(ABSTRACT TRUNCATED AT 250 WORDS)