Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
To the Editor: Based on 18 cases of neonatal
herpes, Dr Brown and colleagues1 argue that
"development of a strategy to reduce this disease burden seems imperative."
What, though, is the actual disease burden? The authors provided no clinical
outcome details about the neonatal herpes cases they observed and did not
acknowledge that theirs is among the highest incidence ever to be reported.
Before broad neonatal herpes preventive efforts (eg, serologic screening)
are instituted, the incidence and severity of neonatal herpes should be better
defined and categorized on a populationwide basis. In California, during the
10-year period of 1985-1995, the incidence of neonatal herpes was stable at
1.1 per 10 000 births,2 a rate 3 times
lower than that reported by Brown et al.1 It
is difficult to imagine that screening and treatment for such an uncommon
disease would ever be efficient or cost-effective.3
Rouse DJ, Stringer JSA. Cesarean Delivery and Risk of Herpes Simplex Virus Infection—Reply. JAMA. 2003;289(17):2208-2209. doi:10.1001/jama.289.17.2208-a