Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
In Reply: Drs Rouse and Stringer request additional
information about the outcome of neonatal herpes infection in our study. These
infants were usually enrolled in ongoing multicenter trials of antiviral therapy
for neonatal herpes.1,2 Two
of the 18 neonates died; of the 9 for whom we have reliable follow-up data,
4 have severe disability. These outcomes are comparable with those previously
reported in literature, with substantial mortality and persistent morbidity
among survivors, even if treated in infancy.3 We
agree that the incidence of neonatal HSV infection appears higher in our area
than in other areas of the country. It is not clear how much of that reflects
regional differences in epidemiology and how much is lack of case ascertainment
in other parts of the country where HSV-2 infection is equally prevalent.
Brown ZA, Wald A, Corey L. Cesarean Delivery and Risk of Herpes Simplex Virus Infection. JAMA. 2003;289(17):2208-2209. doi:10.1001/jama.289.17.2208-a