title: Neonatal herpes prevention: a minor public health problem in some communities.
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.
authors.affiliation: Academic Unit of Sexual Health Medicine, Sydney Hospital, NSW, Australia. bbeaton@mail.usyd.edu.au
authors.forename: A
authors.initials: A
authors.lastname: Mindel
authors.forename: J
authors.initials: J
authors.lastname: Taylor
authors.forename: R L
authors.initials: RL
authors.lastname: Tideman
authors.forename: C
authors.initials: C
authors.lastname: Seifert
authors.forename: G
authors.initials: G
authors.lastname: Berry
authors.forename: K
authors.initials: K
authors.lastname: Wagner
authors.forename: J
authors.initials: J
authors.lastname: Page
authors.forename: C
authors.initials: C
authors.lastname: Marks
authors.forename: B
authors.initials: B
authors.lastname: Trudinger
authors.forename: A
authors.initials: A
authors.lastname: Cunningham
mesh_terms: D000328:Adult; D001315:Australia / Q000453:epidemiology; D005260:Female; D006558:Herpes Genitalis / Q000453:epidemiology* / Q000517:prevention & control; D006561:Herpes Simplex / Q000453:epidemiology* / Q000517:prevention & control; D018259:Herpesvirus 1, Human; D018258:Herpesvirus 2, Human; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000821:virology*; D012307:Risk Factors; D016036:Seroepidemiologic Studies