Top Tips: Herpes Simplex Virus – Do Not Use

Have three minutes to spare? Our top tips give you quick, evidence-based insight into a health topic. Though common and self-limiting in older children and adults, herpes simplex viral infection can cause a spectrum of neonatal disease from simple lesion to devastating encephalitis. How can we identify babies at risk and provide appropriate treatment?

Contributors:

Dr Emma Lim Consultant Paediatrician
Emma Lim is a Consultant in General Paediatrics and Paediatric Infectious Diseases and Immunology at the Great North Children’s Hospital in Newcastle upon Tyne and Paediatric Sepsis Lead for the trust. She has worked regionally and nationally with the Academic Health Science Network, and the Sepsis Trust to increase awareness and develop sepsis pathways. She is an investigator in the EU PERFORM and DIAMONDS Horizon 2020 study to improve management of febrile patients and is the course lead for the RCPCH How to Manage: Paediatric Sepsis series.  

Dr Christo Tsilifis Clinical Fellow, Academic Paediatric Trainee
Christo Tsilifis is a Paediatric Trainee and Academic Clinical Fellow at the Great North Children’s Hospital in Newcastle upon Tyne.   

1. Think Hands And No Kisses
(T-H-A-N-K-S)

Do not let anyone with a cold sore near your baby, don’t let anyone hold your baby without washing their hands, do not let anyone other than parents kiss your baby.

2. Consider HSV infection in any sick baby

Even without maternal history of infection – it is rare, but treatable. Clues include abnormal LFTs, DIC, or abnormal focal neurology. 

3. Empowerment. Vertical transmission

Empower pregnant women to speak to their midwives and obstetricians about HSV infection, particularly if there has been previous genital herpes. Vertical transmission is the most common way for babies to contract HSV. 

4. Consider HSV infection in women around delivery

Think about HSV infection in women with severe vaginal pain or fever with negative Group B streptococcus cultures, particularly around the time of delivery.

5. Time to test

To test for HSV, send viral PCRs from any lesions or mucosal surface, from EDTA blood, and from cerebrospinal fluid. Treat with acyclovir until results are back. Your result is only as good as the swab you take.

Relevant information

The Kit Tarka Foundation. T-H-A-N-K-S.

https://www.kittarkafoundation.org/thanks

The Lullaby Trust.

https://www.lullabytrust.org.uk/over-half-of-uk-parents-unaware-of-risk-kissing-poses-to-newborns/

Deepen your understanding

Our related learning resources

  • podcasts

    The Paeds Round from RCPCH and Medisense

    NEW EPISODE AVAILABLE NOW Listen to real-world advice and guidance on how to manage a range of clinical topics and much else on education, training and working in paediatrics. With Dr Emma Lim, Consultant Paediatrician and Dr Christo Tsilifis, Academic Paediatric Trainee, plus parents, paediatric specialists and junior doctors.

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