Neonatal Herpes

32 cases in 2024 — near the 5-year baseline of ~62.

What is it?

Neonatal herpes is HSV (usually HSV-2, sometimes HSV-1) infection in infants, typically acquired during birth from a mother with active genital herpes. NYS had 32 cases in 2024. It is a serious condition with three presentations: localized skin, eye, and mouth (SEM) disease; disseminated disease affecting multiple organs; and CNS disease (encephalitis). Without prompt treatment, mortality and long-term neurological damage are high.

How it spreads

Most commonly acquired during birth if the mother has active genital herpes at delivery. Risk is highest when the mother has a primary (first-time) HSV infection near the time of delivery. Transmission can also occur through postnatal contact with cold sores on caregivers.

Symptoms

In infants (onset usually 1–3 weeks of life): SEM disease — clusters of vesicles on skin, eye discharge, or mouth sores. Disseminated disease — poor feeding, lethargy, seizures, liver failure, DIC. CNS disease — seizures, bulging fontanelle, temperature instability.

Who is at risk?

Newborns of mothers with active or primary genital herpes at delivery. Risk is highest when mothers have a first-episode primary infection in the third trimester.

What you can do

Based on NYSDOH annual communicable disease report. Threat level reflects 2024 case counts compared to the 5-year baseline.