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Saremi N, Lewis KA, Klausner JD. Neonatal Herpes Reporting in the United States: Review of Current Policies by State. J Pediatric Infect Dis Soc 2024; 13:297-299. [PMID: 38606511 PMCID: PMC11138954 DOI: 10.1093/jpids/piae031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Indexed: 04/13/2024]
Abstract
Despite its devastating impact, neonatal herpes is not a nationally notifiable condition. As of 2023 it is only reportable in 6 states. A consistently applied case definition with designation as a nationally notifiable condition would optimize surveillance and preventative efforts.
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Affiliation(s)
- Natalie Saremi
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Katherine A Lewis
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Jeffrey D Klausner
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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You S, Yaesoubi R, Lee K, Li Y, Eppink ST, Hsu KK, Chesson HW, Gift TL, Berruti AA, Salomon JA, Rönn MM. Lifetime quality-adjusted life years lost due to genital herpes acquired in the United States in 2018: a mathematical modeling study. LANCET REGIONAL HEALTH. AMERICAS 2023; 19:100427. [PMID: 36950038 PMCID: PMC10025423 DOI: 10.1016/j.lana.2023.100427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 10/19/2022] [Accepted: 12/26/2022] [Indexed: 02/10/2023]
Abstract
Background Genital herpes (GH), caused by herpes simplex virus type 1 and type 2 (HSV-1, HSV-2), is a common sexually transmitted disease associated with adverse health outcomes. Symptoms associated with GH outbreaks can be reduced by antiviral medications, but the infection is incurable and lifelong. In this study, we estimate the long-term health impacts of GH in the United States using quality-adjusted life years (QALYs) lost. Methods We used probability trees to model the natural history of GH secondary to infection with HSV-1 and HSV-2 among people aged 18-49 years. We modelled the following outcomes to quantify the major causes of health losses following infection: symptomatic herpes outbreaks, psychosocial impacts associated with diagnosis and recurrences, urinary retention caused by sacral radiculitis, aseptic meningitis, Mollaret's meningitis, and neonatal herpes. The model was parameterized based on published literature on the natural history of GH. We summarized losses of health by computing the lifetime number of QALYs lost per genital HSV-1 and HSV-2 infection, and we combined this information with incidence estimates to compute the total lifetime number of QALYs lost due to infections acquired in 2018 in the United States. Findings We estimated 0.05 (95% uncertainty interval (UI) 0.02-0.08) lifetime QALYs lost per incident GH infection acquired in 2018, equivalent to losing 0.05 years or about 18 days of life for one person with perfect health. The average number of QALYs lost per GH infection due to genital HSV-1 and HSV-2 was 0.01 (95% UI 0.01-0.02) and 0.05 (95% UI 0.02-0.09), respectively. The burden of genital HSV-1 is higher among women, while the burden of HSV-2 is higher among men. QALYs lost per neonatal herpes infection was estimated to be 7.93 (95% UI 6.63-9.19). At the population level, the total estimated lifetime QALYs lost as a result of GH infections acquired in 2018 was 33,100 (95% UI 12,600-67,900) due to GH in adults and 3,140 (95% UI 2,260-4,140) due to neonatal herpes. Results were most sensitive to assumptions on the magnitude of the disutility associated with post-diagnosis psychosocial distress and symptomatic recurrences. Interpretation GH is associated with substantial health losses in the United States. Results from this study can be used to compare the burden of GH to other diseases, and it provides inputs that may be used in studies on the health impact and cost-effectiveness of interventions that aim to reduce the burden of GH. Funding The Center for Disease Control and Prevention.
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Affiliation(s)
- Shiying You
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA
- Corresponding author. Yale School of Public Health, Department of Health Policy and Management, USA.
| | - Reza Yaesoubi
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA
| | - Kyueun Lee
- Department of Health Policy and Management, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Yunfei Li
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Samuel T. Eppink
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Katherine K. Hsu
- Division of Sexually Transmitted Disease Prevention & HIV/AIDS Surveillance, Massachusetts Department of Public Health, Boston, MA, USA
| | - Harrell W. Chesson
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Thomas L. Gift
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Andrés A. Berruti
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Joshua A. Salomon
- Center for Health Policy / Center for Primary Care and Outcomes Research, Stanford University, Stanford, CA, USA
| | - Minttu M. Rönn
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Hwang JS, Friedlander S, Rehan VK, Zangwill KM. Diagnosis of congenital/perinatal infections by neonatologists: a national survey. J Perinatol 2019; 39:690-696. [PMID: 30914779 DOI: 10.1038/s41372-019-0364-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 02/20/2019] [Accepted: 03/05/2019] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To describe the clinical approach used by neonatologists for diagnosis of congenital/perinatal infections (CPI); no such data currently exist. STUDY DESIGN A national survey regarding the diagnosis of toxoplasma, syphilis, rubella, cytomegalovirus, and herpes simplex virus (HSV) infection in neonates. RESULT We received 553 (11%) responses. Central nervous system calcification or hydrocephalus was the commonest trigger to pursue a CPI diagnosis (98%); maternal history was the least frequent (67%). Four hundred twenty-two (76%) used general screening such as "TORCH titer screen" (57%) or total IgG or IgM (39%). Further evaluation targeted known clinical sequelae; but cerebrospinal fluid testing was used in only 65% of those suspected of having HSV or syphilis. Fifty-six percent chose a treponemal instead of a non-treponemal test for syphilis. Multivariable analyses did not identify factors associated with the clinical diagnostic approach. CONCLUSION We observed clinically important deviations from CPI diagnostic test recommendations in a national cohort of neonatologists.
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Affiliation(s)
- Jung S Hwang
- Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Scott Friedlander
- Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Virender K Rehan
- Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA, USA.,Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Kenneth M Zangwill
- Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA, USA. .,Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance, CA, USA.
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Sampath A, Maduro G, Schillinger JA. Infant Deaths Due To Herpes Simplex Virus, Congenital Syphilis, and HIV in New York City. Pediatrics 2016; 137:peds.2015-2387. [PMID: 26933212 DOI: 10.1542/peds.2015-2387] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/23/2015] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Neonatal infection with herpes simplex virus (HSV) is not a nationally reportable disease; there have been few population-based measures of HSV-related infant mortality. We describe infant death rates due to neonatal HSV as compared with congenital syphilis (CS) and HIV, 2 reportable, perinatally transmitted diseases, in New York City from 1981 to 2013. METHODS We identified neonatal HSV-, CS-, and HIV-related deaths using International Classification of Diseases (ICD) codes listed on certificates of death or stillbirth issued in New York City. Deaths were classified as HSV-related if certificates listed (1) any HSV ICD-9/ICD-10 codes for deaths ≤42 days of age, (2) any HSV ICD-9/ICD-10 codes and an ICD code for perinatal infection for deaths at 43 to 365 days of age, or (3) an ICD-10 code for congenital HSV. CS- and HIV-related deaths were those listing any ICD code for syphilis or HIV. RESULTS There were 34 deaths due to neonatal HSV (0.82 deaths per 100 000 live births), 38 from CS (0.92 per 100 000), and 262 from HIV (6.33 per 100 000). There were no CS-related deaths after 1996, and only 1 HIV-related infant death after 2004. The neonatal HSV-related death rate during the most recent decade (2004-2013) was significantly higher than in previous years. CONCLUSIONS The increasing neonatal HSV-related death rate may reflect increases in neonatal herpes incidence; an increasing number of pregnant women have never had HSV type 1 and are therefore at risk of acquiring infection during pregnancy and transmitting to their infant.
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Affiliation(s)
| | | | - Julia A Schillinger
- Sexually Transmitted Disease Control, New York City Department of Health and Mental Hygiene, New York, New York; and Division of Sexually Transmitted Disease Prevention, National Center for HIV, Hepatitis, Sexually Transmitted Diseases, and Tuberculosis Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
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Chentoufi AA, BenMohamed L. Mucosal herpes immunity and immunopathology to ocular and genital herpes simplex virus infections. Clin Dev Immunol 2012; 2012:149135. [PMID: 23320014 PMCID: PMC3540975 DOI: 10.1155/2012/149135] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2012] [Revised: 11/19/2012] [Accepted: 11/20/2012] [Indexed: 02/08/2023]
Abstract
Herpes simplex viruses type 1 and type 2 (HSV-1 and HSV-2) are amongst the most common human infectious viral pathogens capable of causing serious clinical diseases at every stage of life, from fatal disseminated disease in newborns to cold sores genital ulcerations and blinding eye disease. Primary mucocutaneous infection with HSV-1 & HSV-2 is followed by a lifelong viral latency in the sensory ganglia. In the majority of cases, herpes infections are clinically asymptomatic. However, in symptomatic individuals, the latent HSV can spontaneously and frequently reactivate, reinfecting the muco-cutaneous surfaces and causing painful recurrent diseases. The innate and adaptive mucosal immunities to herpes infections and disease remain to be fully characterized. The understanding of innate and adaptive immune mechanisms operating at muco-cutaneous surfaces is fundamental to the design of next-generation herpes vaccines. In this paper, the phenotypic and functional properties of innate and adaptive mucosal immune cells, their role in antiherpes immunity, and immunopathology are reviewed. The progress and limitations in developing a safe and efficient mucosal herpes vaccine are discussed.
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Affiliation(s)
- Aziz Alami Chentoufi
- Pathology and Clinical Laboratory Medicine, Department of Immunology, King Fahad Medical City, P.O. Box 59046, Riyadh 11525, Saudi Arabia
- Faculty of Medicine, King Fahad Medical City and King Saud Bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia
| | - Lbachir BenMohamed
- Laboratory of Cellular and Molecular Immunology, Gavin Herbert Eye Institute, School of Medicine, University of California, Irvine, Irvine, CA 92697, USA
- Institute for Immunology, School of Medicine, University of California, Irvine, Irvine, CA 92697, USA
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Population-based surveillance for neonatal herpes in New York City, April 2006-September 2010. Sex Transm Dis 2012; 38:705-11. [PMID: 21844721 DOI: 10.1097/olq.0b013e31821b178f] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Population-based data for neonatal herpes simplex virus (HSV) infection are needed to describe disease burden and to develop and evaluate prevention strategies. METHODS From April 2006 to September 2010, routine population-based surveillance was conducted using mandated provider and laboratory reports of neonatal HSV diagnoses and test results for New York City resident infants aged ≤60 days. Case investigations, including provider interviews and review of infant and maternal medical charts and vital records, were performed. Hospital discharge data were analyzed and compared with surveillance data findings. RESULTS Between April 2006 and September 2010, New York City neonatal HSV surveillance detected 76 cases, for an average incidence of 13.3/100,000 (1/7519) live births. Median annual incidence of neonatal HSV estimated from administrative data for 1997 to 2008 was 11.8/100,000. Among surveillance cases, 90.8% (69/76) were laboratory confirmed. Among these, 40.6% (28/69) were HSV-1; 39.1% (27/69) were HSV-2; and 20.3% (14/69) were untyped. The overall case-fatality rate was 17.1% (13/76). Five cases were detected among infants aged >42 days. In all, 80% (20/25) of the case-infants delivered by cesarean section were known to have obstetric interventions that could have increased risk of neonatal HSV transmission to the infant before delivery. Over half (68%, or 52/76) of all cases lacked timely or ideal diagnostics or treatment. CONCLUSIONS Administrative data may be an adequate and relatively inexpensive source for assessing neonatal HSV burden, although they lack the detail and timeliness of surveillance. Prevention strategies should address HSV-1. Incubation periods might be longer than expected for neonatal HSV. Cesarean delivery might not be protective if preceded by invasive procedures. Provider education is needed to raise awareness of neonatal HSV and to assure appropriate testing and treatment.
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Monitoring trends and epidemiologic correlates of neonatal herpes: is mandated case reporting the answer? Sex Transm Dis 2011; 38:712-4. [PMID: 21844722 DOI: 10.1097/olq.0b013e3182207227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Karjala Z, Neal D, Rohrer J. Association between HSV1 seropositivity and obesity: data from the National Health and Nutritional Examination Survey, 2007-2008. PLoS One 2011; 6:e19092. [PMID: 21589933 PMCID: PMC3092767 DOI: 10.1371/journal.pone.0019092] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2010] [Accepted: 03/28/2011] [Indexed: 12/18/2022] Open
Abstract
Background Herpes simplex virus (HSV) is among the most common sexually transmitted pathogens in the United States and worldwide. HSV has a high incidence of undetected cases. In addition, there is no treatment, and there is a lack of knowledge why disparities among populations exist. Research studies suggest that fat tissue may participate in body's immune responses, and the impact of obesity on susceptibility to HSV1 infection is not clear. The purpose of this study was to examine whether obesity is a risk factor for HSV1 infection using a large sample from the general population. Methods/Principal Findings This cross-sectional study used data from the National Health and Examination and Nutritional Examination Survey (NHANES) from 2007–2008. Variables, gender, age, race/ethnicity, marital status, education, poverty level, and diabetes represented potential confounders and were included in analyses. The two-tailed Pearson's chi square, student's t test, and a multiple logistic regression analysis were applied to evaluate associations using a significance value of p≤0.05. Adjusted odds ratios with 95% confidence interval represented the degree of these associations. The prevalence of HSV1 infection in US population between 20 and 49 years old was 60.3% (n = 1,536). In this study, having a BMI classified as the obese group (BMI 30–39.9) was significantly associated with HSV1 infection before [unadjusted OR = 1.74 (95% CI 1.20–2.51), p = 0.006] and after controlling for socio-demographic factors [adjusted OR = 1.50 (95%CI 1.06–2.13)], p = 0.026]. This association was stronger than three already established risk factors of age, female gender, and poverty level. Conclusions/Significance This study provides evidence that obesity may play a role in the susceptibility to HSV1 infection. Findings from this study suggest that obesity should be considered when designing preventive measures for HSV1 infection. These results may also explain why some people acquire HSV1 infections and some do not. Further, these findings may justify an increased emphasis on the control and prevention of HSV1 transmission and other pathogens in overweight and obese populations.
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Affiliation(s)
- Zuzana Karjala
- Walden University, Minneapolis, Minnesota, United States of America.
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Flagg EW, Weinstock H. Incidence of neonatal herpes simplex virus infections in the United States, 2006. Pediatrics 2011; 127:e1-8. [PMID: 21149432 DOI: 10.1542/peds.2010-0134] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Neonatal herpes simplex virus (nHSV) infections, although relatively rare, cause significant morbidity and mortality. Estimates of nHSV incidence across the United States vary widely and have been derived by using a variety of methods. We estimated the incidence of nHSV infections for the United States during 2006, as well as demographic-specific rates, by using nationally and regionally weighted estimates from a population-based sample of inpatient data. METHODS We examined inpatient records of infants aged 60 days or younger at admission using the Healthcare Cost and Utilization Project Kids' Inpatient Database. Patients with a length of stay that exceeded 7 days (or deceased during hospitalization) were identified at discharge from the International Classification of Diseases, Ninth Revision, Clinical Modification codes for herpes simplex (054.0-054.9). Cases for which patients had been transferred from another hospital or readmitted were excluded from case counts. RESULTS We found an overall US incidence of 9.6 per 100 000 births in 2006. Rates per 100 000 births among US regions were 8.2 in the Northeast, 12.9 in the Midwest, 8.9 in the South, and 8.8 in the West. Rates of 13.8, 9.9, and 7.5 were observed for black, white, and Hispanic newborns, respectively; these differences were not statistically significant. Rates were significantly higher among cases for which the expected primary payer was Medicaid (15.1) compared with private insurance or managed health care (5.4). Median age at admission was 10 days; 25% of admissions were on the day of birth. CONCLUSIONS This description of regional and demographic-specific nHSV incidence rates for the United States provides important new information on the extent of this potentially devastating disease.
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Affiliation(s)
- Elaine W Flagg
- US Centers for Disease Control and Prevention, 1600 Clifton Rd, Mail Stop E02, Atlanta, GA 30333, USA.
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Congenital anomalies and resource utilization in neonates infected with herpes simplex virus. Sex Transm Dis 2010; 36:680-5. [PMID: 19617865 DOI: 10.1097/olq.0b013e3181aaf54f] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Neonatal herpes simplex virus (HSV) infection, while uncommon, is associated with substantial morbidity and mortality. However, there is little nationally representative data describing resource utilization. METHODS This retrospective cohort study was conducted using the Pediatric Health Information System, an administrative database that contains discharge diagnosis and resource utilization data from 35 free-standing children's hospitals. Patients <or=60 days of age with a primary discharge diagnosis of HSV were study eligible if they received intravenous acyclovir and were discharged between January 1, 2003 and December 31, 2005. RESULTS There were 406 patients with HSV. The median age was 16 days (interquartile range: 8-31 days); 52% of patients were female. Congenital heart disease, the most common congenital anomaly, occurred in 10% of patients. The median length of stay was 15 days; 21 (5%) patients died. HSV was associated with substantial resource utilization. The median hospital charge was $37,431 (interquartile range: $14,667-$74,559) per infant. The presence of congenital heart disease independently increased the hospital length of stay by 93% (adjusted LOS ratio: 1.93; 95% CI: 1.5-2.5). CONCLUSIONS HSV infection in neonates and young infants was associated with substantial resource utilization. The presence of an underlying congenital cardiac anomaly was associated with a significantly longer length of stay and higher hospital charges.
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Incidence of neonatal herpes simplex virus infections in two managed care organizations: implications for surveillance. Sex Transm Dis 2008; 35:592-8. [PMID: 18418296 DOI: 10.1097/olq.0b013e3181666af5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To estimate the incidence of neonatal herpes simplex virus (HSV) infections and to assess the utility of surveillance methods for neonatal herpes in 2 managed care populations. METHODS We identified potential cases using 15 discharge International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9) codes for neonatal HSV and other diseases clinically consistent with this diagnosis. We also searched laboratory databases for positive HSV tests and investigated deaths during the neonatal period. We performed medical chart review using a standardized form. Two pediatric infectious disease specialists reviewed the forms of infants who had a positive HSV test or received a herpes-related diagnosis and made a determination as confirmed, probable, or not a case. RESULTS Among 270,703 infants born from 1997 to 2002, we identified 737 potential cases and completed medical chart abstraction for 699 (95%). Final review identified 35 confirmed or probable cases of neonatal HSV, and the incidence was 12.9 per 100,000 live births. Only 24 (69%) of the 35 cases were confirmed by laboratory testing. Among the 24 confirmed cases, 22 (92%) received an ICD-9 code of 054.xx or 771.2. Among the 60 infants that received an ICD-9 code of 054.xx or 771.2, only 31 (52%) were confirmed or probable cases of neonatal HSV after final review. CONCLUSIONS About 30% of neonatal HSV cases were not laboratory confirmed. The use of ICD-9 codes of 054.xx and 771.2 was a sensitive but not specific method to identify cases of neonatal herpes.
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Jiang L, Yu Z, Du W, Tang Z, Jiang T, Zhang C, Lu Z. Development of a fluorescent and colorimetric detection methods-based protein microarray for serodiagnosis of TORCH infections. Biosens Bioelectron 2008; 24:376-82. [PMID: 18524564 DOI: 10.1016/j.bios.2008.04.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2008] [Accepted: 04/15/2008] [Indexed: 10/22/2022]
Abstract
We developed a protein microarray methodology that has the ability of serodiagnosis of IgM antibodies directed against TORCH pathogens. Six chemical surface modifications were validated by a dimension atomic force microscope (AFM) and contact angle measurement, agarose modified surface of which offered an appropriate platform for detecting IgM antibody. Further, signal amplification sensitivities on agarose modified microarrays were detected by Cy3-labeled biotin-streptavidin and immunogold-based assays. The detection limits of IgM antibody on the microarrays were 0.48 and 0.24 microg/ml, quantitatively equal to 0.25 and 12.5pg, respectively, on each spot as ascertained by the two assays. Satisfactory linear correlations between the signal intensity and the logarithm of the IgM concentration were obtained. Finally, 60 serum samples characterized by a commercial ELISA were evaluated by the protein microarray. There were good concordances between the results of the protein microarray and ELISA assay for sorting of the TORCH infected sera (95.0% by fluorescence-based assay and 96.7% by immunogold-based assay). Clearly, the potential application of this protein microarray format facilitates clinical detection of not only the antibodies directed against TORCH pathogens but also other autoimmune diseases.
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Affiliation(s)
- Li Jiang
- School of Clinical Medicine, Southeast University, Nanjing 210009, China
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Abstract
OBJECTIVES We describe neonatal herpes reporting and the number of cases reported in states with reporting requirements in the United States, 2000-2005. METHODS A national assessment of neonatal herpes reporting practices was conducted using an e-mail and phone query. RESULTS Neonatal herpes was a reportable condition in 9 states in the United States from 2000-2005: CT, MA, FL, OH, NE, LA, SD, DE, and WA. There was no standard surveillance case definition in 5 states and in 4 states there was no specific form for reporting neonatal herpes. Few cases were reported in any state (range, 0-13 cases per year). A total of 112 cases were reported in these 9 states over 5 years (2000-2004); the overall incidence rate was 4 cases/100,000 live births. CONCLUSIONS Although reportable in some states, neonatal herpes is not currently a nationally reportable disease. As currently employed by individual states during this time frame, neonatal herpes reporting does not appear to be a reliable way to assess burden of disease. Development of a standard case definition and assessment of the best approaches for local and national neonatal herpes surveillance may improve performance of such reporting.
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Abstract
PURPOSE OF REVIEW New findings reveal that first-time infection of the mother is the most important factor for the transmission of genital herpes from mother to fetus/newborn. Interventions based on these findings will lead to new management of the pregnant patient with genital herpes prior to pregnancy and measures to prevent the acquisition of herpes during pregnancy. RECENT FINDINGS Risk factors for the transmission of herpes from mother to newborn have been detailed. It is the pregnant woman who acquires genital herpes as a primary infection in the latter half of pregnancy, rather than prior to pregnancy, who is at greatest risk of transmitting this virus to her newborn. This is true for both herpes simplex virus type-1 and herpes simplex virus type-2. Additional risk factors for neonatal herpes simplex virus infection include the use of a fetal-scalp electrode and maternal age of less than 21 years. SUMMARY Risk factors for the transmission of herpes from mother to newborn are detailed. Antiviral suppressive therapy initiated in the late third trimester has been shown to decrease viral shedding and the need for cesarean section.
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Affiliation(s)
- David A Baker
- Health Sciences Center, Stony Brook University Medical Center, Stony Brook, New York 11794-8091, USA.
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Mahnert N, Roberts SW, Laibl VR, Sheffield JS, Wendel GD. The incidence of neonatal herpes infection. Am J Obstet Gynecol 2007; 196:e55-6. [PMID: 17466681 DOI: 10.1016/j.ajog.2006.10.911] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2006] [Revised: 10/17/2006] [Accepted: 10/31/2006] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The incidence of perinatal transmission of neonatal herpes infection has recently been reported at 1 in 3200 births. The main objective of this study was to determine a population-based incidence of neonatal herpes simplex virus infection. STUDY DESIGN This was a retrospective chart review of newborn infants presenting with herpes infection established by cerebrospinal fluid polymerase chain reaction or lesion culture between 1999 and 2003. Only infants delivered at our institution were considered to establish a population-based incidence. RESULTS Four cases of neonatal herpes infection were identified based on polymerase chain reaction and culture diagnosis. During the study period 78,115 infants were delivered at our institution yielding an incidence of 1 in 20,000 live births. CONCLUSION The incidence of neonatal herpes infection at our institution is lower than reported elsewhere. A national surveillance program of neonatal herpes is needed to measure the burden of disease across the United States.
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Affiliation(s)
- Nichole Mahnert
- Department of Obstetrics and Gynecology, The University of Texas Southwestern Medical Center, Dallas, TX, USA
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Sauerbrei A, Wutzler P. Herpes simplex and varicella-zoster virus infections during pregnancy: current concepts of prevention, diagnosis and therapy. Part 1: Herpes simplex virus infections. Med Microbiol Immunol 2006; 196:89-94. [PMID: 17165093 DOI: 10.1007/s00430-006-0031-0] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2006] [Indexed: 10/23/2022]
Abstract
Primary herpes simplex virus (HSV) infection may lead to severe illness in pregnancy and may be associated with transplacental virus transmission and fetal infection. The consequences may be abortion, stillbirth and congenital malformations. In neonates, the clinical findings after intrauterine HSV infection are characterized by skin lesions, diseases of the eye and neurologic damage. Herpes genitalis of pregnant women at the time of labor may result in life-threatening neonatal herpes. Currently, neither active nor passive immunization is available to prevent HSV infections during pregnancy and in the newborn infant. Therefore, antiviral treatment using aciclovir and/or valaciclovir must be considered in all primary episodes of genital herpes as well as in neonates who show signs of either infection. Clinical herpes lesions of the genitalia and/or positive test for virus detection at the time of delivery are an indication for cesarean section. However, this surgical intervention may be reduced by suppressive treatment of recurrent genital herpes with aciclovir or valaciclovir.
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Affiliation(s)
- A Sauerbrei
- Institute of Virology and Antiviral Therapy, Friedrich-Schiller University of Jena, Hans-Knoell-Strasse 2, 07745 Jena, Germany.
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