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Cesarean Delivery and Risk of Herpes Simplex Virus InfectionCesarean Delivery and Risk of Herpes Simplex Virus Infection

JAMA. 2003;289(17):2208-2209. doi:10.1001/jama.289.17.2208-a
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AUTHOR INFORMATION

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

CESAREAN DELIVERY AND RISK OF HERPES SIMPLEX VIRUS INFECTION

To the Editor: Based on 18 cases of neonatal herpes, Dr Brown and colleagues1 argue that "development of a strategy to reduce this disease burden seems imperative." What, though, is the actual disease burden? The authors provided no clinical outcome details about the neonatal herpes cases they observed and did not acknowledge that theirs is among the highest incidence ever to be reported. Before broad neonatal herpes preventive efforts (eg, serologic screening) are instituted, the incidence and severity of neonatal herpes should be better defined and categorized on a populationwide basis. In California, during the 10-year period of 1985-1995, the incidence of neonatal herpes was stable at 1.1 per 10 000 births,2 a rate 3 times lower than that reported by Brown et al.1 It is difficult to imagine that screening and treatment for such an uncommon disease would ever be efficient or cost-effective.3

References
Brown ZA, Wald A, Morrow RA, Selke S, Zeh J, Corey L. Effect of serologic status and cesarean delivery on transmission rates of herpes simplex virus from mother to infant.  JAMA.2003;289:203-209.
Guiterrez KM, Falkovitz Halpern MS, Maldonado Y, Arvin AM. The epidemiology of neonatal herpes simplex virus infections in California from 1985 to 1995.  J Infect Dis.1999;180:199-202.
Rouse DJ, Stringer JS. An appraisal of screening for maternal type-specific herpes simplex virus antibodies to prevent neonatal herpes.  Am J Obstet Gynecol.2000;183:400-406.

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Brown ZA, Wald A, Morrow RA, Selke S, Zeh J, Corey L. Effect of serologic status and cesarean delivery on transmission rates of herpes simplex virus from mother to infant.  JAMA.2003;289:203-209.
Guiterrez KM, Falkovitz Halpern MS, Maldonado Y, Arvin AM. The epidemiology of neonatal herpes simplex virus infections in California from 1985 to 1995.  J Infect Dis.1999;180:199-202.
Rouse DJ, Stringer JS. An appraisal of screening for maternal type-specific herpes simplex virus antibodies to prevent neonatal herpes.  Am J Obstet Gynecol.2000;183:400-406.
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