July 17, 2017 – The parents of a month-old baby announced Monday that their child died just days after being diagnosed with viral meningitis caused by HSV-1. The Iowa couple, whose plight made national news, say the disease was most likely given to the baby girl by someone infected with the herpes simplex virus type 1, most commonly associated with cold sores. The parents said their baby most likely got this virus from being handled by someone who was infected and didn’t know it. Media reports say that the baby would have had lifelong health challenges if she survived.
After the baby was diagnosed, but before she died, we talked to infectious disease experts William Schaffner, MD, at the Vanderbilt University School of Medicine in Nashville, and Camille Sabella, MD, of the Cleveland Clinic, to learn more about this virus and newborns. Neither expert was involved with the case.
WebMD: Can you tell us more about the virus that might have infected this baby?
Schaffner: This kind of meningitis, encephalitis due to herpes simplex virus type 1, is very unusual in newborns. HSV-1 is very commonly distributed in the population. It’s almost always a benign infection. It infects people, but doesn’t make them sick and it can be carried around the mouth, and you may not get symptoms at all. So it kind of hangs around for a while and can be with you for a prolonged period of time.
WebMD: How does a baby contract HSV-1?
Schaffner: Perhaps someone who … had this virus in and around their mouth kissed this baby or had the virus on their fingers and touched the baby. Then it’s on the surface of the baby and then the virus, for reasons we don’t really understand, gets inside to the baby, circulates in the bloodstream and finds its way to the brain and the spinal cord and the coverings, those meninges, those membranes that cover it.
WebMD: What happens to a newborn baby who contracts this virus?
Sabella: In the first month of life it can be very, very serious and they can have a whole host of different manifestations. This virus can basically infect any organ and can cause a lot of damage, not just to the brain but also to things like the liver, the blood stream, the kidneys, the heart. It can involve many, many organs and the meninges and the brain is one common place that this virus commonly attacks. It not only causes meningitis, but also causes encephalitis, which is not only infection of the brain lining, but also the brain cells. So when we talk about neonatal herpes, it usually doesn’t just involve the brain, it can, but it usually causes more than just that.
WebMD: What treatments are there?
Schaffner: So the baby is going to get all that supportive care to make sure that the hydration is good, the baby is fed, the baby may need a breathing machine to help it breathe, extra oxygen, etc.. They also get treatment with the antiviral drug that actually attacks the virus itself with the hopes of quickly killing the virus and then letting the body recover. But if this [case] is indeed encephalitis that involves the substance of the brain, the healing process may get rid of the virus and the inflammation, but there may have been some damage caused by the virus that cannot be restored.
WebMD: Does age of the baby matter?
Sabella: Many, many folks get infected with the herpes virus beyond the neonatal age group, and most of the time don’t even know they‘ve become infected. But a baby in the first month of life has an immune system that’s not developed enough to deal with certain viruses like the herpes virus and when they get infected with that it can quickly spread through their blood stream and infect many of the different organs that we spoke of.
WebMD: Is there any way to prevent a baby from getting the disease?
Sabella: …We usually don’t like babies in their first month or two of life going out a whole lot. Being exposed to different people and people touching them is certainly not something that we recommend. And if someone is going to touch a baby or hold the baby, then certainly at a minimum wash their hands very, very well beforehand. Two other ways we can really protect babies is to make sure the babies as well as their moms have all the vaccinations that they need. One very important way is before the baby is going to be born during fall, winter, spring is to protect them from flu viruses. The best way to do that is to vaccinate the pregnant mom sometime during her third trimester. If you vaccinate the mom against the flu, they will develop antibodies against the virus and pass it on to the baby which will protect it. Another way to do that is to breastfeeding whenever possible, that also provides direct antibodies and immunity from moms to the babies after the babies are born.
WebMD: If a parent thinks there was a chance of exposure, what are the symptoms they should watch for in their newborn?
Sabella: In babies, the features of illness are very subtle. Anytime the baby is not doing what the parents think that they should be doing, certainly if they’re not as responsive, sleeping a lot more, if they’re not feeding well, generally not looking well, then they should they should certainly talk about that with their pediatricians.
CBS4indy.com: “Parents of newborn battling life-threatening illness are warning others”
William Schaffner, MD, Professor of Preventive Medicine, Department of Health Policy, Professor of Medicine, Division of Infectious Diseases, Vanderbilt University School of Medicine
Camille Sabella, MD, Pediatrician and infectious disease expert, Cleveland Clinic