National surveillance for neonatal herpes simplex virus infections

Article Abstract:

Herpes simplex is a viral infection that infects the skin and mucous membranes such as the mouth and genital region. Infants can acquire the herpes simplex virus (HSV) from the mother's genitals during the birth process, although it is also possible to obtain the infection from nonmaternal sources. Neonatal herpes is fatal in 40 percent of the infected infants. Cesarean section is recommended for women with genital herpes to prevent the infant from acquiring the infection while passing through the birth canal. Since neonatal herpes does not have to be reported in some states, the actual nationwide incidence is unknown. The Centers for Disease Control (CDC) studied the incidence and origin of HSV infections in infants born in 4,968 hospitals. Of the 184 cases reported over a 18-month period, 22 percent of the mothers had a previous history of genital herpes. Only nine percent of those reported a flare-up of the infection at the time of the delivery. Cesarean section was performed in 33 percent of the deliveries. Of the 62 Cesarean births, six were solely to prevent neonatal herpes; an additional five cesarean deliveries were the result of other obstetrical complications and to prevent neonatal herpes. Cesarean delivery was unable to prevent a neonatal infection in 15 patients. Most mothers did not have evidence of a herpes lesion during delivery. Not all women had symptoms of a herpes infection during delivery, and therefore another route of transmission must exist. The herpes virus is thought to travel from the vagina to the uterus, infecting the fetus before delivery. To effectively prevent neonatal herpes, other modes of prevention must be considered. Identifying infected women who do not have symptoms by means of a highly specific blood test may offer some help. The effectiveness of cesarean delivery in the prevention of genital herpes needs to be evaluated.

Infection, Maternal-fetal exchange, Fetus, Physiological aspects, Demographic aspects, Virus diseases, Disease transmission, Herpes genitalis, Genital herpes, Pregnancy, Virus diseases in pregnancy

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Condom use and use-effectiveness in high-risk populations

Article Abstract:

Latex condoms are used to prevent the passage of diseases among sex partners. Although they have been proven an effective disease barrier in the laboratory, it is unknown whether their use is actually preventing the spread of sexually transmitted diseases. The task of the Sacramento Special Study is to study whether condoms are being used, their effectiveness in preventing the transmission of sexually transmitted diseases (STD) and their acceptance among users. The study surveyed condom use among 2,045 persons attending a sexually transmitted diseases clinic. Of 122 patients exposed to an STD in 1971, 91 (76.4 percent) never used a condom, 21 (17.2 percent) used a condom at least once and 10 (8.2 percent) reported using a condom every time they had sex. In a Centers For Disease Control (CDC) study of female prostitutes, it was found that none of the 22 prostitutes who, each time they had sex, demanded their partners wear condoms had antibodies against the human immunodeficiency virus, the virus responsible for AIDS. It is suggested that educational messages regarding proper condom use be modeled after the Swedish Association for Sex Education program.

Sexually transmitted diseases, Prevention, Condoms, Sexually transmitted disease prevention

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Comparison of virus culture and the polymerase chain reaction for diagnosis of mucocutaneous herpes simplex virus infection

Article Abstract:

Polymerase chain reaction (PCR) testing does not seem to consistently identify patients with herpes simplex virus (HSV) infections even though it appears to be more precise than virus culture testing. PCR is a technique that amplifies segments of genetic material for identification. Two hundred forty-six patients with suspected HSV infections were tested with both PCR and culture sample tests. Doctors identified 59% of the samples positive for HSV. However, the PCR test was negative for 27 patients identified by doctors as having HSV. PCR tests identified 31 patients with HSV that culture testing missed.

Evaluation, Diagnosis, Polymerase chain reaction

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