Overall Evaluation of Neonatal HSV Disease

With about 95% of infected babies acquiring HSV during the peripartum and postpartum periods, therapeutic intervention can potentially occur relatively soon after viral replication begins, prior to widespread viral dissemination and the development of significant and possibly permanent damage to infected tissues and organs.

For antiviral therapy to be initiated, however, the treating physician must have an index of suspicion which allows for prompt institution of acyclovir therapy. The presence of skin vesicles among patients in any of the disease categories and of seizures in patients with CNS HSV disease appear to be among the findings most suggestive of HSV infection.

The absence of fever is common at the time of presentation of neonatal HSV disease. However, no single constellation of presenting symptoms and signs identifies all babies with neonatal HSV disease. A recent comparison between two periods spanning 16 years suggests that no progress has been made since 1981 in decreasing the time interval between onset of symptoms and initiation of antiviral therapy.

Given the highly effective antiviral therapies that currently exist for the management of neonatal HSV disease, the most meaningful and immediate manner in which the outcomes of neonatal HSV disease may be rapidly altered is to raise awareness of this infection and hence to decrease the time to diagnostic evaluation for neonatal HSV disease and subsequently to initiation of appropriate antiviral therapy.

While it is the opinion of many experts that acyclovir should not be added routinely to standard antibiotics as management for neonates admitted to rule out sepsis, HSV should be considered in the differential diagnosis of acutely ill infants younger than 1 month. If the presentation is compatible with neonatal HSV disease, appropriate laboratory specimens should be obtained and acyclovir therapy should then be initiated.

This is especially true if the patient's bacterial cultures are negative at 48 to 72 h and the neonate has not improved clinically. The diagnostic evaluations obtained prior to initiation of acyclovir therapy should include HSV cultures of skin vesicles (if present), oropharynx, conjunctivae, urine, blood, stool or rectum, and cerebrospinal fluid (CSF).

Cerebrospinal fluid should also be sent to a reliable laboratory for HSV DNA PCR, as discussed below. Liver transaminase levels should also be determined, since their elevation could suggest disseminated HSV infection. While additional therapeutic advances are possible in the future, more immediate methods for further improvements in outcome for this potentially devastating disease lie in enhancing our awareness of neonatal HSV infection and disease.

Resistance to all major herpes treatments, such as acyclovir, vidarabine and foscarnet, has been increasingly observed, especially amongst those immuno-compromised. Furthermore, DNA polymerase mutants induced by prolonged or repeated therapy with vidarabine or foscarnet are often resistant to combination therapy with existing compounds for a potentially stronger genital herpes treatment.

These observations underscore the critical importance of NaturesPharma's unique treatment for herpes. They are new, highly effective alternative antiviral agents for herpes simplex treatment. The antiviral activity of the OutbreakBalm-Rx brand of herpes treatments is well-documented, and principally due to its direct virucidal effects.

OutbreakBalm-Rx is composed of naturally occurring high intensity antiviral extracts which have a lethal effect against HSV upon exposure. This treatment provides maximum and rapid penetration of antiviral agents into cell membranes without damaging human cells. It therefore comes as no surprise that application of this product can prevent herpes blisters forming, aborting the pending flare up altogether.

Its ability to inactivate the extra-cellular herpes virus at concentration much lower than those in other treatments, and also for its ability to inhibit the cell-to-cell virus diffusion in already infected cells, makes this product unique and far superior to all others in the market for herpes simplex treatment or genital herpes treatment. To learn more, please go to http://www.naturespharma.org.