Neonatal Herpes Simplex Virus Infections in Israel

Background: The incidence and the clinical characteristics of neonatal herpes simplex virus (NHSV) infection in Israel are unknown. Methods: We reviewed the medical records of NHSV cases who were born between January 2001 and December 2007 in 5 medical centers located in central Israel. Cases were identified using International Classification of Diseases, 9th revision codes. In addition, parents of survivors were interviewed by telephone. Results: In the 8-year study period, 22 cases of NHSV were identified (an incidence rate of 8.4 per 100,000 live births). Most patients (77.2%, 17 cases) manifested as skin, eye and/or mouth infection, 13.6% (3 cases) as localized central nervous system disease and 9.1% (2 cases) as disseminated disease. Most (76.4%) herpes viruses typed in our series were HSV-1. None of the mothers had documented intrapartum visible genital HSV lesions or a previous history of genital herpes. Ritual circumcision was the source of HSV-1 transmission in 7 infants (31.8% of cases). Conclusions: The incidence of NHSV infection in Israel was found to be similar to the lower part of the scale reported in the United States, however higher than the incidence reported in Canada or in Europe. Similar to more recent reports, our series demonstrates the shift toward the predominance of HSV-1 in NHSV infection. In addition, none of the mothers in our series had a previous history of genital herpes. This study emphasizes the need for awareness of HSV infection in Israeli neonates.