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Unfortunately, when infants do contract neonatal herpes, the results can be tragic.About half of infants who are treated with antiviral medication escape permanent damage.

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There is also a small risk of transmission from asymptomatic shedding (when the virus reactivates without causing any symptoms).

Fortunately, babies of mothers with long-standing herpes infections have a natural protection against the virus.

Herpes antibodies in the mother's blood cross the placenta to the fetus.

These antibodies help protect the baby from acquiring infection during birth, even if there is some virus in the birth canal.

In addition, newly infected people - whether pregnant or not - have a higher rate of asymptomatic shedding for roughly a year following a primary episode.

This higher rate of asymptomatic shedding, plus the lack of antibodies, create the greater risk for babies whose mothers are infected in the last trimester.

But on the other hand, the risk is extremely low, experts agree especially for women with known, long-standing infections.

Neonatal herpes is not a reportable disease in most states, so there are no hard statistics on the number of cases nationwide.

But others may suffer serious neurological damage, mental retardation or death.

It's fear of these terrible consequences, rather than the level of risk, that makes neonatal herpes a concern.

"The rate of neonatal herpes is very low, even though the prevalence of genital herpes in our country is quite common." Transmission rates are lowest for women who acquire herpes before pregnancy -- one study (Randolph, JAMA, 1993) placing the risk at about 0.04% for such women who have no signs or symptoms of an outbreak at delivery.

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