Yes, a newborn can die from herpes, but fast antiviral treatment and close hospital care usually keep neonatal herpes infection under control.
The question “can a newborn die from herpes?” is frightening, and parents deserve a clear, direct answer. Neonatal herpes is rare, yet it can be life-threatening when the virus spreads through a baby’s body or brain.
This article explains how neonatal herpes works, how often it leads to death, what warning signs matter most, and which steps lower the risk for your baby. It does not replace care from your baby’s doctor, but it can help you feel more prepared to act fast if something seems off.
Can A Newborn Die From Herpes? Understanding Risks And Outcomes
Doctors use the term “neonatal herpes simplex virus infection” for herpes in babies during the first month to six weeks of life. Both herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) can cause it. Without treatment, serious forms of neonatal herpes can lead to death in many babies who catch it. With modern antiviral drugs such as acyclovir, the outlook has improved, but the infection still needs urgent care.
Specialists group neonatal herpes into three main patterns: disease limited to the skin, eyes, or mouth; infection in the brain and nervous system; and widespread, or disseminated, disease that hits many organs at once. The chance of death climbs steeply when the brain or several organs are involved.
Types Of Neonatal Herpes And Death Risk
Not every baby with herpes has the same outlook. The pattern of infection, timing of treatment, and overall health of the infant all matter. The table below summarises common patterns and what they usually mean for survival.
| Type Or Situation | Typical Death Risk | Short Description |
|---|---|---|
| Skin, Eye, And Mouth (SEM) Disease | Low with prompt IV acyclovir | Blisters on skin or around eyes or mouth, baby usually otherwise stable. |
| Central Nervous System (CNS) Disease | Moderate without care; lower with treatment | Virus reaches the brain, leading to seizures, poor tone, and feeding problems. |
| Disseminated Disease | High without care; around half lower with treatment | Multiple organs such as liver, lungs, and brain involved; baby appears seriously unwell. |
| Congenital Infection (In The Womb) | High risk of loss or severe disability | Infection starts before birth and can cause growth problems and birth defects. |
| Postnatal Infection From Cold Sore Contact | Ranges from low to high, depending on spread | Passed after birth from a person with mouth sores who kisses or touches the baby. |
| Recurrent Localised Herpes In Treated Baby | Low for death, higher for long-term nerve problems | Blisters return on skin or eyes in a baby who had previous neonatal herpes. |
| Exposure Only, No Proven Infection | No direct risk from herpes infection | Baby is monitored and tested because the birth parent has genital herpes. |
This table shows why doctors take any concern about neonatal herpes seriously. Even babies with blisters only on the skin can progress to deeper infection if treatment is delayed, so hospital teams usually start antiviral therapy while tests are pending.
How Newborns Catch Herpes
Most newborns who develop herpes pick up the virus during birth from genital secretions that contain HSV-1 or HSV-2. Risk rises when the birth parent has a first-ever genital herpes episode near delivery, because their body has not had time to build and pass protective antibodies to the baby. Longer time between water breaking and delivery, use of scalp electrodes, and forceps or vacuum delivery can add to the risk.
Some babies catch herpes after birth when a person with a cold sore kisses them or when the virus spreads from a sore on the hand to the baby’s skin or mouth. Health organisations such as the NHS neonatal herpes guidance stress simple steps like handwashing and keeping cold sores under a dressing to cut this route of spread.
Rarely, the virus reaches the baby before birth through the placenta or from infection of the womb. These babies may be born with skin scars, eye problems, or small heads, and often have severe illness.
Early Symptoms Parents Tend To Notice
Neonatal herpes can appear any time in the first six weeks, though many cases start between days five and twenty-one. Early symptoms can be hard to spot because they look similar to common newborn issues or other infections. Still, certain patterns should always send a family to urgent medical care.
Warning signs can include:
- Clusters of small blisters or sores on the skin, around the eyes, or in the mouth
- Fever or, in some babies, an unusually low temperature
- Poor feeding or refusal to feed
- Sleepiness or hard-to-wake behaviour
- Fast breathing, pauses in breathing, or grunting sounds
- Jittery movements, unusual stiffness, or seizures
Any of these symptoms in a baby under six weeks call for same-day medical assessment, especially if someone in close contact has known herpes infection. If a parent ever finds themselves asking again “can a newborn die from herpes?” while seeing these changes, the safest move is to go straight to emergency care instead of watching and waiting at home.
What Doctors Do When They Suspect Neonatal Herpes
Because neonatal herpes can worsen quickly, doctors do not wait for full test results before starting treatment. In the emergency department or newborn unit, staff begin a careful assessment right away, checking breathing, heart rate, blood pressure, oxygen levels, and blood sugar.
Most babies with suspected neonatal herpes will have several tests on the first day in hospital. These can include:
- Blood tests to look for infection and to check liver and kidney function
- Swabs from the eyes, mouth, nose, and any skin blisters for herpes PCR testing
- A lumbar puncture to test spinal fluid for herpes DNA and to rule out other causes of meningitis
- Chest X-rays or ultrasound scans when lungs, liver, or other organs may be involved
At the same time, the team usually starts intravenous acyclovir, an antiviral drug that blocks herpes replication. Guidance from groups such as the US Centers for Disease Control and Prevention and paediatric societies recommends early treatment while tests are pending for any newborn with strong signs of herpes infection or high-risk exposure.
Treatment, Survival, And Long-Term Effects
Babies treated for neonatal herpes usually stay in hospital for at least two to three weeks while they receive intravenous acyclovir. The course often lasts fourteen days for disease limited to skin, eyes, and mouth, and twenty-one days for brain or disseminated disease. Blood work and spinal fluid tests may be repeated near the end of treatment to confirm that the virus is under better control.
Once the initial course ends, many infants go home on oral acyclovir for several months. This long-term suppressive treatment lowers the chance of new outbreaks on the skin and may improve neurodevelopmental outcomes in babies with previous brain infection.
Survival depends strongly on how fast treatment starts and how widespread the infection is. With water-tight early care, babies with skin, eye, and mouth disease now rarely die from herpes. For central nervous system or disseminated disease, deaths still occur even with treatment, yet modern outcomes are better than older studies where many untreated infants died.
Some survivors, especially those who had brain or widespread disease, later develop learning delays, movement problems, hearing loss, or vision loss. Children who had only skin, eye, and mouth involvement and were treated early often grow and learn in line with other children their age, though they may need repeat eye checks and hearing tests.
Timing Of Treatment And Likely Outcomes
The timing of antiviral therapy can make a large difference to survival and long-term health. The table below sets out common scenarios that doctors describe when talking with families whose babies are being evaluated for herpes.
| When Treatment Starts | Typical Hospital Plan | Likely Outcome Pattern |
|---|---|---|
| Before Symptoms, High-Risk Exposure | Short course of IV acyclovir plus close monitoring and testing. | Low chance of infection developing; death from herpes rare. |
| Within First 24 Hours Of Symptoms | Full IV acyclovir course; full set of tests and organ care. | Best chance of survival and lower rate of severe disability. |
| Days Two To Four Of Illness | IV acyclovir plus care in a specialist unit; help for failing organs as needed. | Survival still possible, but risk of brain injury or death higher. |
| Late Presentation, After Several Days Unwell | Intensive care, mechanical ventilation, and machines that stand in for failing organs may be needed. | High risk of death and of serious long-term problems in survivors. |
| No Antiviral Treatment Given | Applies mainly to settings where diagnosis is missed or care is unavailable. | Highest death rate, especially for disseminated and brain disease. |
These patterns are based on population data and cannot predict what will happen to one child. Even so, they show why rapid recognition and treatment change the odds in favour of the baby.
How Parents And Caregivers Can Lower Risk
Parents who live with genital herpes often worry constantly about passing it to their baby. Many babies born to parents with herpes never get infected, especially when pregnancy care includes open conversation about symptoms and timing of outbreaks.
Steps that reduce risk include:
- Telling the maternity team early in pregnancy about any past or current genital herpes
- Using antiviral tablets in late pregnancy when recommended to reduce genital shedding of the virus
- Planning a caesarean birth when there are fresh genital sores or early symptoms at the time labour starts
- Not kissing a newborn when a cold sore is present and keeping any sores under a clean dressing
- Washing hands before touching the baby and after touching any lesions
People who breastfeed can usually continue, as long as there are no open sores on the breast that the baby would touch with their mouth. If sores appear on one side, milk can often still be fed from the other breast, using pumped milk when needed.
When To Seek Emergency Help
Any baby under six weeks who seems unwell should be taken seriously. Parents should head to emergency care or call their local emergency number without delay if they notice:
- Seizures, unusual stiffening, or repeated jerking movements
- Blue or grey skin colour, or pauses in breathing
- Extreme sleepiness or difficulty waking the baby for feeds
- Feeding less than half the usual amount over several feeds
- Clusters of blisters on the skin, especially around the eyes or mouth
At the hospital, parents can share any history of genital herpes, cold sores, or recent illness in themselves or close contacts. This information helps doctors weigh neonatal herpes alongside other possible causes and start the right tests and treatment early.