Background:
Neonatal herpes (NNHS) is a serious disease in newborns resulting in significant sequelae and high fatality rates. NNHS is not a nationally reportable disease in the United States, but some states have requirements for reporting.

Objective:
To describe the surveillance systems for NNHS and burden of disease in states with reporting requirements, 2000-2004.

Method:
From September to November, 2005, we identified states with NNHS reporting and conducted a phone survey with persons responsible for the reporting system at State Health Departments (SHD) to inquire about their surveillance system.

Result:
In nine of 50 states NNHS was reportable: Connecticut, Massachusetts, Florida, Ohio, Nebraska, Louisiana, South Dakota, Delaware, and Washington State. All had passive surveillance systems that were integrated wtih the Sexual Transmitted Disease program; these systems were flexible and relatively simple. There was no standard case definition used for surveillance in five states. The reporting process varied, but often multiple sources including clinicians, laboratories, hospital and local health departments reported cases. Four states did not have a specific field for NNHS on the reporting form. The fewest number of reported cases was in Connecticut with one case from 2000-2004; the greatest was in Ohio with 40 cases from 2000-2003. Overall, incidence rates ranged from 0-9 cases/100,000 live births. Eight SHDs did not disseminate data back to persons and/or facilities involved with the reporting systems.

Conclusion:
Few states have NNHS surveillance. In those with NNHS reporting, the incident rates were 6-10 times lower than estimates in literature. Use of established NNHS surveillance systems may not be an optimal strategy to assess burden of the disease.

Implications:
Studies should be conducted to determine public health usefulness of the NNHS reporting.