Progress in Standardizing Neonatal Herpes Simplex Virus (nHSV) Surveillance in the United States

Background: Neonatal herpes simplex virus (nHSV) infection is a serious disease that results in death for 50 to 60% of untreated cases; survivors often suffer some degree of neurologic impairment, depending on the extent of disease dissemination. Though some U.S. jurisdictions have this disease as a reportable condition, it is not nationally reportable, and no standardized national surveillance system exists. As a result, little is known about the prevalence of this infection or its epidemiology, and more needs to be learned about maternal risk factors, opportunities for prevention, delays in diagnosis and treatment, and appropriateness of therapy.

Objectives: To describe the development of the Council of State and Territorial Epidemiologists (CSTE) Neonatal Herpes Simplex Virus Working Group and the progress made in developing standard surveillance methods.

Methods: In April 2008, the Neonatal Herpes Simplex Virus Working Group, composed of representatives from state and local health departments, the Centers for Disease Control and Prevention (CDC), and the CSTE, was formed. Utilizing recommendations from an Expert Panel convened by CDC, as well as lessons-learned from state and local health departments, the Working Group developed standard methods for conducting surveillance.

Results: The Working Group accomplished the following: 1) adopted a standard case definition for surveillance purposes; 2) developed a list of standard clinical and epidemiological data elements; 3) developed a standard data collection form and database; and 4) identified other surveillance needs. Future efforts will include data collection by individual jurisdictions and data consolidation, analysis, and results reporting. 

Conclusions: The Working Group has developed standards that can be used by public health agencies to establish or enhance existing surveillance for nHSV infections.

Implications for Programs, Policy, and/or Research: By establishing standards for nHSV surveillance, public health agencies will be assisted in efforts to better understand the burden of this disease and opportunities for prevention and treatment.