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Subject:
From:
Rachel Myr <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sun, 13 Aug 2006 23:35:44 +0200
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Linda Anderegg posts on a case of a young breastfed newborn who died of
herpes meningitis and asks why mother's antibodies did not protect the baby.

There was a case in Seattle in the late 1970's or early 1980's of a baby who
was infected with herpes by the father, via mother's breasts.  Father had
oral lesions, mother had no prior infection, his mouth was in contact with
her breasts and baby contracted the virus there.  That baby also died.  The
case was written up because the mechanism of transmission was atypical.

This could be a possibility in the mother Linda mentioned, but it could also
be that the mother was infected just before giving birth and had one or more
lesions inside her vagina or even on her cervix, thus not discovered, in
which case the infection would overwhelm the baby before maternal antibodies
were present in high enough amounts to protect it.  The same is true for a
few other viral illnesses, notably chickenpox.  If a woman comes down with
chickenpox less than 5 days before, or one week after, she gives birth, the
baby can get a life-threatening infection with the varicella virus.

Until it was learned that it is only when mother is experiencing her first
herpes outbreak ever when she goes into labor that there is a risk to the
baby from being born vaginally, they used to do cesareans very liberally if
there was any suspicion that there were herpes lesions or an outbreak on the
way.  Recurrences do not carry the same risk to the baby because there are
maternal antibodies present in high enough titres to provide protection.

Rachel Myr
Kristiansand, Norway

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