A new global review shows a concerning trend: a dangerous infection in newborns called neonatal herpes is on the rise. This infection, caused by the herpes simplex virus, is known for its high risk of death and long-term health problems. The analysis found that, on average, about 8 out of every 100,000 newborns are affected, which is roughly 1 in 10,000. But the risk isn't the same everywhere. It's highest in the Americas, where the rate is over 13 cases per 100,000 live births. In Europe, it's about 5 per 100,000, and in the Western Pacific region, it's just under 3 per 100,000. The study also reveals a shift in which virus is to blame. Globally, the two types, HSV-1 and HSV-2, cause nearly equal shares of cases. However, HSV-1 is becoming more common each year, while HSV-2 is becoming slightly less common. Most importantly, the overall number of cases is increasing by about 3.5% annually. This means more families worldwide are facing this serious threat to their newborn's life and long-term health.
Global neonatal HSV incidence 8.2 per 100k births, rising 3.5% annually; nHSV-1 proportion increasingA dangerous virus is affecting more newborns worldwide, with cases rising each year
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This systematic review and meta-analysis assessed the global epidemiology, regional variations, and temporal trends of neonatal herpes simplex virus (nHSV) infection, caused by HSV-1 or HSV-2. The study, conducted in accordance with PRISMA guidelines, reviewed PubMed, Embase, and national surveillance reports through 12 December 2024. It included 143 relevant publications from three of the six WHO regions, providing 140 nHSV incidence rate measures and 103 proportions of incident nHSV-1 vs. nHSV-2 cases. Random-effects meta-analysis was used to estimate pooled mean outcomes, and meta-regression analyses assessed associations, temporal trends, and potential sources of heterogeneity. The global pooled and regional population-weighted mean incidence rate was 8.2 (95% CI = 5.9-10.7) per 100,000 live births. Regional incidence was highest in the Americas (13.3 per 100,000; 95% CI = 9.9-17.2), followed by the European Region (5.2 per 100,000; 95% CI = 3.4-7.3) and the Western Pacific Region (2.9 per 100,000; 95% CI = 2.2-3.6). Globally, nHSV-1 and nHSV-2 accounted for pooled and weighted means of 47.3% (95% CI = 39.5-55.0) and 52.8% (95% CI = 45.2-60.5) of cases, respectively. The highest nHSV-1 proportion was in the Western Pacific Region (57.7%; 95% CI = 49.2-66.1), while the highest nHSV-2 proportion was in the Region of the Americas (60.5%; 95% CI = 55.8-65.1). Meta-regression analyses showed an annual increase of 3.5% (95% CI = 1.5-5.6) in nHSV incidence rate, alongside a yearly 1.4% (95% CI = 0.9-1.9) increase in the proportion of nHSV-1 cases and a 1.1% (95% CI = 0.6-1.6) decrease in the proportion of nHSV-2 cases. The study concludes that nHSV affects approximately one in 10,000 newborns, with regional variations and a rising incidence rate, and that the increasing dominance of nHSV-1 over nHSV-2 reflects shifting HSV epidemiology.
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