Strategies for the prevention of neonatal herpes: just a matter of opinion?

Neonatal herpes is a devastating disease with, in most countries, a low incidence. Strategies for prevention differ widely and are usually based on 'expert opinion'. Caesarean delivery in case of a herpes recurrence during delivery and suppressive aciclovir during the last weeks of pregnancy probably only have a modest effect on reduction of transmission. Type-specific serology will most likely not become available on a large scale. Therefore, counseling on safe sex practices may be important. Establishing incidence rates of neonatal herpes on a regular basis should be pursued, especially in low incidence areas.