Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, GA.
Sex Transm Dis. 2019 Feb;46(2):125-131. doi: 10.1097/OLQ.0000000000000923.
Neonatal herpes (nHSV) is a potentially fatal disease caused by herpes simplex virus (HSV) infection during the neonatal period. Neonatal herpes simplex virus infections are not nationally notifiable, and varying incidence rates have been reported. Beginning in 2006, New York City (NYC) required reporting of nHSV infections and conducted case investigations. We compared the use of administrative hospital data with active surveillance to monitor trends in nHSV infection.
We compared the incidence and characteristics of nHSV cases as measured using population-based surveillance and administrative hospital discharge data collected between 2006 and 2015. Surveillance cases were defined as laboratory-confirmed HSV infections in NYC-resident infants aged 60 days or younger at diagnosis. Administrative cases were defined as NYC-resident infants aged 60 days or younger at hospital admission whose records included an HSV diagnosis. Neonatal herpes cases after ritual Jewish circumcision with direct orogenital suction were excluded.
There were 107 surveillance cases (9.9 per 100,000 live births) and 131 administrative cases (12.1 per 100,000 live births). Incidence was highest in infants born to non-Hispanic black mothers aged 20 years or younger (surveillance, 57.2 per 100,000 live births; administrative data, 31.2 per 100,000 live births). The distribution of cases by year did not significantly differ across data sources. Surveillance cases had a higher case-fatality rate (18.7%) compared with administrative cases (8.4%; P = 0.019).
Administrative hospital data can be used to measure the incidence of nHSV infection and describe disease burden across population subgroups in jurisdictions where nHSV reporting is not required. However, administrative data may underascertain nHSV case fatality.
新生儿疱疹（nHSV）是一种由单纯疱疹病毒（HSV）感染引起的潜在致命疾病，发生于新生儿期。HSV 感染的新生儿疱疹并未在全国范围内进行通报，且发病率报道不一。自 2006 年起，纽约市（NYC）要求报告 nHSV 感染并开展病例调查。我们将使用行政医院数据与主动监测进行比较，以监测 nHSV 感染的趋势。
我们比较了 2006 年至 2015 年期间通过基于人群的监测和行政医院出院数据收集的 nHSV 病例的发病率和特征。监测病例定义为在诊断时年龄为 60 天或以下的纽约市居民婴儿的实验室确诊 HSV 感染。行政病例定义为在医院入院时年龄为 60 天或以下的纽约市居民婴儿，其记录中包括 HSV 诊断。排除因犹太割礼而直接经口-生殖器抽吸引起的新生儿疱疹病例。
有 107 例监测病例（每 10 万活产儿 9.9 例）和 131 例行政病例（每 10 万活产儿 12.1 例）。发病率最高的是年龄在 20 岁或以下的非西班牙裔黑人母亲所生的婴儿（监测数据：每 10 万活产儿 57.2 例；行政数据：每 10 万活产儿 31.2 例）。不同数据源的病例分布在年份上无显著差异。监测病例的病死率（18.7%）高于行政病例（8.4%；P=0.019）。
在不需要报告 nHSV 的司法管辖区，行政医院数据可用于衡量 nHSV 感染的发病率，并描述各人群亚组的疾病负担。但是，行政数据可能会低估 nHSV 的病死率。
