"What makes you decide to do something further depends on what the baby looks like," Abramson said. "This is a disease that is much less common than bacterial infections."
About 1,500 to 2,200 babies under 1 month old contract herpes each year in the United States, and untreated, the virus is fatal in up to 85 percent of cases. The majority of neonatal herpes simplex infections are caused by HSV-2, but about 30 percent are caused by HSV-1, according to the American Academy of Family Physicians.
A specialist in pediatric infectious disease may be more finely tuned to infections like herpes than another type of doctor. Unfortunately, without active signs of infection, the symptoms of HSV-1 are non-specific. Indeed, the advice Raveney received from general practitioners and midwives led her to believe her daughter was not ill and was simply taking some time to settle into the family routine.
A herpes infection in an infant may have caught anyone by surprise. Raveney said she read voraciously while she was pregnant and never came across any information on the risks of herpes viruses for babies. Doctors she spoke with following Mira's death told Raveney they tend not to bring up herpes as a risk factor with parents to avoid panic and anxiety for an uncommon complication.
"What's one sentence in a book or one word from a midwife?" Ravaney said. "I just think that even if it's just one baby, you need to warn people of that."
Abramson pointed out that doctors will bring up the risks and possible courses of action for birth and child care if there is a clear indication or past history that one or both parents has a herpes simplex virus. Otherwise, Abramson said there is so much ground to cover with expecting parents that a rare complication like herpes is often left out of the discussion.
Abramson added there are some things parents who have a herpes simplex virus can do to reduce the chance of passing it on to their infants, including washing their hands before and after touching their children and wearing masks to prevent viral transfer from the nose or mouth to the hands and then on to the baby.
Since Mira's death, Raveney has learned of three other families who have lost children due to a herpes virus infection.
"That breaks my heart," Raveney said. "It shows that it happens, and people don't know about it and don't talk about it."