LAUSR

Background Neonatal infection with Herpes Simplex Virus (nHSV) is a reportable condition in Florida. Healthcare providers are required to report cases of nHSV, and clinical laboratories are required to report the results of tests in which HSV is detected. However, electronic laboratory reporting (ELR) to the Florida Department of Health is incomplete, and results are not captured in the repository used for case-based reporting of other nationally reported sexually transmitted infections. We estimated the incidence of laboratory-confirmed nHSV in Florida using provider-reported cases alone, ELR alone, both provider and ELR reports, and the incidence yielded by a capture-recapture methodology. Methods Provider-reported cases of nHSV (infants <60 days of age with HSV infection confirmed by culture or polymerase chain reaction) during 2011–2017, and laboratory reports of HSV-positive culture or PCR results in the same age group, over the same period, were extracted and analyzed. Provider-reported cases were matched with ELR results using name, date of birth, and specimen collection dates. Chapman’s estimator for capture-recapture was used to estimate nHSV incidence in Florida. Rates of nHSV infections per 100,000 live births were calculated. Results Providers reported 113 nHSV cases and ELR identified 197 nHSV cases during 2011–2017. Of these, 44 cases were common to both datasets, leaving 266 unique nHSV reports. Given the number of unmatched cases, Chapman’s estimator suggests 501 (95% C.I. 401–600) nHSV cases occurred in Florida during the study period. The incidence of nHSV using only provider–reports was 7.4 cases/100,000 live births; ELR-only was 12.8; combined provider and ELR reports was 17.3; and Chapman’s estimator was 32.7. Conclusion The incidence of nHSV measured using current provider- and ELR-reporting may substantially underestimate the disease burden in Florida. Expanding the number of healthcare facilities and laboratories electronically reporting nHSV infections and encouraging providers to report nHSV cases could help address the gap in reporting. Disclosure No significant relationships.