Understanding herpes is your key to control of the disease. The following is a question and answer summary.
Q. How is oral herpes usually acquired?
A. Most primary cases of oral herpes are seen in young children. Children get this form of herpes from the active cold sores of adults and older children who care for or play with them. Direct contact, often momentary, is all that is necessary to pass the virus. Most cases of oral herpes in adults are believed to be reactivations of latent infections that were acquired in childhood. However, new primary cases of oral herpes in adults undoubtedly also occur. Direct contact, often momentary, is all that is necessary to pass the virus. Most cases of oral herpes in adults are believed to be reactivations of latent infections that were acquired in childhood. However, new primary cases of oral herpes in adults undoubtedly also occur.
Q. If both partners in a relationship have herpes, can they reinfect each other?
A. Yes. Prevention must be practiced just as though only one of the partners had herpes.
Q. Can a male protect his partner during an outbreak by wearing a condom?
A. Not in all cases. Sex should be avoided during active episodes.
Q. Are medical personnel ever at risk of catching herpes infections?
A. Medical personnel can sometimes get herpes infections on the hands or fingers after caring for or performing routine procedures on patients with active infections. Use of gloves when working with such patients is advised. When the sores of oral herpes are present, a person may also shed virus in his saliva. Dental personnel should be aware of this phenomenon and take precautions.
Q. What kind of herpes infection in a pregnant woman offers potential danger to the unborn child?
A. Genital herpes, especially a first infection.
Q. Why is a primary (first) case of genital herpes in a pregnant woman considered a special risk to the unborn child?
A. During a primary infection, the amount and duration of virus production are considerable. Therefore, there is greater opportunity for virus to linger in the mother’s genital area or to form a large pool for potential spread.
Q. What may happen if a woman gets genital herpes for the first time late in her pregnancy?
A. If the mother’s primary infection occurs during the last three months of pregnancy, there is a possibility that the virus will remain in the genital tract up until the time of birth. If so, the child would be born through an infected birth canal and might become infected during delivery.
The baby should not be infected through the mother’s bloodstream, but if the bag of waters is ruptured during either a primary case or a recurrence, the virus may ascend the vaginal canal and infect the unborn child. The risk is greater during a primary case because of the greater amount of virus present. If herpes simplex is present in the genital tract of a pregnant woman near the time of delivery, her physician usually will plan a Caesarean section.
Q. What may happen to an infant that is born through a birth canal infected with herpes simplex virus?
A. The newborn may contract a very serious herpes simplex infection that could include widespread skin eruptions, internal organ involvement, and damage to the nervous system leading to mental retardation or death.
Q. Will lovemaking be prohibited during pregnancy?
A. Some doctors will advise abstinence during the last six weeks of pregnancy, just to be safe. Also, if the spouse has either a primary episode or a recurrence in the last six weeks, intercourse should definitely be avoided to prevent transmission of virus to the expectant mother.
Q. Is a recurrence as serious as a primary case when delivery is near?
A. The amount of virus produced in a recurrence is much less than in a primary episode, and the time of viral shedding is much shorter. However, if a recurrence occurs near the time of delivery, active herpes virus may still be present in the birth canal when the baby is ready to be born, and the baby can become infected just as if the episode were a primary one. The attending physician will test the area for virus and make the appropriate decision at that time.
Q. Can recurring cervical sores spread up into the uterus?
A. There is no proven medical evidence that recurrences in the cervix can spread to the uterus.
Q. What can a woman do to prevent congenital herpes?
A. If a pregnant woman or her sexual partner has or has had genital herpes, she should inform her doctor. Some babies with congenital herpes are born to women with no symptoms of the disease. It is important to remember that infection in a partner may lead to congenital herpes even when the mother has never had any symptoms of the disease. Once informed, the physician can monitor the mother for the presence of herpes simplex virus throughout the pregnancy, and plan the best care for her and her baby.
Q. What effect does maternal oral herpes have on the fetus?
A. Probably none. In oral herpes, the site of viral herpes multiplication is confined to the mouth region, which is far removed from the place where the baby is developing. Consequently, it is highly unlikely that the virus could ever spread to the unborn child.
During the first few months of life, however, the newborn is very susceptible to developing a more virulent type of herpes disease than is the older child or adult and may be at risk from herpes anywhere on the mother’s body.
The mother or anyone with oral herpes should avoid kissing or fondling the newborn. The hands should always be carefully washed before handling the baby.
Q. What is the relationship between herpes and cancer?
A. The relationship is not clear. Data suggest that women who have had genital herpes have a higher risk of getting cervical cancer, but it is not known exactly why just yet. Women who have had genital herpes should get a Pap smear twice a year.
Q. Has there been any connection between genital herpes and cancer in the male?
A. To date there has been no proven connection between genital herpes in men and urogenital cancer.
Q. Can genital herpes lead to herpes encephalitis?
A. No. Herpes encephalitis is a rare, often fatal, condition in which herpes simplex virus infects the brain and spinal cord.
Q. Does dye-light therapy work as a herpes treatment?
A. Several years ago, the dye-light method was a popular herpes simplex treatment. It involved painting herpes sores with a specific dye and then exposing the painted area to light for short periods of time. When tested in a double-blind clinical trial, however, the specific dye-light method was found no more effective than the control procedure. Also, scientists were concerned that the dye-light method might produce defective herpes viruses which, in turn, could possibly lead to cancerous changes in treated cells.
Q. Are the treatments that are advertised in newspapers and magazines worthwhile?
A. No. They will not only fail to cure herpes but some of them could be dangerous to your health. Zovirax, the new antiviral agent, is the only drug approved by the FDA. It will reduce viral shedding and may decrease the duration of sores. It will not affect the virus in the latent form nor will it prevent recurrences.
The key to control of herpes is prevention and thorough understanding. Practice good hygiene and the potential for complications are minimal.