Herpes: your questions answered

Herpes Can Happen to Anyone

Herpes: your questions answered

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Did you know that the virus that causes “cold sores” or “fever blisters” on or around the mouth can also infect other areas of the body? The infection is caused by the herpes simplex virus. And it’s very common.

Most people with herpes infection don’t even know it. They may not have symptoms or not notice them.

For people who do have symptoms, a herpes infection may show up as one or more blisters. These can be on or near the mouth, eyes, genitals, or rectum. After the blisters break, they turn into sores or ulcers. These sores are painful and take about a week to heal.

Once someone is infected with herpes simplex, the virus goes into hiding and stays in the body for the rest of their lives. The virus can re-emerge at any time and cause an outbreak. Some people have outbreaks several times per year. Tingling or burning in the area can signal that an outbreak is looming.

There are two types of herpes simplex viruses: HSV-1 and HSV-2. HSV-1 is often transmitted during childhood. You can get it from close contact with someone who has the infection.

For example, a family member with a cold sore may kiss a child. HSV-1 is the main cause of herpes of the mouth or eyes.

Although it’s possible for HSV-2 to infect the mouth or eyes, it’s usually found in the genital area.

There’s no cure for herpes. But anti-herpes medicine can speed healing of the sores. If taken every day, this medicine can also lower the risk of future outbreaks.

“It’s the first episode that is particularly important to treat,” says Dr. Jeffrey I. Cohen, a herpes infection expert at NIH. That’s because the first outbreak is often the most severe. In addition to sores, you may have a fever and body aches. Also, the nearby lymph nodes might be swollen and painful.

A doctor may suspect a diagnosis of herpes from looking at a sore. But lab tests on a sample taken from the sore is needed to confirm the diagnosis. A blood test for HSV-1 and HSV-2 is also available to confirm if someone has been infected.

Researchers are working to develop herpes vaccines. “There are two different types of vaccines being developed for herpes virus,” Cohen explains. “One is a vaccine that would prevent infection in people who have not been infected with the virus.” Cohen’s research team at NIH is working on this type of vaccine.

“The other type of vaccine is for people who are already infected,” he says. “The idea is that we could boost their immune system so that they have fewer recurrences.”

The fact that most people don’t know that they’re infected makes vaccines especially important.

When someone is diagnosed with herpes, they may feel anger, sadness, or shame. They also may fear rejection by romantic partners.

Keep in mind that herpes outbreaks can be managed. People can lower the risk of infecting someone else by avoiding direct contact during an outbreak. For those with genital herpes, using anti-herpes medicine every day and condoms during sexual activity also reduces the risk of infection for a romantic partner.

Talk with your doctor if you have questions about preventing or managing herpes. And help fight the stigma of herpes by sharing the facts in the Wise Choices box.

Source: https://newsinhealth.nih.gov/2018/06/herpes-can-happen-anyone

Herpes

Herpes: your questions answered

  • “Herpes: What 45 million people need to know” (PDF)

Herpes is one of the most common viral infections in the United States. One of every four Americans over 18 has been exposed to genital herpes. Most people don't know they're infected.

What causes herpes?

Herpes is a viral infection of the skin caused by the Herpes Simplex Virus (HSV). There are two types of herpes: HSV-1 and HSV-2.

HSV-1 usually causes infections of the mouth such as “cold sores” or “fever blisters” on the lips. Most of the time HSV-2 causes genital herpes. But, either type of herpes can cause an infection of the mouth or genitals.

How is it spread?

Herpes is spread by direct skin-to-skin contact with someone who is infected. You can get herpes from someone who has sores on his or her lips, skin or genitals. But, most of the time, herpes is spread when someone does not have any signs or symptoms. The herpes virus can still rub off a person's skin even when he or she has no sores that you can see.

Remember: you can get herpes from someone who has no sores or symptoms and if you have herpes you can spread it even if you have no sores or symptoms.

What are the signs and symptoms?

Only about half the people who get herpes have symptoms. Those who do have symptoms usually have an outbreak two to 10 days, or within three weeks, after they get the virus. The first symptoms are usually the worst. They are called primary herpes.

Signs and symptoms may include:

  • A fever, headache, and muscle aches. Three days later, painful blisters and skin ulcers appear where you were infected. This may be your mouth, genital area, anus and/or rectum.
  • Blisters may be “hidden” in your vagina.
  • About a week after the skin rash, tender and swollen glands, or lymph nodes, may develop in your groin.

If you do not get treatment, your rash and pain will usually go away within 3 to 4 weeks.

Your sores will heal, but the virus will never go away. It will always stay in your body in a latent form. This means it will be quiet, hidden, and you will not have symptoms. But, herpes can become active again and cause new sores. This is called “recurrent” herpes.

  • The second time you have symptoms, they will usually hurt less and not be as bad as the first time. Recurrent herpes often starts with a burning or itchy feeling one to two days before a skin rash begins.

Can herpes cause any more problems?

The most severe problem (complication) happens when a woman passes the virus to her baby during delivery. If the infant is infected, it is very serious.

This infection often causes the baby to die or suffer mental retardation and blindness. This problem is rare and usually happens when a woman gets herpes for the first time near delivery.

If a woman has a genital herpes outbreak when she goes into labor, she may need a C-section (Cesarean delivery).

Urinating may be very painful if you have sores on your vulva (the external parts of the female genitals). You may be more comfortable if you sit in a tub of warm water and urinate into the bath water.

It is rare, but the first time you have herpes, it can cause the nerves to your bladder to become inflamed. If this happens, you will not be able to urinate. This is a temporary problem. You should see a health care provider for treatment.

How will I know if I have herpes?

If you have any sores, blisters, or red areas on your genitals your health care provider should examine you. He or she will swab the area to test for the virus. If you don't have any sores, a blood test can be done to see if you have ever been exposed to herpes.

Is there a cure?

No. Herpes is a chronic, lifelong infection. It will never go away. Even though there is no cure, antiviral medicines can help to:

  • Treat the symptoms,
  • Lower your chances of having an outbreak,
  • Lower the number of times you shed the virus without knowing it, and
  • Prevent you from having the symptoms again.

Medicines include:

  • Acyclovir (ay sye' kloe veer) which is also called Zovirax;
  • Famcyclovir (fam sye' kloe veer) also called Famvir, and
  • Valacyclovir (val ay sye' kloe veer) or Valtrex.

These work best if you take them at the first sign of burning or itching, before the sores appear. Another way to take them is to take a small amount each day. Acyclovir is given to newborns who are infected during birth.

What about my partner(s)?

Because herpes is a sexually transmitted disease (STD), your sex partners should be checked for symptoms. Many partners do not have symptoms that can be seen or felt. But, your partners still need to be checked for infection and other STDs.

Since herpes is a lifelong infection, it is important to talk openly and honestly with your partners. If you'd advice about how to talk to your partners, call one of the numbers at the end of this fact sheet.

When can I have sex again?

You should not have oral, vaginal or anal sex when you have sores. Also do not have any kind of sex if you think you might be getting an outbreak. Remember: you can pass the virus to your partners even when you do not have symptoms.

You should tell your current and future partners that you have herpes.

How can I prevent herpes?

Not having sex (abstinence) is the only sure way to avoid infection.

To lower your chances of giving or getting herpes, use latex or polyurethane condoms every time you have oral, vaginal or anal sex. Using these condoms the right way each time you have sex can reduce your risk of genital herpes.

Using condoms will not totally stop the risk of giving or getting herpes because this disease is spread through “skin-to-skin contact” from sores/ ulcers OR infected skin that may look normal.

Condoms also help prevent the spread of other STDs including HIV, the virus that causes AIDS.

If you are sexually active, you and your partners should get a full physical checkup. This includes a complete sexual history and testing for common STDs. You should be checked for gonorrhea, chlamydia, syphilis, herpes, genital warts, trichomoniasis, and HIV.

Will anyone know the results of the exams?

Your test results and any treatment will be kept absolutely confidential. No one can find out your results, except you. If you are under 18 you can be checked and treated for STDs without getting permission from your parents.

To learn more:

If you have more questions about herpes, or you want to know how to find a clinic near you, call your local health department or family planning program.

You may also call the STI Resource Hotline at: 1-919-361-8488. You can reach them Monday to Friday from 8am to 6pm (EST).

You can also find a testing center near you athttp://gettested.cdc.gov/.

Source: https://www.health.ny.gov/publications/3801/index.htm

Neonatal herpes simplex Symptoms & Causes

Herpes: your questions answered

At Children’s Hospital Boston, we understand that you may have a lot of questions when your child is diagnosed with neonatal herpes simplex.

•           What exactly is it?

•           What are potential complications in my child’s case?

•           What are the treatments?

•           Are there any possible side effects from treatment?

•           How will it affect my child long term?

We’ve tried to provide some answers to those questions here, and when you meet with our experts, we can explain your child’s condition and treatment options fully.

Background

According to the Centers for Disease Control and Prevention (CDC), about .03% of babies born in the United States contract neonatal herpes simplex, most of them as they pass through the birth canal—in rare circumstances, it is also possible for a baby to be infected in the uterus or immediately after birth.

  • Some studies indicate that delivery by Caesarean section, which avoids the birth canal, can reduce the risk of congenital herpes.  

Causes

The herpes simplex virus can be transmitted from a mother to her baby before, during or after birth.

  • If you have had a history of herpes infections, make sure to let your doctor know before you give birth.

Symptoms

Some signs that your baby may have herpes are:

  • irritability
  • blisters anywhere on her body
  • trouble breathing
    • grunting
    • blue appearance (cyanosis)
    • rapid breathing
    • short periods of no breathing
  • jaundice
  • bleeding easily

Herpes simplex infections can be divided into three categories:

  • localized skin infection— small, fluid-filled blisters on the skin and around the eyes and mouth that burst, crust over, and heal
  • encephalitis —an inflammation of the brain, which can cause problems with brain and spinal cord function, including seizures
  • disseminated herpes infection— the most dangerous type of herpes infection. The herpes virus is spread throughout your child’s body and can affect multiple organs, including the liver, brain, lungs, and kidney.

A baby infected with herpes may not have all the symptoms of the disease.

  • Most symptoms surface by the end of the baby's first week, while more severe central nervous system problems will not appear until the baby's second week.

If left untreated, encephalitis and disseminated herpes infections are potentially fatal.

Long-term outlook

Neonatal herpes simplex is a serious condition that can even be fatal if left untreated. If we begin treatment quickly, however, we can minimize the long-term effects on your child’s health.

For more information, see the Treatment and Care tab.

Questions to ask your doctor

Many parents are concerned about neonatal herpes simplex and can have lots of questions about the condition and how it can affect their baby.

You may find it helpful to jot down questions as they arise—that way, when you talk to your doctor, you can be sure that all of your concerns are addressed.

Here are some questions to get you started:

  • Should I get tested for herpes?
  • What can I do to prevent infection?
  • I have herpes. Is there any way to prevent passing it on to my baby?
  • What steps can we take if my baby does get infected?
  • What’s the long-term outlook for a baby with neonatal herpes?

FAQ

Q: What is herpes simplex?
A: Herpes simplex is a virus that can be passed from mother to baby, and potentially cause a serious infection in a newborn.

Q: How common is neonatal herpes simplex?
A: About 1 every 3,500 babies born in the United States contracts neonatal herpes simplex.

Q: Why is neonatal herpes simplexa problem?
A: Neonatal herpes simplex is a serious condition that requires immediate treatment. If left untreated, the virus can cause brain and spinal cord function, as well as cause harm to the liver, lungs and kidneys. For more information on potential problems, see Signs & Symptoms [LINK].

Q: Is there any way to prevent infection?
A: Most babies born to mothers infected with the herpes simplex virus are completely healthy. However, a baby is at greater risk for contracting herpes if the mother's first herpes infection occurs in the third trimester of pregnancy.

  • Some studies indicate that delivery by Caesarean section, which avoids the birth canal, can reduce the risk of congenital herpes.  

Q: How can I tell if my baby has neonatal herpes simplex?
A: Signs that your baby may have herpes are:

  • irritability
  • blisters anywhere on her body
  • trouble breathing
    • grunting
    • blue appearance (cyanosis)
    • rapid breathing
    • short periods of no breathing
  • jaundice
  • bleeding easily

However, some of these symptoms are also present with other conditions, so the best way to know for sure is to check with your child’s doctor.

Q: How is neonatal herpes simplex diagnosed?
A: Diagnosis is sometimes difficult because babies with neonatal herpes may not have the characteristic blisters of the disease. In addition, many symptoms of herpes resemble other diseases or disorders. However, the following tests can diagnose neonatal herpes:

  • Skin culture — taking a sample of the blister by scraping or removing a piece of tissue
  • Blood test
  • Swab culture — taking a sample with a cotton swab from the nose, throat or rectum
  • Urine test
  • CT scan or MRI scan of the head

If you or your doctor suspects that your baby may have neonatal herpes simplex, we typically test both the mother and the baby for the presence of the virus.

  • If you are pregnant and know that you have herpes simplex or know that you’ve recently been exposed to the virus, ask your doctor to perform a test.

Q: What are our treatment options?
A: Here at Children’s, physicians in our Fetal-Neonatal Neurology Program treat neonatal herpes simplex in infants.

  • We treat babies with neonatal herpes simplex with a course of intravenous antiviral medication over a period of several weeks.
    • The most commonly used treatments for neonatal herpes are called ganciclovir and valganciclovir.

Q: What is my child’s long-term outlook?
A:Neonatal herpes simplex is a serious condition that can even be fatal if left untreated. If we begin treatment quickly, however, we can minimize the long-term effects on your child’s health.

For more information, see the Treatment and Care tab.

Q: What makes Children’s different?
A: Our physicians are expert, compassionate and committed to focusing on the whole child, not just his condition—that’s one reason we’re frequently ranked as a top pediatric hospital in the United States.

And at Children’s, we consider you and your child integral parts of the care team and not simply recipients of care. You and your care team will work together to customize a plan of care for your child.

Fetal-Neonatal Neurology Program
Learn more about our program for babies with congenital neurological conditions.

Source: http://www.childrenshospital.org/conditions-and-treatments/conditions/n/neonatal-herpes-simplex/symptoms-and-causes

Living With Herpes | Common Questions and Answers

Herpes: your questions answered

Finding out you have herpes can be tough, but it’s not the end of the world. Millions of people living with herpes have great lives and relationships.

It’s normal to have lots of different feelings after you find out that you have herpes. You might feel mad, embarrassed, ashamed, or upset at first.

But you’ll probably feel a lot better as time goes by, and you see that having herpes doesn’t have to be a big deal. People with herpes have relationships and live totally normal lives.

There are treatments for herpes, and there’s a lot you can do to make sure you don’t give herpes to anyone you have sex with.

Millions and millions of people have herpes — you’re definitely not alone. Most people get at least one STD in their lifetime, and having herpes or another STD is nothing to feel ashamed of or embarrassed about.

 It doesn’t mean you’re “dirty” or a bad person — it means you’re a normal human who got a really common infection.

The reality is that herpes can happen to anybody who has ever been kissed on the lips or had sex — that’s a LOT of people.

Herpes isn’t deadly and it usually doesn’t cause any serious health problems. While herpes outbreaks can be annoying and painful, the first flare-up is usually the worst. For many people, outbreaks happen less over time and may eventually stop completely. Even though the virus hangs around in your body for life, it doesn’t mean you’ll be getting sores all the time.

The best thing to do when you find out you have herpes is follow your doctor’s directions for treating it. If you’re having a hard time dealing with the news, talking with a close friend or a support group for people living with herpes may make you feel better.

And tell anyone you have sex with that you have herpes. It’s not the easiest conversation, but it’s an important one. Here are some tips:

How do I talk with people about having herpes?

It might feel scary to admit you have herpes, but talking about things can really ease your mind. You could lean on a close, non-judgmental friend that you trust to keep the conversation private.

Parents, brothers and sisters, aunts and uncles, and other family members can also be a source of comfort. Remember, herpes is really common, so it’s possible the person you’re talking to has herpes, too.

There are a lot of online support groups for people who have herpes, and the American Sexual Health Association has a list of support groups that meet in person. 

What do I need to know about dating with herpes?

Some people feel their love lives are over when they find out they have herpes, but it’s just not true. People with herpes have romantic and sexual relationships with each other, or with partners who don’t have herpes.

Talking about STDs isn’t the most fun conversation you’ll ever have. But it’s super important to always tell partners if you have herpes, so you can help prevent it from spreading.

There’s no one way to talk about having an STD, but here are some tips that may help:

  1. Keep calm and carry on. Millions of people have herpes, and plenty of them are in relationships. For most couples, herpes isn’t a huge deal. Try to go into the conversation with a calm, positive attitude. Having herpes is simply a health issue — it doesn’t say anything about you as a person.

  2. Make it a two-way conversation. Remember that STDs are super common, so who knows? Your partner might have herpes too. So start by asking if they’ve ever been tested or had an STD before.

  3. Know your facts. There’s a lot of misinformation about herpes out there, so read up on the facts and be prepared to set the record straight. Let your partner know there are ways to treat herpes and avoid passing it on during sex.

  4. Think about timing. Pick a time when you won’t be distracted or interrupted, and a place that’s private and relaxed. If you’re nervous, you can talk it through with a friend first, or practice by talking to yourself. It sounds silly, but saying the words out loud can help you know what you want to say and feel more confident when you talk to your partner.

  5. Safety first. If you’re afraid that a partner might hurt you, telling them in person might not be safe. You’re probably better off with an e-mail, text, or phone call — or in extreme cases, not telling them at all. Call 1-800-799-SAFE or visit the National Domestic Violence Hotline website for help if you think you may be in danger.

So … when do you tell your new crush about your herpes status? You might not need to tell them the very first time you hang out, but you should let them know before you have sex. So when the relationship starts heading down that path and you feel you can trust the person, that’s probably a good time.

It’s normal to be worried about how your partner’s going to react. And there’s no way around it: Some people might freak out.

If that happens, try to stay calm and talk about all the ways there are to prevent spreading herpes.

You might just need to give your partner a little time and space to process the news, which is normal. And most people know that herpes is super common and not a big deal.

Try not to play the blame game when you talk to your partner. If one of you has a herpes outbreak for the first time during the relationship, it doesn’t automatically mean that somebody cheated.

Herpes symptoms can take days, weeks, months, or even years to show up after you get the infection. So it’s usually really hard to tell when and where someone got herpes. The most important thing is that you both get tested.

If it turns out only one of you has herpes, talk about how you can prevent passing it on.

Tell your past partners too, so they can get tested.

Will having herpes affect my pregnancy?

If you’ve had genital herpes for a while and you get pregnant, you probably don’t need to worry — it’s unly that you’ll give herpes to your baby during birth. But you should still let your doctor know you have genital herpes if you’re pregnant, no matter what.

If you get herpes while you’re pregnant, it’s a lot more dangerous — especially late in the pregnancy. It can cause a miscarriage or cause you to deliver too early.

If you give herpes to your baby during birth, it can cause brain damage or eye problems.

If you have herpes sores when you go into labor, your doctor might suggest that you to have a C-section so you don’t pass the virus to your baby during delivery.

If your partner has herpes and you don’t, don’t have unprotected vaginal, anal, or oral sex when you’re pregnant, since that’s the most common way to get herpes. The doctor might tell your partner to take herpes medication during your pregnancy so they’re less ly to pass on the virus. Check out “How to prevent herpes” to learn more about how to avoid getting herpes. 

Oral herpes isn’t dangerous during pregnancy or birth. But if you have a cold sore after you give birth, don’t kiss your baby until the sore is totally healed.

Source: https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/herpes/living-with-herpes

Genital Herpes – CDC Fact Sheet

Herpes: your questions answered

Genital herpes is an STD caused by two types of viruses. The viruses are called herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2).

What is oral herpes?

Oral herpes is usually caused by HSV-1 and can result in cold sores or fever blisters on or around the mouth. However, most people do not have any symptoms. Most people with oral herpes were infected during childhood or young adulthood from non-sexual contact with saliva.

Oral herpes caused by HSV-1 can be spread from the mouth to the genitals through oral sex. This is why some cases of genital herpes are caused by HSV-1.

How common is genital herpes?

Genital herpes is common in the United States. More than one every six people aged 14 to 49 years have genital herpes.

How is genital herpes spread?

You can get genital herpes by having vaginal, anal, or oral sex with someone who has the disease.

If you do not have herpes, you can get infected if you come into contact with the herpes virus in:

  • A herpes sore;
  • Saliva (if your partner has an oral herpes infection) or genital secretions (if your partner has a genital herpes infection);
  • Skin in the oral area if your partner has an oral herpes infection, or skin in the genital area if your partner has a genital herpes infection.

You can get herpes from a sex partner who does not have a visible sore or who may not know he or she is infected. It is also possible to get genital herpes if you receive oral sex from a sex partner who has oral herpes.

You will not get herpes from toilet seats, bedding, or swimming pools, or from touching objects around you such as silverware, soap, or towels. If you have additional questions about how herpes is spread, consider discussing your concerns with a healthcare provider.

How can I reduce my risk of getting genital herpes?

The only way to avoid STDs is to not have vaginal, anal, or oral sex.

If you are sexually active, you can do the following things to lower your chances of getting genital herpes:

  • Be in a long-term mutually monogamous relationship with a partner who is not infected with an STD (e.g., a partner who has been tested and has negative STD test results);
  • Using latex condoms the right way every time you have sex.

Be aware that not all herpes sores occur in areas that are covered by a latex condom. Also, herpes virus can be released (shed) from areas of the skin that do not have a visible herpes sore. For these reasons, condoms may not fully protect you from getting herpes.

If you are in a relationship with a person known to have genital herpes, you can lower your risk of getting genital herpes if:

  • Your partner takes an anti-herpes medication every day. This is something your partner should discuss with his or her doctor.
  • You avoid having vaginal, anal, or oral sex when your partner has herpes symptoms (i.e., when your partner is having an outbreak).

I’m pregnant. How could genital herpes affect my baby?

If you are pregnant and have genital herpes, it is very important for you to go to prenatal care visits. Tell your doctor if you have ever had symptoms of, or have been diagnosed with, genital herpes.

Also tell your doctor if you have ever been exposed to genital herpes.

There is some research that suggests that genital herpes infection may lead to miscarriage, or could make it more ly for you to deliver your baby too early.

Herpes infection can be passed from you to your unborn child before birth but is more commonly passed to your infant during delivery. This can lead to a potentially deadly infection in your baby (called neonatal herpes). It is important that you avoid getting herpes during pregnancy.

If you are pregnant and have genital herpes, you may be offered anti-herpes medicine towards the end of your pregnancy. This medicine may reduce your risk of having signs or symptoms of genital herpes at the time of delivery. At the time of delivery, your doctor should carefully examine you for herpes sores.

If you have herpes symptoms at delivery, a ‘C-section’ is usually performed.

How do I know if I have genital herpes?

Most people who have genital herpes have no symptoms, or have very mild symptoms. You may not notice mild symptoms or you may mistake them for another skin condition, such as a pimple or ingrown hair. Because of this, most people who have herpes do not know it.

Herpes sores usually appear as one or more blisters on or around the genitals, rectum or mouth. The blisters break and leave painful sores that may take a week or more to heal. These symptoms are sometimes called “having an outbreak.” The first time someone has an outbreak they may also have flu- symptoms such as fever, body aches, or swollen glands.

People who experience an initial outbreak of herpes can have repeated outbreaks, especially if they are infected with HSV-2. Repeat outbreaks are usually shorter and less severe than the first outbreak. Although the infection stays in the body for the rest of your life, the number of outbreaks may decrease over time.

You should be examined by your doctor if you notice any of these symptoms or if your partner has an STD or symptoms of an STD. STD symptoms can include an unusual sore, a smelly genital discharge, burning when urinating, or (for women) bleeding between periods.

How will my doctor know if I have herpes?

Your healthcare provider may diagnose genital herpes by simply looking at your symptoms. Providers can also take a sample from the sore(s) and test it. In certain situations, a blood test may be used to look for herpes antibodies. Have an honest and open talk with your health care provider and ask whether you should be tested for herpes or other STDs.

Please note: A herpes blood test can help determine if you have herpes infection. It cannot tell you who gave you the infection or how long you have been infected.

Can herpes be cured?

There is no cure for herpes. However, there are medicines that can prevent or shorten outbreaks. One of these anti-herpes medicines can be taken daily, and makes it less ly that you will pass the infection on to your sex partner(s).

What happens if I don’t get treated?

Genital herpes can cause painful genital sores and can be severe in people with suppressed immune systems.

If you touch your sores or the fluids from the sores, you may transfer herpes to another part of your body, such as your eyes. Do not touch the sores or fluids to avoid spreading herpes to another part of your body. If you do touch the sores or fluids, immediately wash your hands thoroughly to help avoid spreading your infection.

If you are pregnant, there can be problems for you and your developing fetus, or newborn baby. See “I’m pregnant. How could genital herpes affect my baby?” above for information about this.

Can I still have sex if I have herpes?

If you have herpes, you should talk to your sex partner(s) and let him or her know that you do and the risk involved. Using condoms may help lower this risk but it will not get rid of the risk completely. Having sores or other symptoms of herpes can increase your risk of spreading the disease. Even if you do not have any symptoms, you can still infect your sex partners.

You may have concerns about how genital herpes will impact your overall health, sex life, and relationships. It is best for you to talk to a health care provider about those concerns, but it also is important to recognize that while herpes is not curable, it can be managed with medication. Daily suppressive therapy (i.e.

, daily use of antiviral medication) for herpes can also lower your risk of spreading genital herpes to your sex partner. Be sure to discuss treatment options with your healthcare provider.

Since a genital herpes diagnosis may affect how you will feel about current or future sexual relationships, it is important to understand how to talk to sexual partners about STDsexternal icon.

Herpes infection can cause sores or breaks in the skin or lining of the mouth, vagina, and rectum. This provides a way for HIV to enter the body.

Even without visible sores, having genital herpes increases the number of CD4 cells (the cells that HIV targets for entry into the body) found in the lining of the genitals.

When a person has both HIV and genital herpes, the chances are higher that HIV will be spread to an HIV-uninfected sex partner during sexual contact with their partner’s mouth, vagina, or rectum.

Where can I get more information?

STD information and referrals to STD ClinicsCDC-INFO1-800-CDC-INFO (800-232-4636)TTY: 1-888-232-6348

In English, en Español

Source: https://www.cdc.gov/std/herpes/stdfact-herpes.htm

Answering Questions About Herpes in Pregnancy

Herpes: your questions answered

Herpes during pregnancy is a common concern. Because one in every five women is infected with the herpes virus, it is ly that herpes may be a topic that will be raised during a prenatal class, or afterward in private.

An expectant mother who has a history of herpes may have concerns about protecting her baby from this virus.

She may also have concerns about her own health, relationship issues including the support of her husband and family, or how to communicate with her health-care provider and make the best choices for a safe birth experience. Her childbirth educator can be a source of support and empowerment.

Keywords: herpes in pregnancy, neonatal herpes, herpes education, herpes and cesarean surgery

Recently, a mother in one of my childbirth classes asked me about herpes. She told me she had “heard” that herpes is very dangerous for newborn babies.

I told her that it was a medical question, so she should talk to her doctor about it. Now, I am reconsidering whether I gave her the best answer.

Is herpes a medical issue that I should send to the doctor, or should I have given the mother some information in addition?

One of a perinatal educator’s goals is to provide quality prenatal education. Being the one with the answers is not always easy. There can be times when you are asked a question or a statement is made for which you may not have an immediate answer. Sometimes, you will have to send a mother somewhere else for information or support.

However, in this case, your “second guessing” seems better than your first response. Herpes during pregnancy is a common concern.

According to the American College of Obstetricians and Gynecologists (ACOG), one in every five women is infected with the herpes virus (ACOG Committee on Practice Bulletins, 2007); thus, herpes is a topic that may ly be discussed during a prenatal class, or afterward in private.

Especially since the woman came to you with the question, I think that it is advisable for you to listen to her and to respond to her concerns on whatever level you can. You will not be making a medical diagnosis or prescribing a treatment a doctor does. The interaction with you may identify “nonmedical” issues, such as the reactions of family members.

For example, 30 years ago, a diagnosis of herpes carried a significant stigma for some people.

Could this be an issue with this woman’s mother? Or, is she concerned about telling the baby’s father? If the focus of the woman’s concern is a medical option, your interaction with her may help her to prepare for a more informed and meaningful discussion with her doctor.

The first question that you may need to answer is, “What is herpes?” Herpes simplex virus (HSV) is an incurable, recurrent viral infection that affects more than 45 million adolescents and young adults in the United States (ACOG Committee on Practice Bulletins, 2007).

With a portion of this population being women of childbearing age, the risk of transmitting HSV to the fetus during pregnancy or labor and birth is a major concern.

The highest risk of transmission is related to the mother acquiring HSV during pregnancy, especially during the last trimester.

To understand why the transmission of HSV is an issue for concern, one needs to have a knowledge of HSV transmission and infection. The spread of HSV is through person-to-person contact, with sexual contact being the main route of transmission.

Passage of the infection from one partner to another can happen without the persons being aware of their infectious state (Kriebs, 2008). Infection can occur through viral shedding or mild episodic outbreaks. Symptoms of an outbreak can range from mild to severe local irritation.

The characteristics of an outbreak may be tingling, burning, or pain prior to the appearance of vesicles that form ulcers that crust over, possible systemic malaise, or mild pubic irritation.

To assist with the diagnosis of HSV, doctors may collect cultures, which are most effective early in the outbreak (Kriebs, 2008). Other diagnostic methods include viral DNA by polymerase chain reaction and serology (Kriebs, 2008).

Classification of HSV is designated as type 1 (HSV-1) or type 2 (HSV-2). Typing of the virus is diagnosed by serologic assay (Kriebs, 2008). Either type of HSV may cause genital herpes (Perozzi, Zalice, Howard, & Skariot, 2007).

In the United States, HSV-2 is always the genital infection (ACOG Committee on Practice Bulletins, 2007). However, currently, up to 80% of new cases of herpes infection are being diagnosed as HSV-1 (ACOG Committee on Practice Bulletins, 2007).

This information helps the obstetrical provider and the woman choose the best course of action for her pregnancy.

Many women may still have questions. As a trusted source of information, the perinatal educator can be another avenue for answers. A class participant concerned about herpes might ask the perinatal educator for information prior to the start of a class or just after.

It is recommended that the educator be prepared to answer questions about herpes during pregnancy. It is also important for the perinatal educator to be nonjudgmental and to provide direct and accurate information.

When giving any information, the perinatal educator must always refer the woman back to her obstetrical provider.

It is recommended that the educator be prepared to answer questions about herpes during pregnancy.

An expectant mother who has a history of herpes may well have concerns about protecting her baby from the virus. To help the woman have a safe and healthy pregnancy, her health-care provider can review treatment options with her.

One option is to provide suppression therapy by using acyclovir (Zovirax) or valacyclovir (Valtrex) at 36 weeks’ gestation until birth (Majeroni & Ukkadam, 2007). Suppression therapy has been shown to be beneficial in decreasing viral shedding of HSV (Kriebs, 2008).

The treatment regimens of acyclovir are 400 mg by mouth twice daily or valacyclovir, 500 mg to 1,000 mg daily (Kriebs, 2008). The other way to prevent transmission of herpes to the infant is cesarean surgery, which the woman must discuss with her health-care provider.

Another important feature of HSV in pregnancy is the timing and the rate of perinatal transmission to the neonate. There is about a 1% risk of asymptomatic viral shedding that can lead to about a 4% risk of transmission (Ural, 2010).

The neonate at the highest risk is the one with the mother who has contracted herpes during pregnancy, rather than the mother who has a history of HSV (Corey & Wald, 2009).

Understanding these risks and providing screening for HSV can help reduce the rates of transmission during pregnancy.

After talking with her health-care provider, the woman may remain apprehensive about the possible need for cesarean surgery. For women who have active lesions during the time of birth, cesarean surgery is the current recommendation (Ural, 2010).

The perinatal educator can encourage the woman to discuss what her health-care provider has told her and can help identify the need for any further information about her option of cesarean surgery.

This approach can decrease the woman’s confusion and fear, help her prepare for the best possible experience under the circumstances, and support her right to informed consent.

For women who have active lesions during the time of birth, cesarean surgery is the current recommendation.

Researchers conducted a study to understand the importance of HSV serologic screening during pregnancy (Gardella et al., 2007). The results showed that obstetricians feel HSV serologic screening is important during pregnancy, yet many do not routinely provide screening during routine prenatal care.

Baker (2007) suggests the reason for not screening in pregnancy is related to the lack of recommendations from the Centers for Disease Control and Prevention or from ACOG.

Baker also supports the school of thought that all prenatal clients should have serologic testing for herpes to determine whether the client has or is susceptible to the disease.

When discussing herpes and pregnancy, it is important not to forget the effects of the virus on the neonate. The disease in neonates can be hard to diagnose. The symptoms may include fever, irritability, lethargy, or even a decreased desire to feed (Perozzi et al., 2007). The symptoms occur approximately 1 week after birth (Perozzi et al., 2007).

The infection can manifest in three ways in the neonate: skin, eye, or mouth lesions; affects on the central nervous system, which may or may not have skin involvement; and disseminated infection involving multiple sites (Perozzi et al., 2007).

Severe cases of herpes in the neonate can lead to lifelong complications; thus, prevention is the basis for decreasing the negative effects of herpes on the neonate.

Severe cases of herpes in the neonate can lead to lifelong complications; thus, prevention is the basis for decreasing the negative effects of herpes on the neonate.

Armed with the previous information, the perinatal instructor can approach the conversation about herpes with confidence.

By responding to concerns and providing information about herpes in pregnancy, the perinatal educator can help empower the expectant mother to make the best decision concerning her pregnancy and birth.

For the expectant mother, knowledge and empowerment can lead to a rewarding perinatal experience.

“Ask an Expert” answers are not official Lamaze International positions and are not intended to substitute for consulting with your own certified professional. Nayna Philipsen, coordinator of the “Ask an Expert” column, welcomes your questions or your own expertise on various topics for publication in a future column (e-mail her at ude.nippoc@nespilihpn).

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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3209744/

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