Given the recent news stories about the effects of herpes infections in newborns, I thought I’d help explain the significance of neonatal exposure and how it can affect a baby’s health. First, though, I’d like to review a little background information on the virus. Herpes refers to a group of viruses that can cause lesions (typically blister-like bumps) and pain. This lesions can affect the mouth, genitals, anus or skin in other regions. Other symptoms can include ulcer-like lesions, pain with urination (particularly if urine gets on one of the ulcers, fever, itching, enlarged lymph nodes or vaginal discharge.
There are 2 main types of herpes, herpes simplex 1 (HSV1) and herpes simplex 2 (HSV2). Typically, HSV1 affects the mouth and causes “fever blisters,” and HSV2 more commonly affects the genitalia. That being said, there can be genital outbreaks of HSV1 in some cases. More than 50% of Americans are infected with HSV1, and between 18-23% of people in the U.S. have been infected with HSV2. (Of note, none of these infections were transmitted via a toilet seat).
Primary outbreaks of herpes tend to be more painful than recurring outbreaks, although some people may not experience symptoms for months to years after exposure. Recurrent outbreaks are often more frequent at first, but gradually slow in both frequency and severity. Transmission typically occurs during skin-to-skin contact, such as with unprotected intercourse. Spread of the virus is most common either just before a blister is formed or once it is present; however, even an asymptomatic carrier may pass along the virus. Treatment of symptoms and outbreaks are possible, but once someone is a carrier of the virus, there isn’t a cure.
So, what’s that mean for my baby? Babies exposed to herpes viruses can develop meningitis, a severe neurologic illness that involves inflammation of the covering of the brain and spinal cord. Some symptoms can include fever, light sensitivity, neck pain, and headache, although babies may just show signs of drowsiness or poor feedings. Sometimes, these babies can have blister-like lesions. If spread throughout the bloodstream, the virus can cause kidney and liver failure or even death. Even for babies who have more mild infections, observation in the NICU and long courses of antiviral medications are often advised.
How do I avoid passing the virus to my baby? Be sure to let your ob/gyn know if you’ve ever had any painful genital lesions or been diagnosed with genital herpes. Suppressive (preventative) treatment may be indicated, especially for moms considering a vaginal delivery, and for those who have an outbreak (or pre-outbreak symptoms) at time of delivery, cesarean section is recommended. This is even more important for moms who are having a primary genital herpes outbreak as they are 30 times more likely to infect their baby during the labor process and pass along the virus to the baby in over half of cases. As for transmission of HSV1, avoid kissing or exposing your baby to your saliva/skin lesions if you have an active outbreak, ie fever blisters, or if you are having symptoms that are suggestive of an impending outbreak, especially during the first two months of life. Occasionally, these lesions can affect the breast, so be sure to notify your doctor if blister-like lesions develop on your breast.
That being said, don’t be afraid to love on your little girl or guy. Just be sure to use common sense and reasonable precautions to avoid transmission of herpes after delivery, and if you aren’t sure if something is safe, be sure to ask your doctor. We hope you all enjoy some good baby snuggles and get to have happy, healthy babies :)
Dr Nick
There are 2 main types of herpes, herpes simplex 1 (HSV1) and herpes simplex 2 (HSV2). Typically, HSV1 affects the mouth and causes “fever blisters,” and HSV2 more commonly affects the genitalia. That being said, there can be genital outbreaks of HSV1 in some cases. More than 50% of Americans are infected with HSV1, and between 18-23% of people in the U.S. have been infected with HSV2. (Of note, none of these infections were transmitted via a toilet seat).
Primary outbreaks of herpes tend to be more painful than recurring outbreaks, although some people may not experience symptoms for months to years after exposure. Recurrent outbreaks are often more frequent at first, but gradually slow in both frequency and severity. Transmission typically occurs during skin-to-skin contact, such as with unprotected intercourse. Spread of the virus is most common either just before a blister is formed or once it is present; however, even an asymptomatic carrier may pass along the virus. Treatment of symptoms and outbreaks are possible, but once someone is a carrier of the virus, there isn’t a cure.
So, what’s that mean for my baby? Babies exposed to herpes viruses can develop meningitis, a severe neurologic illness that involves inflammation of the covering of the brain and spinal cord. Some symptoms can include fever, light sensitivity, neck pain, and headache, although babies may just show signs of drowsiness or poor feedings. Sometimes, these babies can have blister-like lesions. If spread throughout the bloodstream, the virus can cause kidney and liver failure or even death. Even for babies who have more mild infections, observation in the NICU and long courses of antiviral medications are often advised.
How do I avoid passing the virus to my baby? Be sure to let your ob/gyn know if you’ve ever had any painful genital lesions or been diagnosed with genital herpes. Suppressive (preventative) treatment may be indicated, especially for moms considering a vaginal delivery, and for those who have an outbreak (or pre-outbreak symptoms) at time of delivery, cesarean section is recommended. This is even more important for moms who are having a primary genital herpes outbreak as they are 30 times more likely to infect their baby during the labor process and pass along the virus to the baby in over half of cases. As for transmission of HSV1, avoid kissing or exposing your baby to your saliva/skin lesions if you have an active outbreak, ie fever blisters, or if you are having symptoms that are suggestive of an impending outbreak, especially during the first two months of life. Occasionally, these lesions can affect the breast, so be sure to notify your doctor if blister-like lesions develop on your breast.
That being said, don’t be afraid to love on your little girl or guy. Just be sure to use common sense and reasonable precautions to avoid transmission of herpes after delivery, and if you aren’t sure if something is safe, be sure to ask your doctor. We hope you all enjoy some good baby snuggles and get to have happy, healthy babies :)
Dr Nick
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