Testing And Treatment For Herpes
The only way to know if you have herpes for sure is to get tested, which you can do in your doctor’s office, or a clinic like Planned Parenthood. Make sure you ask your healthcare provider to specifically screen for herpes if you’re getting tested for STIs. If you have a sore or blister, the doctor will take a sample of fluid and evaluate it. There is also a blood test for herpes. Talk to a health care provider about your testing options to figure out whats right for you.
Herpes is a virus, so it can’t be cured. But it can be managed with medicine, which can prevent future outbreaks and the chance that you could give it to someone else. Your doctor can also prescribe medicine to help ease your symptoms when you’re having an outbreak.
Genital Herpes Treatment During Pregnancy
Women taking antiviral drugs for herpes — either daily suppressive therapy or occasional therapy for outbreaks — should consult their doctor about whether to take the drugs during pregnancy. The answer is not set in stone: You and your doctor have to discuss the risks and benefits to decide what’s right for you.
For pregnant women with a history of genital herpes, the doctor might recommend daily doses of an antiviral medication during the month before their due date.
Herpes infection in a newborn is also serious. Do not allow anyone with a cold sore on the mouth to kiss the baby. If you have a cold sore, don’t kiss the baby, and wash hands with soap and water before touching the baby.
Wouldnt Testing Everyone Stop The Spread Of Genital Herpes
We dont know. There is no evidence that diagnosing genital herpes with a blood test in someone without symptoms would change their sexual behavior and stop the virus from spreading. In addition, without knowing the benefits of testing, the risk of shaming and stigmatizing people outweighs the potential benefits. For these reasons, testing everyone for herpes is not recommended at this time.
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What About Mental Health
We also know that due to the stigma, learning that you are positive for herpes can impact your mental health. Research shows that people diagnosed with herpes are more likely to become depressed, withdraw socially, and experience reduced self-esteem. The shame associated with contracting herpes can make a big impact on a persons quality of life. This is despite the fact that its a common virus that affects people of all walks of life, all social circles, and all socioeconomic classes. It not only affects people who have casual sex partners but also people who limit their sexual behavior to monogamous relationships. It can even affect people who have only had one partner.
I can almost guarantee you know multiple people who have genital herpes even if no one has ever told you. Also, many cases of genital herpes occur as a result of oral sex from someone who has a history of cold sores .
How Can I Make Sure I Dont Get Genital Herpes
If you test negative for genital herpes, the following steps can help protect you from getting a herpes infection during pregnancy:
- If your partner has genital herpes, abstain from sex during any active herpes outbreak. Between outbreaks, use a condom from start to finish every time you have sexual contact, even if your partner has no symptoms. Consider abstaining from sex during the last trimester.
- If you dont know whether your partner has genital HSV, you may wish to ask your partner to be tested. If your partner has genital or oral HSV, there is a very real chance that you may acquire it unless you take steps to prevent transmission.
- Do not let your partner perform oral sex on you if your partner has an active cold sore . This can give you genital herpes.
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Blood Type And Rh Status And Antibody Screen
Blood tests will check your blood type, your Rh status, and an antibody screen. Your blood type needs to be checked so that a potential mix-up of bloods can be averted if there is a need for a transfusion.
Rh-negative women need to be identified in advance so that they can be considered as candidates for RhoGAM, an immunoglobulin that is given at 28 weeks of pregnancy and within 72 hours of delivery in order for the mother to keep from becoming Rh sensitized. Occasionally, RhoGAM is also given when there is a potential risk for fetal blood to mix with the mother’s blood, such as in a car accident or in amniocentesis.
Why it’s important : Giving this medication prevents the mother’s body from mounting an antibody response against an Rh positive baby in future pregnancies. An antibody screen detects antibodies, both Rh and less common types, that may occur in the fetus or newborn.
Why it’s important : Antibodies have the potential for causing blood disease in the fetus and newborn.
Natural History Of Genital Herpes
But how can genital herpes during pregnancy go undetected? Genital herpes is caused by two types of HSV, type 1 and type 2 . HSV-1 presents with cold sores around the mouth and lips, while HSV-2 causes genital sores and is the most common cause of what we call genital herpes. The time between transmission of the virus to a new host and the onset of symptoms is between 2 to 14 days. However, most infections with HSV-2 occur with some mild tingling or itching in the genital area or without the presentation of any symptoms at all, resulting in many being unaware that they have contracted the illness. To make matters worse, the disease lives on indefinitely in the body, regardless of whether a person received any treatment for it. This means that the distinctive symptoms of red sores may arise at any time when your immune system is weakened, be through illness or stress. Be aware though that while this may sound frightening, many already live with virus in their body, such as people who have suffered from chicken pox.
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How Common Is Herpes
1 in 6 people in the U.S. aged 1449 years have genital herpes.
Herpes spreads through oral, anal, and vaginal sex. People can reduce the risk of transmitting herpes to another person by using condoms or dental dams during sex and avoiding having sex when they are experiencing an outbreak of herpes.
How Common Herpes Really Is
Enough people have herpes to make it a totally commonplace infection, even though we may not treat it as one.
Nearly 48 percent of people aged 14 to 49 in the United States were estimated to have HSV-1 between 2015 and 2016, according to the most recent data from the CDC. This high prevalence makes sense because many people actually get the virus from nonsexual contact as children, the CDC explains. This can happen when a parent greets a child with a kiss on the mouth or while a kid is playing with other little ones, since children arent exactly known for their respect of personal space. Remember: HSV-1 often presents as cold sores, but its possible that some people with HSV-1 actually have genital herpes.
So, about genital herpes. You may have heard that one in six people has this infection. Thats a little bit of an outdated figure, Christine Johnston, M.D., an associate professor and herpes researcher at the University of Washington School of Medicine, tells SELF. That number is related to national survey data released by the CDC in 2010 and based on the years 2005 through 2008. This nationally representative research, published in the CDCs 2010 National Health and Nutrition Examination Survey , tested peoples blood samples for antibodies of HSV-1 and HSV-2, estimating that 16.2 percent of Americans aged 14 to 49 had HSV-2 between the years 2005 and 2008. Thats around one in six.
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Herpes Simplex Virus Infections
The herpes simplex virus causes a variety of infections, characterized by dormant periods with no symptoms and sporadic outbreaks of red, itchy, painful blisters. Generally, there are two types of herpes: genital herpes and oral herpes . However, herpes lesions from both types can be found anywhere on the body, including on the skin, mouth, eyes, and genitals.
Type 1 infections are most often found on the mouth, while type 2 infections tend to occur in the genital area.
Do They Test For Herpes Simplex 2 During Pregnancy
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After The Baby Is Born
The possibility of acquiring neonatal herpes after birth is a risk for every baby. When such infections do occur, the cause is almost always HSV-1, which spreads from an adult who has an oral infection . In many cases, the adult is a family member who has no idea that the minor irritation of the cold sore can be dangerous to an infant with an immature immune system.
To help protect your baby, educate family members about the danger of cold sores. Don’t kiss your baby when you have an active sore, and also ask friends and relatives not to do so. In addition, if you have an outbreak of genital herpes, be sure to wash your hands before touching the baby. No extreme precautions are necessary. There is no risk in holding the baby, breast feeding, or having the baby in bed with you.
If the baby’s mother has genital herpes, it is worth keeping a close eye on the baby for several weeks after birth, just to make sure no infection develops. Symptoms usually start in the first 14 days of life and may develop any time in the first month.
Make sure you tell your pediatrician specifically if either parent has a history of genital herpes. “OBs don’t always talk to pediatricians,” notes Stanberry. Don’t assume something you’ve told your obstetrician gets conveyed to your pediatrician.
American Social Health Association, 1996
How Is Herpes Treated In Pregnancy
Its not clear whether all antiviral medications for genital herpes are safe during pregnancy, so follow your doctors lead when it comes to treatment.
Herpes symptoms may be managed with antivirals and during an outbreak, and they may reduce the length and severity of it. Daily medication, which is called suppressive therapy, can also reduce the number of outbreaks you experience.
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Herpes Treatment During Pregnancy
If you are experiencing symptoms that could be associated with herpes, discuss those symptoms with your doctor. In general, treatment is recommended for symptomatic herpes infections. However, people without symptoms generally are not treated during early pregnancy.
Near the time of delivery, obstetricians recommend using suppressive therapy to reduce the risk of a late-term outbreak. This daily treatment is generally started at 36 weeks of gestation and continued through delivery. Preventing an outbreak may also reduce the risk of needing a C-section instead of being able to deliver vaginally.
Can Herpes Be Transmitted To An Infant During Pregnancy Or Delivery
When babies contract herpes, its known as neonatal herpes. Also called birth-acquired herpes, neonatal herpes can happen if your baby is exposed to genital herpes during vaginal delivery.
Neonatal herpes is considered rare, but when it does happen, there can be serious complications, such as permanent injury to the babys nervous system, developmental disabilities, and death.
The risk to your baby is greatest if you acquire HSV for the first time during the third trimester of pregnancy. Thats because the levels of the HSV in your system will be highest during that time, and youll have fewer protective antibodies to pass on to the baby prior to delivery.
If you contract a genital herpes infection during the third trimester, the risk of passing the virus to your baby during delivery is
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What Are Possible Complications Of Herpes
Theres some research that a genital herpes infection may lead to miscarriage or result in the preterm delivery of your baby, which is why its important to discuss any symptoms you have with your physician so your case can be managed carefully.
If you have recurrent herpes , youre at an extremely low risk less than 1 percent of transmitting herpes to your unborn baby.
Same goes if a routine screening for sexually transmitted diseases at your first prenatal visit diagnoses HSV for the first time, or if youre infected during the first trimester of your pregnancy and are asymptomatic.
Only women who are infected for the first time in late pregnancy have a greater risk of infecting their unborn babies, because their bodies have not yet produced HSV antibodies. In the rare case that a newborn gets herpes, transmission most often occurs when the baby passes through the mothers infected birth canal.
To prevent this from happening, your health care provider may prescribe medication in your third trimester to decrease the chances of a herpes outbreak around the time you give birth. And if you have active sores or youre expecting a breakout near your due date, you might be advised to have a cesarean section to minimize the risk of infection.
How Can I Get Tested For Genital Herpes
If you have symptoms, the best test is a viral culture. To perform this test, your health care provider must take a sample from a herpes outbreak while it is active, preferably on the first day. Test results are available in about a week.
If you dont have symptoms, a blood test can tell you whether you carry HSV-2, the type of herpes that usually infects the genital tract. A blood test may also tell you whether you have HSV-1, but in many cases this simply means you have oral herpes.
Ask your doctor about these tests as they differ regionally and some tests are not accurate. Also the doctor needs to be aware how to interpret the test in light of the clinical presentation.
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How Can You Manage Herpes In Pregnancy
Fortunately, herpes is rarely transmitted to a baby during pregnancy since most newborns with HSV get it when they pass through an infected birth canal. If the amniotic sac breaks before birth, very rarely the fluid in an infected birth canal can infect a baby who has not yet passed through it.
But because this infection can cause severe problems for your baby, including skin lesions, eye disease and brain damage, he will be treated with antiviral medications in the unlikely event hes exposed to herpes during birth. This treatment is given intravenously and he may need to stay on it for several weeks.
When you go into labor, your doctor should carefully examine you for herpetic lesions. If you arent experiencing sores or symptoms at delivery time, a vaginal birth may be possible.
If, however, you have sores or early symptoms of a herpes outbreak , a cesarean delivery may be recommended to reduce the chance the baby will come in contact with the virus.
If You Get A Positive Result Don’t Panic It Really Doesn’t Mean Much
All of this is to say that unless you have symptoms consistent with the herpes virus, why put yourself through the emotional turmoil of getting a blood test that may or may not give you legit results? As Hutcherson notes, if you do get a blood test and it comes back positive but you’re asymptomatic, what does that mean for you if you have nothing to treat? For many, due to the high rate of stigma still surrounding herpes, it can mean feelings of self-contempt, humiliation, and distress, all of which could be avoided if you aren’t experiencing any symptoms.
To recap, while there are some tests for herpes that can prove correct, none are 100 percent perfect, and blood tests are particularly problematic since they can produce false positives and negatives. We also know that the majority of the population has some form of herpes, so IMO it’s a mystery as to why we’re still making a big deal out of it. No one likes blisters or sores, but neither does anyone love having acne, a widespread condition without the same level of attached shame.
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Congenital And Neonatal Infection
Itis necessary to distinguish between congenital infection and neonatal infection with HSV. In fact, HSV infection of the newborn can be acquired during pregnancy, intrapartum and postnatally. The mother is the most common source of infection for the first two routes of viral transmission. Congenital infection is very rare due to the acquisition of the virus in utero it comes to the neonatal HSV infection when the appearances of the lesions are more than 48 hours after birth .
Intrauterine HSV infection accounts for 5% of HSV infections in neonates. The highest risk of intrauterine infection has been observed in pregnant who develop disseminated HSV infections and 90% of those are related to HSV-2. Both primary and recurrent maternal infection can result in congenital disease, even if the risk after recurrent infection is small.
Intrauterine viral transmission is highest during the first 20weeks of gestation leading to abortion, stillbirth, and congenital anomalies. The perinatal mortality is 50% .
In 8590% of neonatal HSV infections, HSV is acquired at the time of delivery and 510% are caused by early postnatal viral acquisition. A percentage of 7085% of neonatal HSV infections are caused by HSV-2, whereas the remaining cases are due to HSV-1. The HSV-2 infection carries a graver prognosis than that caused by HSV-1 .
The disease transmission to the newborn is dependent on the type of maternal genital infection at the time of delivery.
