Herpes Simplex Virus and Pregnancy
What is Herpes and How is It Spread?
Herpes Simplex Virus (HSV) is similar in nature to the viruses that cause chickenpox and shingles. Following the initial infection the HSV can hide within nerve cells where the body's immune system can't reach them. When the right conditions are present, the virus attacks. There are two main types of HSV, Type 1, which is associated with cold sores around the mouth and lips, and Type 2, which is associated with genital sores. However, either type can infect the genitals or mouth and lips, or pregnant women with genital sores caused by either form of HSV can pass the infection on to their babies.
Herpes infections are spread by direct contact with an infected person. Sexual intercourse or oral-to-genital contact can spread the disease. An infected person can spread it on themselves by touching the infected area and then touching themselves with unwashed hands. Children often get herpes virus from infected people who kiss them or touch them after touching their infected areas without washing their hands.
The Symptoms of Herpes
The symptoms of herpes, when they do appear, are small clusters of blisters that appear in the genital area (or mouth). They itch and become painful. Eventually they break and leave painful sores. Fever, fatigue, aches and pains and urethral or vaginal discharge often occurs. Doctors diagnose herpes by examining the sores or by doing a swab of the blisters and ordering a viral culture. The first attack (primary) lasts from seven to ten days, but can last as long as four weeks if the blisters become infected. The average infected person experiences four or five recurrences a year. Most herpes outbreaks do not produce symptoms. They are silent infections that generally go undiagnosed. However, individuals with symptomless infections can pass the virus on to others, including a newborn baby.
Herpes and the Pregnant Woman
About 45 million Americans have genital herpes and don't know it and according to the Centers for Disease Control and Prevention, up to one million new cases occur each year, including about 1,000 in newborn babies. About one in four women who are pregnant have been infected with genital herpes; although most of them are not aware they are infected.
Even though most women with genital herpes have healthy babies, some women do pass the virus on to their babies during labor and delivery. That is why it is especially important for pregnant women to recognize the symptoms of this disease and seek immediate treatment if they think they are infected. Women should also tell their health care provider of any previous infections they may have had so the provider can take precautions to protect the new baby.
Chances of Passing it On to Baby
Women who acquire a primary infection near the time of their delivery are between 30 and 50 percent likely to pass the virus on to their babies during a vaginal delivery, symptoms or not. A newly infected woman has had less time for her body to produce antibodies to fight the disease, so the risk is higher to the baby. If a woman has had herpes before her pregnancy and has a flare-up or silent infection at the time of vaginal delivery has about a 3 percent chance of infecting her baby. There are times when what seems to be a new infection is really a flare-up of an old, silent infection. In these cases the risk of spreading the infection is low. However, a blood test will reveal if the infection is new or not.
Most babies get herpes from their mothers at delivery, or, sometimes the baby can become infected before birth - but this is very rare.