Genital Herpes : The Emotional Impact, Herpes and Newborns

by Food and Drug Administration (FDA)

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The first time Phinney told someone, it didn't go well. He hadn't had the virus long and he was very distraught. "I transferred some of my anxiety about herpes to that person," he says. After learning more about herpes and accepting his condition, Phinney was more at ease with telling. "I don't think the words or the setting are very important. I think the single most important thing was being well-educated and comfortable with my own condition."

When Phinney told Karen, now his wife, he still faced several fears — "The fear of infecting someone else and also facing the possibility that someone I was interested in and wanted to be in a long-term monogamous relationship with would reject me."

But Karen was very accepting and willing to put things in perspective, says Phinney. "She came with me to support group meetings. She told us [the group] that she had decided that I was the person she wanted to spend the rest of her life with and although she didn't want to get herpes ... it wasn't something that was an insurmountable block to establishing a relationship."

Phinney was on suppressive antiviral therapy when he met Karen and he continues to stay on it. He has not had an outbreak in over a year. In the couple's six years together, there is no evidence that Karen has been infected. "We're operating on the presumption that by keeping my outbreaks in check, we're reducing the probability of my infecting her."

Phinney's presumption is the subject of ongoing studies. Researchers have found that daily doses of antiviral herpes drugs reduce asymptomatic shedding, but whether this suppressive therapy can help prevent transmission is not yet known.

Another area of long-time study is a herpes vaccine. No vaccine has been shown to be effective in human studies, but researchers continue to work toward that end.

In the meantime, learning about the disease and talking openly with a partner can help people with herpes take control of their lives. "Once they understand it and recognize it, control is a lot easier," says Ashley. "Over time, it becomes a nuisance rather than a mind-altering and life-changing event."

Herpes and Newborns

A mother with genital herpes can easily deliver a healthy baby. And most can have a normal vaginal delivery. Less than 0.1 percent of infants born in the United States each year get infected with genital herpes during birth, according to the American Social Health Association.

A mother who was infected with herpes prior to getting pregnant passes herpes antibodies on to her fetus, protecting it from becoming infected with the virus. After birth, as the baby develops its own immune system, it loses these antibodies.

The danger period is late in pregnancy. The greatest chance of delivering a baby infected with herpes occurs in women who first become infected with genital herpes in the last trimester, says Zane Brown, M.D., professor of obstetrics at the University of Washington in Seattle. "The mother doesn't have time to build up antibodies."

For newborns infected with herpes, the consequences are devastating. "More than 40 percent die or have severe brain damage," says Brown.

Brown recommends a cesarean section if the primary infection is in the latter half of the pregnancy, or if the mother with long-standing genital herpes has any symptoms of genital herpes at the time of labor. He also recommends that all expectant mothers get a type-specific blood test for herpes in the first trimester of pregnancy. If negative for both HSV-1 and HSV-2, her partner should be tested. If the partner has herpes, sexual contact that could put the mother at risk of acquiring genital herpes should be avoided in the last trimester of pregnancy.

For several months after birth, infants are at risk for getting herpes. People with oral herpes (cold sores) should avoid kissing the baby. Wearing a mask over the cold sore when around the baby is recommended.

If a baby is infected with herpes, early treatment is critical. The FDA has approved the drug acyclovir in injectable form to treat infants with herpes.

Herpes Blood Tests

The standard testing procedure for herpes is to obtain a viral culture of a sore within the first 48 hours after symptoms appear. Beyond 48 hours, there is a risk of the culture yielding a "false negative" result because the sore may have begun healing and there may not be live virus present. Blood tests can be used to confirm a negative viral culture result or to help determine herpes infection in a person with no visible symptoms.

About the Author

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