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Signs herpes outbreak is coming

Cold sores -- also called fever blisters -- are a painful infection caused by the herpes simplex virus (HSV).
Although cold sores generally are not serious, the infection may be life-threatening for anyone who has AIDS or whose immune system is depressed by other disorders or medications. The infection from a cold sore may cause blindness if it spreads to the eye, and meningitis or encephalitis if it spreads to the brain. Cold sores are usually caused by the herpes simplex virus (HSV) type 1, which is transmitted by such forms of contact as kissing an infected person or sharing eating utensils, towels, or razors. Pregnant women who are infected with either herpes simplex virus 2 (HSV-2) or herpes simplex virus 1 (HSV-1) genital herpes have a higher risk for miscarriage, premature labor, retarded fetal growth, or transmission of the herpes infection to the infant while in the uterus or at the time of delivery.. During a first infection, the virus is shed for longer periods, and more viral particles are excreted. An infection that first occurs in the late term does not allow the mother to develop antibodies that would help her baby fight off the infection at the time of delivery. The risk for transmission also increases if infants with infected mothers are born prematurely, if there is invasive monitoring, or if instruments are required during vaginal delivery. Very rarely, the virus is transmitted across the placenta, a form of the infection known as congenital herpes. Infants may acquire congenital herpes from a mother with an active herpes infection at the time of birth. Unfortunately, only 5% of infected pregnant women have a history of symptoms, so in many cases herpes infection is not suspected, or symptoms are missed, at the time of delivery. Obtaining routine herpes cultures on all women during the prenatal period is not recommended. Performing chorionic vilus sampling, amniocentesis, and percutaneous fetal blood draws can safely be performed during pregnancy. If lesions in the genital area are present at the time of birth, Cesarean section is usually recommended. If lesions erupt shortly before the baby is due then samples must be taken and sent to the laboratory.
Some doctors recommend anti-viral medication for pregnant women who are infected with HSV-2. Herpes infection in a newborn can cause a range of symptoms, including skin rash, fevers, mouth sores, and eye infections. Herpes meningitis, an inflammation of the membranes that line the brain and spinal cord, occurs in up to 10% of cases of primary genital HSV-2. Iridocyclitis is another serious complication of ocular herpes, in which the iris and the area around it become inflamed. Herpes simplex is particularly devastating when it occurs in immunocompromised patients and, unfortunately, coinfection is common.


The majority of patients with HIV are co-infected with HSV-2 and are particularly vulnerable to its complications. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. These blisters are usually caused by HSV type 1, but can less commonly be due to HSV type 2. Possible ComplicationsThe severity of symptoms depends on where and how the virus enters the body. Although about 25 - 30% of pregnant women have genital herpes, less than 0.1% of babies are born with neonatal herpes. Transmission can occur if the amniotic membrane of an infected woman ruptures prematurely, or as the infant passes through an infected birth canal. Also rarely, newborns may contract herpes during the first weeks of life from being kissed by someone with a herpes cold sore.
Aggressive treatment with antiviral medication is required, but may not help systemic herpes.
If there is evidence of an active outbreak, doctors usually advise a Cesarean section to prevent the baby contacting the virus in the birth canal during delivery. Samples are cultured to detect the virus at 3 - 5-day intervals prior to delivery to determine whether viral shedding is occurring. Recent studies indicate that acyclovir (Zovirax) or valacyclovir (Valtrex) or famciclovir (Famvir)Valtrex can help reduce the recurrence of genital herpes and the need for Cesarean sections.
It is important to treat babies quickly, before the infection spreads to the brain and other organs. In most cases, ocular herpes causes inflammation and sores on the lids or outside of the cornea that go away in a few days. In children, this is often caused by thumbsucking or finger sucking while they have a cold sore.
A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions.
They may show up anywhere on your body, but are most likely to appear on the outside of your mouth and lips, your nose, cheeks, or fingers. A person with a cold sore who performs oral sex on another person can give that person genital lesions with HSV-1.
Except in very rare instances and in special circumstances, the disease is not life threatening, although it can be very debilitating and cause great emotional distress.
The baby is at greatest risk from an asymptomatic infection during a vaginal delivery in women who acquired the virus for the first time late in the pregnancy. This increased risk is present if the woman is having or has recently had an active herpes outbreak in the genital area.


If no lesions are present and cultures indicate no viral shedding, a vaginal delivery can be performed and the newborn is examined and cultured after delivery.
Women begin to take the drug on a daily basis beginning in the 36th week of pregnancy (last trimester). Neonatal herpes can spread to the brain and central nervous system causing encephalitis and meningitis and leading to mental retardation, cerebral palsy, and death. Scarring and corneal thinning develop, which may cause the eye's globe to rupture, resulting in blindness. It can also occur in adult health care workers, such as dentists, because of increased exposure to the herpes virus. HSV-2 infection increases HIV levels in the genital tract, which makes it easier for the HIV virus to be spread to sexual partners.
Blisters form, then break and ooze; a yellow crust or a scab develops and eventually sloughs off, revealing new skin underneath. After the first infection, many people develop antibodies and never have another cold sore. Similarly, a person who performs oral sex on another person with genital HSV-2 lesions can develop oral lesions. The virus may be triggered by certain foods, stress, fever, colds, allergies, sunburn, and menstruation. Fortunately, rapid diagnostic tests and treatment with acyclovir have both significantly improved survival rates and reduced complication rates.
Fortunately, herpes meningitis usually resolves without complications, lasting for up to a week, although recurrences have been reported. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Recurring herpes and a first infection that is acquired early in the pregnancy pose a much lower risk to the infant. For those who recover, nearly all suffer some impairment, ranging from very mild neurological changes to paralysis. The best chances for a favorable outcome occur in patients who are treated with acyclovir within 2 days of becoming ill.
Any duplication or distribution of the information contained herein is strictly prohibited.



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