Herpes in Women: Risks, Testing, and Pregnancy Considerations - Obstetrics and Gynecology

Dr. Zhang Kunmin reply Obstetrics and Gynecology

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Hello, in response to your description: Although cutaneous herpes simplex is generally not a life-threatening disease, its high contagiousness and unpredictable recurrences can be a significant psychological burden for patients.
Herpes transmission occurs primarily through direct contact with lesions or secretions, such as kissing, parent-child transmission, sexual intercourse, and neonatal infection during delivery.
If a mother has oral herpes, she should avoid feeding her child food that has been chewed.
It has been observed that the virus can survive on surfaces for up to thirty minutes.
Typically, the primary infection has an incubation period of 2 to 2 days, with a duration of about 20 days, after which the virus enters the nerve ganglia and becomes latent.
Subsequently, 38% of individuals experience more than six recurrences within one year after the initial infection, with an average of four recurrences per year; those infected with type 2 are particularly prone to recurrence.
Recurrent oral herpes usually heals within ten to fourteen days.
During this period, in addition to avoiding contact with the lesions, one should also refrain from activities that could irritate the blisters, such as shaving, sucking fingers, or biting nails, as this may lead to new blisters appearing on other areas of the skin before the original lesions have healed.
Additionally, it is advisable to avoid kissing, sharing cups or utensils, towels, and lip balm.
Triggers for recurrence include trauma, sun exposure, menstruation, emotional stress, pressure, surgery, sleep deprivation, insomnia, and pregnancy.
Some optimistically believe that an outbreak indicates they are overworked, serving as a reminder to rest; however, current research shows that the virus can still be produced even in the absence of clinical symptoms, potentially leading to spread or transmission.
In fact, it is believed that most transmission occurs during periods when the skin appears normal and free of lesions (Brock's study indicates 80%), especially within the first year of initial infection, where the virus may be shed on 3% of days, and 70% of infections are transmitted by asymptomatic individuals.
Studies have also found that individuals infected with genital herpes type 2 have a 10% chance of transmitting the virus to another person within a year.
If an outbreak occurs within two weeks before delivery, some scholars recommend a cesarean section to prevent transmission to the child.
Statistically, the rate of transmission through the birth canal during the initial infection is 50%, while the infection rate for recurrent herpes is 1%.
For pregnant individuals with genital herpes who plan to deliver vaginally, acyclovir 400 mg three times a day can be used for prevention after 36 weeks of pregnancy.
Anyone with active herpes simplex should avoid caring for newborns, and if the partner of a postpartum individual has active herpes simplex, they should avoid sexual intercourse as the due date approaches or use condoms.
Thank you! Wishing you peace and health.
Dr.
Zhang

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Reply Date: 2016/04/29