Can You Swim with Someone Who Has Oral Herpes? Risks Explained - Obstetrics and Gynecology

Dr. Zhang Kunmin reply Obstetrics and Gynecology

---

Hello, the inquirer:
1.
Disease Description
Herpes simplex is a viral infectious disease caused by the herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2).
After infection, there may be localized primary lesions, and there is a possibility of recurrence after healing.
If the infection occurs in the genital area, it is referred to as "genital herpes."
(1) Herpes Simplex Virus Type 1 (HSV-1) primarily occurs in young children, with most primary infections being mild and asymptomatic.
Only about 10% of primary infections will have persistent fever and discomfort lasting more than a week, leading to varying degrees of symptoms, including vesicular lesions in the oropharynx, keratoconjunctivitis, widespread skin rashes, and meningitis.
If a newborn is infected, it can lead to fatal congenital herpes.
Approximately 2% of primary infections can cause acute pharyngitis and tonsillitis.
Recurrent infections typically present as clean vesicles on an erythematous base, usually occurring on the lips and face, healing with crusting within a few days.
Recurrent infections can be triggered by trauma, fever, physiological changes, or intermittent illnesses.
Individuals with compromised immune function may experience severe and disseminated recurrent infections.
Both primary and recurrent infections can affect the central nervous system.
HSV-1 often causes meningitis, presenting with fever, headache, leukocytosis, meningeal inflammation, drowsiness, altered consciousness, and coma.
These symptoms can be confused with other intracranial disorders (such as brain abscesses or tuberculous meningitis).
Since antiviral treatment can reduce mortality, brain tissue biopsy can be performed for early diagnosis of suspected cases.
(2) Herpes Simplex Virus Type 2 (HSV-2) typically causes genital herpes.
Genital herpes primarily occurs in adults and is transmitted through sexual contact.
This viral infection may be asymptomatic and recurrent.
In women, primary infections usually occur in the vulva and cervix, while recurrent infections typically occur in the vagina, perineum, legs, and buttocks.
In men, lesions usually appear on the glans or foreskin, and in men who have sex with men, lesions may also occur in the anus and rectum.
Other genital areas may also be affected depending on the sexual practices.
This type of virus can cause aseptic meningitis and radiculitis but does not lead to meningitis.
If a pregnant woman's vagina is infected with this virus, there is a high risk of transmission to the newborn, resulting in disseminated visceral infections, encephalitis, or even death.
HSV-2 is a risk factor for cervical cancer in women.
(3) Diagnosis
Diagnosis of herpes simplex can be made through specific cytological changes (multinucleated giant cells containing intranuclear inclusions from scraped tissue or biopsy) and antigen-antibody tests.
Confirmation requires direct fluorescent antibody (FA) testing or viral isolation from oral or genital lesions; in cases of encephalitis, confirmation can be made through brain biopsy.
Primary infections can be diagnosed using serological methods.
Differentiation between HSV-1 and HSV-2 is achieved through viral isolation.
2.
Infectious Agent
Herpes simplex virus type 1 and type 2 have immunological differences, and their growth patterns differ in tissue culture, chick embryo culture, and animal experiments.
3.
Epidemiology
Herpes simplex is a global disease, with approximately 70% to 90% of adults having HSV-1 antibodies.
Primary HSV-1 infections usually occur before the age of 5, but some cases of primary herpes infections in adults have also been reported.
HSV-2 infections typically occur after the onset of sexual activity, making it less common in children or adolescents.
About 20% of adults have HSV-2 antibodies, with higher prevalence rates (over 60%) in lower socioeconomic groups.
4.
Reservoir
Humans.
5.
Mode of Transmission
(1) Herpes Simplex Virus Type 1 is primarily transmitted through contact with the saliva of HSV-1 carriers; healthcare workers (such as dentists) who come into contact with the virus may develop herpetic whitlow.
(2) Herpes Simplex Virus Type 2 is primarily transmitted through sexual contact.
Both HSV-1 and HSV-2 can be transmitted through homosexual behavior, oral-genital, or oral-anal routes.
6.
Incubation Period
2 to 12 days.
7.
Period of Communicability
The infectious period for primary infections is 7 to 12 days, while for recurrent infections, it is 4 days to 1 week.
Women who are infected with the virus have a 50% chance of recurrence, regardless of symptoms, but recurrences may not always present with symptoms.
Asymptomatic individuals may still shed the virus in their secretions, making them contagious.
8.
Susceptibility and Resistance
Most individuals are susceptible.
9.
Control Measures
(1) Prevention Methods
1.
Health education and maintaining personal hygiene are the most direct methods of preventing infection.
2.
Patients with eczema should avoid contaminating the skin with infectious materials.
3.
Healthcare workers should wear gloves when coming into contact with suspicious lesions.
4.
To prevent neonatal infection, cesarean delivery should be performed if primary or recurrent genital herpes occurs during pregnancy.
5.
Using condoms during sexual intercourse can reduce the risk of herpes simplex infection.
6.
Although Acyclovir may reduce recurrences in immunocompromised patients, there is currently no effective antiviral preventive method.
(2) Management of Patients and Sexual Contacts
1.
Reporting: Currently, herpes simplex is not a reportable infectious disease in Taiwan.
2.
Isolation: Patients with herpes simplex should avoid spreading lesion secretions, especially from newborns, children with eczema or burns, and immunocompromised patients.
3.
Disinfection: Not necessary, but personal hygiene and cleanliness should be maintained.
4.
Quarantine: Not a routine quarantine item.
5.
Vaccine: None available at present.
6.
Follow-up, examination, and confirmation of infection sources for sexual contacts: Not of practical value.
7.
Treatment: Herpes simplex can be treated with acyclovir, which only alleviates pain and speeds up ulcer healing but does not cure the patient or prevent herpes transmission.
Therefore, treatment is not necessary unless the patient's symptoms are severe or threaten other organs.
(Information source: Department of Health)
Based on your situation, as long as appropriate preventive measures are taken, you should be able to avoid infection.
Wishing you peace and health!
Dr.
Zhang

---

Reply Date: 2011/02/16