Herpes simplex refers to a virally induced disease caused by two types of viruses, Herpes simplex virus 1 and 2 (HSV-1 and HSV-2).  The two viral subtypes belong to a much large family of related herpes viruses.  In general HSV-1 is transmitted orally where as HSV-2 is transmitted sexually.  In the oral form the disease manifestations appear as cold sores and blisters on the face and mouth.  In the genital form, lesions appear on the skin and elicit feelings of pain, burning, itchiness, classic inflammatory responses.  Learn more about the virus itself here: http://en.wikipedia.org/wiki/Herpes_simplex_virus

The virus infects nerve cells and slowly crawls along the nerves until the terminals where they take up residence and remain for life.  The Greek word “herpes” in fact means to creep along.  Over time, the virus proliferates during flare-ups but become less active as they age.  There is no cure of this disease, so dealing with recurrent infections is a much especially when there are exacerbating factors such as secondary illnesses and treatments that involve the immune system.  Our health experts advise people with frequent flare-ups to hook up with the right information such as the following resource to manage the disease: http://www.hsvoutbreak.com/living-with-herpes

When the virus has occupied a person’s cells, there are periods of “asymptomatic shedding” during which time the virus multiplies and is released in a form that lets it penetrate the skin to travel to the outside world.  This is troubling for certain people who are sick or are managing another condition.  For example pregnant women infected with either viral subtype deal with miscarriages, premature labor, slower fetal growth, and infection of the baby before delivery.

These grim effects are balanced against the relative rarity of transmission.  Even though 25% of women have HSV-1 or HSV-2, only a small number of those women birth a child who has the same virus.

The most worrying aspect of HSV-1 and HSV-2 for pregnant women perhaps is the possibility that the mother is being infected for the very first time late in the pregnancy process.  If the first infection occurs early, then the mother’s immune system has time to crank out antibodies to fight the infection.  The unborn baby will benefit from these antibodies that stay active for life.  If the first infection occurs late, say in the 3rd trimester, then the baby does not get these protective antibodies because the mother will be making it for the first time so not enough antibody is in the blood to protect the fetus immediately.

Expectant mothers who have HSV-1 and 2 infections should tell their doctor and come up with a plan that would minimize problems.  If the placenta is to be sampled, then enough to should be taken from one person that a viral test is also performed.  Active infection near the time of birth requires the mother to consider the possibility of a Caesarian birth.  This is one of the most active modes of trans-infection.

If these countermeasures don’t work it’s time to start thinking long term to deal with the disease in your children.  Viral infections in newborns are unpredictable and are associated with a constellation of symptoms including rashes, sores, and eye infections.  More worryingly, the virus knows no tissue bounds and invades critical systems such as the brain and nervous system.  Anti-viral medications while not perfect will help reduce the severity of infections.  Expectant mothers who are immunocompromised often suffer from coinfection with other viruses.

Expectant mothers might want to take extra precautions to not get infected by viruses during their three terms.  Infection by HSV-1 is the easiest from other people and occurs via exposure to saliva, liquid droplets in breath, and even skin contact.

(Photo Credits: Seattle Municipal Archives / Creative Commons)