Herpes Virus in Children

Herpes is a virus that can cause several types of infections. Herpes simplex 1 is extremely common and usually causes cold sores on or near the mouth. Herpes simplex 2 is also common and typically causes genital herpes. Herpes affects not only adults but also children. Most children contract herpes simplex 1 at some point and do not suffer any serious consequences. But in newborns, herpes can result in serious complications.

General Symptoms

• The most common symptoms of herpes infections are sores, blisters and ulcers on either the lips or genitals. Sometimes other body parts can be affected, particularly the eyes. Children experiencing a first bout with herpes often get gingivostomatitis, meaning ulcers inside the mouth. Sometimes a fever and generalized malaise, including flu-like symptoms, are present. In infants the disease can sometimes progress to severe systematic conditions. Herpes symptoms appear for a while and then disappear, at which time the virus retreats inside the body along nerve cells and lies dormant. It can reactivate intermittently to cause symptoms again. As there is no cure, herpes is considered a lifelong disease.

Gingivostomatitis

• By the time they reach adolescence, about 62 percent of Americans have contracted herpes simplex 1. It's quite common for babies to be infected when their parents or other relatives, well intentioned but in fact carrying the virus on their lips, kiss them. The first outbreak in children is usually a case of gingivostomatitis, which causes painful ulcers in the mouth along with a fever, irritable temperament and lack of appetite. Children with the condition may experience dehydration because mouth pain makes it difficult to drink anything. Though the condition is uncomfortable, it does not require medical treatment, and it typically clears up within five days. Sometimes--20 percent to 40 percent of the time--the infection recurs within a year. The second time around, the symptoms won't be as severe. The child will probably get typical cold sores on the lips, lasting less than 10 days.

Birth

• Some babies catch herpes during the birthing process with potentially serious consequences. This generally occurs when the mother, during the third trimester of pregnancy, experiences a primary episode of genital herpes, meaning she has just caught the virus. She may have lesions, or she may have an asymptomatic case where viral particles are, nonetheless, still shed. If it's known that a woman is experiencing a primary or secondary (recurrent) episode of genital herpes near the time of delivery, she should be treated with antiviral medication to reduce the risk of spreading the infection to her baby. Generally, if active sores are present in the genital area when it's time to deliver the baby, the doctor will perform a caesarean section.

Neonatal Herpes

• Neonatal herpes can present in several ways. Sometimes it affects only the skin, the eyes and the mouth. But other times it travels to the central nervous system, in which case it can cause encephalitis, an infection of the brain. It can also become disseminated to the liver, the lungs and other body parts. Signs of such systemic infection can include irritability, fever, seizures and lethargy. When encephalitis is present, about 15 percent of infants die, and when the disease is disseminated, about 57 percent die. To avoid such outcomes, treatment must be provided early: Typically, high doses of intravenous acyclovir for two to three weeks.

Avoiding Transmission

• Even after birth, infants are susceptible to severe herpes infections because their immune systems are not yet fully developed. Once children are six months old, they're better equipped to fight the virus. If you have herpes, either oral or genital, you can take steps to protect your newborn from the infection. Women who have cold sores on their lips should wear a surgical face mask until the lesions dry up and crust over. Don't kiss the baby while you have active herpes mouth sores. If you have genital herpes, protect your children by taking common-sense steps such as washing your hands after you touch a herpes lesion.