Possible indirect hsv transmission to baby

[booger14]

I have hsv-1 genitally which was confirmed via blood test and for the most part I am asymptomatic.  When I have outbreaks I can't tell because I don't have the typical presentation of herpes.  I do not get vesicular lesions.  I am terribly worried that I may have transmitted this to my infant son soon after birth.  He was born via c section.  At the time of suspected transmission, he was still partially healing from a circumcision (7 days out).  I used the bathroom, then I took the dog outside for a moment.  I heard him crying and in the hustle to get to him, I can't recall if I washed my hands after I used the bathroom.  I changed his diaper within 3-5 minutes of using the bathroom.  I used wet wipes and used a gauze pad and coated it with vaseline.  Within 4-5 days, I noticed what looked liked lesions on his glans penis.  I recently started using antibiotic ointment to help with healing and was wondering could this have caused some contact dermatitis.  When I discontinued the antibiotic ointment and switched back to vaseline, it began to clear up and heal.  I took him to the doctors for a well check and mentioned to them about the lesions.  They seemed to think that there was no way this could've happened, unless I had an active lesion on my hand (herpetic whitlow) with direct contact with him, which I don't have.  At that time, they didn't feel like it was necessary to do any blood testing or cultures because the irritation had passed.  Of course, they suggested if it happened again, to bring him in.  He has never run a fever, feeding very well and is growing and developing appropriately.  Typically, babies infected with HSV are lethargic, have a fever, have poor feeding, seizures, etc.  He has not exhibited any of these associated symptoms.  When the lesions were on his glans, he did not act like it was causing him any discomfort.  I was wondering if I did transmit, was his presentation so mild due to the fact he received passive immunity from me.  Often with it being a primary episode, it presents much worse.  Everything I have read indicates if a newborn is infected shortly after birth, they are often hospitalized and receive IV antivirals for 14 days.  I have read several places that the virus can't live longer than 10 seconds once it hits the air, then I have read other research that supports contradicting evidence.  I am very worried that I may have unintentionally transmitted it to him.  If this is the case, I will just die.  

[HowardH]

You are seriously overthinking this; your child's pediatrician is exactly right. You may never shed virus from your genital HSV1 infection. The typical course of genital HSV1 is few or no recurrent outbreaks and relatively little viral shedding. Forty percent of people with initial genital HSV1 never have a recurrence (at least not within the first 2-3 years), and genital HSV1 is rarely transmitted to partners even through unprotected sex. The chance the sort of indirect contacts you describe could infect your baby is very, very low.

As for the "lesions" near your baby's circumcision site, the doctor has already reassured you. If they continue or more lesions appear, of course immediately take him back to the doctor.

Also, the vast majority of newborn herpes due to HSV1, other than being born to a mom with an active genital infection at the time of delivery, is from oral herpes, not genital.

From here on out, just be careful about genital hygiene when caring for your baby -- i.e. hand wash or an alcohol gel like Purel after using the toilet and before changing diapers, putting your fingers near his face, etc. And if in doubt about any symptoms in the baby, of course return quickly to the doc. Otherwise just don't worry about this.

Best wishes for you and your growing family!

[booger14]

I know it's pretty unlikely this occurred, but I'm afraid it's still possible.  The fact his skin was still healing from his circumcision didn't help either :-(.