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HSV2 symptoms in children
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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HSV2 symptoms in children

Hello Doctors.  I have HSV 2 and 1.  Not sure of locations.  Have had it for a few years.  I have two toddlers who I worry for greatly.  I have read that HSV2 genital is not really passable via household contact.  However this medical journal:
http://www.medscape.com/viewarticle/527730_5
states that up to 25% of HSV2 carriers may also have an oral infection, and that HSV2 transmission to kids can happen indirectly, perhaps being more common with oral infections.

I ask because one of my toddlers recently had a single large lesion on their lip, which may have been hsv 2.  I am deeply concerned.  (There is NO sexual abuse in our family)

1.  Is there any new info on HSV 2 oral transmission and how common it is in the population?
2.  If HSV 2 lesions are suspected in children, is PCR the only option?  A blood test would calm my nerves.
3.  Is kissing toddlers and newborns a bad idea when you have HSV2?
4.  I am certain you have run into parents who have concerned with this issue before. Is it really something that is so unlikely that we shouldn't worry?
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Welcome to our Forum. the estimate you quote is far higher than most experts would find reasonable. further, HSV is not spread through casual contact.  Statistically your HSV-1 is most likely to be an oral infection but there is a slight chance that it could be genital.  The likelihood that your HSV-2 is oral however is very, very low.  I would not worry about transmitting HSV-2 to your child.

In response to you specific questions:
1.  No, not that I am aware of.
2.  PCR or culture are the only definitive means for diagnosis of HSV.  PCR is more sensitive than culture.  
3.  No, no meaningful risk for HSV-2 transmission from kissing
4.  I would urge you not to worry.  

Take care. EWH
3 Comments
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I appreciate your reassurance, however when it is your kids in a situation like this it is hard to shrug off.  Do you have children Doctor?

1. Is there a realistic statistic of the amount of HSV2+ who have oral infection?
2. If my pediatrician and I go ahead with a blood test for my child, would there be potential for an unreliable false positive due to my child's young age?
3.  I noticed Dr. Handsfield recently answered a post about a man who may have infected his child and wife.  Has this issue been studied closely?
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Not that your question is any relevant but yes, I have children.

1.  No, oral HSV-2 is not common enough for there to be good statistics, particularly in children.
2.  I do not know that testing your child with the blood test for HSV-2 would be more likely to give a false postive result than other use of the test in ways that are not recommended (i.e. I would estimate that chances of a positive result in your child being falsely positve being at least 50% and probably higher). Further, what good would such a test do you or your child, not matter what the result?  None I suspect.  On the other hand, should there be a false positvive result (more likely than finding that your child has HSV-2) that would be harmful.
3.  I did not read that interchange and cannot comment.  This is not an area of close study as it is too rare to be able to study in meanigful ways.

The tone of your questions suggests that you are overly fearful about this.  Testing and worrying about it is not the way to go.  If you cannot put the sorts of fears that you voice here aside, I suggest you talk this through with a counselor or someone able to help you work through it.  EWH
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H. Hunter Handsfield, M.D.Blank
University of Washington
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Edward W Hook, MDBlank
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