I have a question

Hi
I have been having some pain in my right leg and a slight burning feeling in top of my right foot.  I have done a lot of research on the internet about std's and it is quite alarming all that is out there.  One of the symptoms of genital herpes is this could this be that?  I am also currently six weeks pregnant and am scared to death.  I have never had the presence of any sores or abnormal discharge.  How long could herpes realistically take to show symptoms?

[H. Hunter Handsfield, M.D.]

Such symptoms don't suggest STD nor, to my knowledge, anything that would be dangerous for your pregnancy.  Herpes can cause "neuropathic" symptoms (burning, tingling, etc) but not so distant from the genitals and I'm sure that's not what's going on.  Of course, you should tell your obstetrician about your symptoms at your next visit.

Congratulations on your pregnancy!  Best wishes--  HHH, MD

[mamabear28]

thankyou for responding to me so quickly.  I still would like to know what the realistic incubation is for genital herpes.  I have some concern my husband and I have just reunited within the last two months and I had a relationship with someone during the time which we were split.  I have no reason to think that this person has given me anything I am just really scared for me and the baby.  Way to much info on the internet if you know what I mean.  Also the other question I have is I just found out that one of children who I care for ( I have a in home day care ) dad has genital herpes while charging the little boys diaper today I noticed a line of irritated sores, it wasn't there on Tuesday ( I did not have him yesterday ) they weren't blistered or anything like that I was wondering could the father have given the little boy the virus by touch if he touched himself prior?  What is the likely hood of that?  They would look like a blister wouldn't they?  It didn't resemble any of the pictures on the internet.

[H. Hunter Handsfield, M.D.]

The quick response is accidental, as is this one; I think you and I just happened to be online at the same time!

First, your baby is safe.  Herpes can be a problem in pregnancy, but almost all risk to the baby comes when herpes is first acquired toward the end of pregnancy--i.e., after the 6th month or so.  Second, you're not going to get herpes from diapering an infected child, even if that baby has the infection (which I agree is extremely unlikely).  It is possible to catch herpes by handling lesions, but then your infection would be on your hand or fingers, or perhaps transferred to your eyes--not to your genital area.

Finally, given your sexual history--and also given the possibility (which you don't mention but might be logical) that your husband had other partners when you were separated--consider asking your obstetrician to do a herpes blood test.  Even though your risk is low, it sounds to me you are likely to keep worrying about it until you know for certain you are not infected.  And if your test happens to be positive (which could be an infection acquired years ago, not necessarily recently), your obstetrician can be on extra alert for symptoms as you approach term, so that if necessary extra steps can be taken to protect the baby.

If you get a herpes test, be sure it is the right kind.  The ONLY generally available test that is accurate for this purpose is the Focus Technologies HerpeSelect HSV-2 test.  Make sure your doctor orders that test; if the lab s/he normally uses doesn't do that test, insist it be sent to a lab that does.  (Alternatively, you could have a Western Blot test for HSV-2, but it is much more expensive and not so widely available.)  If your obstetrics provider doesn't know what this is all about, ask him/her to read up on it!  (The HerpeSelect test is fairly new, and many labs and health care providers still aren't up to speed on the facts of herpes testing.)

Good luck--  HHH, MD