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Type I Herpes - Neonatal Concerns from Previous Post
Dear Dr. Handsfield, a number of years ago I posted a thread on type 1 herpes….it is listed below: www.medhelp.org/posts/STDs/Predisposed-to-genital...1/.../1131932, I was surprised to find it but it does give you more information on my history. It may also come up in the search “predisposed”….since my old account is not active.

My wife is now pregnant and I have become concerned given my history posted on this previous thread. Both my wife and I have been blood tested for Hsv and we both show positive for type 1 and negative for type 2….this is not unusual since we both had cold sores before we met and believe we acquired them in our youth (as my post described in my symptoms). My concern is my unusual type 1 outbreak I had on my knee later life, and that I mentioned in my post, (which has never returned and this has been now over 16 years ago). I am myself am concerned about the birth since I am worried that since I have this on my knee and mouth and will give my wife type 1 herpes genitally, even though I have not seen this in my genital region. As you suggested in the post I am not wrestling with her to spread this infection. However, her pregnancy has even created greater concern and anxiety on my part; since I have read about neonatal herpes. Given the history from my previous post, and tests results indicated, should we take any further precautions in our pregnancy or take further testing that might have not existed since I talked with you via the post those few years ago. Thank you so much for your help and understanding. Perhaps as a new father I am worried too much, but I certainly trust your expertise and insight.
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239123 tn?1267651214
Welcome back to the forum.

Neonatal herpes -- transmission of HSV to a newborn -- occurs primarily when the mother acquires genital herpes near term, i.e. during the last few weeks of pregnancy.  It is very rarely acquired when the mother (or father or both) has a longstanding HSV infection, even if genital.  That your genital HSV-1 included an atypical non-genital outbreak of the leg does not indicate increased risk to the baby.

Anytime a pregnant woman has a history of genital herpes (of if her husband/partner does), it should be discussed with the obstetrician so that she can be on the lookout for outbreaks at the time labor begins.  However, if a outbreak does not occur at that time, the risk to the baby is minimal, usually zero.  And if there is an outbreak, a cesarian section may be done so the child doesn't pass through an infected birth canal.  (Sometimes anti-HSV treatment, such as acyclovir, is prescribed during the last month of pregnancy, to reduce the chance of an outbreak at the time of delivery.)

Bottom line:  Your wife needs to tell her Ob about your and her HSV-1 history and blood test results.  From then on you can rely on the Ob's expertise to be sure there is no risk to the baby.  But even without these precautions, the actual risk to the baby is extremely low.

I hope this has helped.  Best wishes--  HHH, MD
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Thank you doctor...both my wife and myself have never had any outbreaks in our genital region....do I now need to prepare her for this possibility?Since I myself had a previous infection orally with HSV 1 prior to my outbreak on my knee cap a few years later (again you said this was quite rare) but it was aquired in my youth, and you named it herpes gladatorium since I wrestled in school....this was listed from my previous post. My concern was that I did not want to spread this to our child, or my wife from accidentally touching him with my mouth or knee. This is why I joked about wrestling with my wife and I hope to be able to do with my future child. Perhap this does not change your answer but as a concerned future parent I wanted to know my risks of passing herpes to my child or my wife since I have had herpes in different places on my body. Does this change any of your response. I really do appreciate all your help and information.
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239123 tn?1267651214
I should have emphasized that since your outbreaks are oral, there is even less chance of transmission to your baby.  In fact, whatever small risk there might be probably will come after the baby is born:  during her first month of life, it will be important for both you and your wife to be on the alert for an oral herpes outbreak, in which case you will avoid kissing her until it heals.

All things considered, there is virtually no risk to the baby.  For confirmation of this perspective, discuss it with your wife's Ob durnig her prenatal care, and with the baby's pediatrician after she is born.  But do your best not to worry.  Look at it this way:  half of all babies are born into households in which one or both parents have oral HSV-1.  Yet how many babies have you ever heard of who had neonatal herpes.  It's a very rare problem!

That will end this thread.  Best wishes for an uneventful pregnancy and healthy baby.
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239123 tn?1267651214
University of Washington
Seattle, WA