HSV1 in child, many questions

[tampamom35]

My 5 year old daughter was diagnosed with HSV at the end of August. She had just started school on Monday and that Friday she came home from school with a fever. On Wednesday of that week her left eye was a little red and irritated, but the next day it seemed fine. On Friday, when she had a fever, it was red again and irritated. By Sunday of that weekend, her eye was very red and she had some little tiny "bumps" that started developing around the eye. I took her to the pediatrician and they diagnosed her with pink eye and put her on eye drops and an antibiotic. On Tuesday, her eye wasn't looking any better and was actually looking worse, and more bumps were present. She had little lesions around her eyelid and her eye would be matted shut when she woke up. I took her back to the pediatrician and the doctor took one look at her and said "its herpes, take her to an eye doctor now." I got her in to my eye doctor within a couple hours and they confirmed that it was herpes (the pedi did a culture and it came back positive for herpes) and put her on a different eyedrop and acyclovir. I initially wasn't very freaked out at the diagnosis, but I was very perplexed as to where she picked the virus up and after some thinking, started getting pretty upset about it. She's 5 years old and has to deal with this the rest of her life???? Its just not fair.

So now, 4 months later, she's had a 2nd outbreak, though much less severe than the initial outbreak, and is again taking the acyclovir. My questions are these:

- how can she spread the virus?
- can she end up with genital herpes if she touches an open lesion on her face and then her genitals?
- if she takes a bath with her sibling during an outbreak but has no open lesions, can she spread the virus to the sibling? what about a swimming pool?
- do i need to keep her home from school during an outbreak?
- is there any possibility she'll "outgrow" the virus?

I've done some online research and found some helpful info, but nothing that answers these questions.

Thank you!!

[gracefromHHP]

In a household, everyone should have their own towel, washcloth, toothbrush, razor and body puff - common germs are easily transmitted through sharing those so each family member needs their own.   Is herpes likely to be transmitted through sharing them? No, but many other germs are easily transmitted through doing so so never a good idea not to do so.


Shedding is when the virus is active and can be transmitted to others. It happens when there are obvious lesions present as well as periodically in between.

Her pediatrician should be fine as long as the eye doctor did a full exam to make sure it's just an external herpes infection and doesn't involve her actual eye.

[waterwater]

hi tampamom
im not grace obviously, just another concerned mommy :) i have genital hsv1 and when i went to the doctor with my initial outbreak she offered me a repeat prescription for the anti viral medicine so that as soon as i felt tingling or like i was going to get an outbreak, i could go straight to the pharmacy and get the medicine instead of having to wait to see a doctor again. i just thought this might be something you could ask your doctor about for your daughter? so that you can get on to it straight away. sorry to hear that you and your daughter are going through this :(

[tampamom35]

And shedding - what is this? What do I need to know about it?

[tampamom35]

Just thought of a couple more questions.

What about sharing towels when she has an ob? Is this a way to transmit the virus to siblings?

During this ob, her lesions haven't been open at all, ever. They went from little tiny blisters to being scabbed over, or at least appearing that way. When no liquid/discharge is present, is it possible to spread the virus?

Should she begin being treated by an epidemiologist or a disease specialist, or is the pediatrician sufficient? I feel like the pedi may not be the best source for information and they don't really even want to touch her when we've been in with this virus. They don't run screaming from her like she's a leper, but they comment on how contagious it is and I need to stop her from touching that area.

And lastly, ever since she had the initial ob, her left eye (the one that had the virus initially) has been watery. I waited over 3 months to see if it would improve any, but it didn't. I took her back to the eye doctor and they said that it could be a clogged tear duct or that that eye may just be watery from now on. They gave me some eyedrops and told me to buy an OTC eye drop once the ones they gave me were gone to help with a clogged tear duct, if in fact that was the problem. They couldn't see that it was clogged, but couldn't be positive that it wasn't. The drops seemed to have been helping then I got a little lax with them, and thats about the time this 2nd ob happened. It could be a complete coincidence, but I'm thinking maybe the repeated rubbing/wiping of the eye brought this on. I'm going to be more vigilant with the eye drops from now on.

[gracefromHHP]

recurrences will heal faster than the original ob did. The body builds up antibodies to help fight the virus better with recurrences.   recurrences will be about the same as this one for the  most part.

daily suppressive therapy will help her have less recurrences if it turns out she is having them every few months. Better to prevent recurrences than try to deal with them when they happen if you find she is having them every few months.

[tampamom35]

Thanks, Grace. I was wondering about being on the antiviral all the time, if its really necessary or makes much difference. I've noticed that it seems like its going away quicker this time. I noticed the area under her left eye (which was where the initial outbreak was) was red and irritated this past Wednesday. I asked my husband what she did and he said he thought she scratched it at the park. I asked my daughter what happened and she said she had a bite there. On Thursday it was more red and irritated, but she wasn't complaining about it. Friday morning I looked at it and saw little tiny blisters and RAN to the pedi just knowing it was a flare up, which they confirmed and she started taking the acyclovir that day. Like I said in my previous post, its much less severe than the initial outbreak. Will subsequent outbreaks be less severe or will they just vary?

[gracefromHHP]

Most children get hsv1 from their caretakers - parents , other family members or childcare providers. they can also get it from playmates too.  You might never figure out when and from whom she contracted hsv1 from.   Typically it is only oral - 1 out of every 3 children her age on average has hsv1 orally - it's THAT common in small children.  Typically herpes around the eye is from oral herpes moving up the facial nerves to the eye area but in that age group, it sometimes is just from infection at that area specifically ( think how they still tend to touch everything, put things in their mouths as well as rub their eyes frequently).  

will she outgrow herpes? No she will not. she will always have it. Will she continue to get recurrences for a lifetime? only time will tell.

she can go swimming and bathe with her siblings. transmission is only an issue from kissing and touching actual lesions from her.  

she doesn't have to stay home during recurrences. you should discuss with her pediatrician having acyclovir on hand to start at the very start of the signs of a recurrence. the sooner it is started, the better it works.  If you find she is having recurrences every few months, discuss going on daily suppressive therapy to prevent recurrences.  

once you have herpes on one body part, you aren't likely to transmit it to other body parts. No real reason to think she'd touch her eyes and then touch her genitals and spread the virus elsewhere.

teach her that when her eye infection is present, she needs to be careful to not touch her eyes.  Remind her that if she does, hand sanitizer or hand washing is a good idea.  

grace