HSV and pregnancy

Giovanni Maga maga at vetbio.unizh.ch
Fri Feb 16 04:52:18 EST 1996


In article <mcoon-1502960953010001 at pesto.microbiol.washington.edu>,
mcoon at u.washington.edu (upyers) wrote:


> Ms Maga goes on to suggest some reasonable considerations and Janice
> whould be wise to consult with her doctor.
> 


I do not want to be misunderstood here. I think that Janice shouldn't be
worried about any transmission of HSV1 to the baby during gestation. I
also strongly recommend NOT to take oral ACV (as well as ANY other
systemic drug) during pregnancy unless absolutely required and always
under strict medical control. I thought this should have been clear from
the fact that HSV infection can occurr only with direct contact of the
virus with the baby. Very unlikey to happen with a supraorbital infection.
I was pointing out that the major risk for a baby to acquire HSV infection
is virus contact during delivery. This in case ACTIVE GENITAL lesions are
present at the time of delivery. Moreover, neonatal HSV infections  are
almost invariably due to primary outbreaks in the mother, wherease the
risk from a recurrency is much lower (due to acquired antibodies from the
mother). BTW, almost 70% of people worlwide are infected by HSV1. This
happens ofetn during the infancy, most of the times asymptomatically. I
also said that, since Janice is at her 3nd month of gestation, topic
treatment with ACV will control the infection enough to allow it to
completely recede well before the time of delivery. I was simply putting
the point on a common sense base: since I am not Janice's physician (I'M
NOT a physician at all), I cannot simply say do not worry. I just said
what are the facts, hoping to convince her she IS NOT at risk now, but
always recommending not self- (or internet-based) diagnosis but to ask her
gynecologist for advice, maybe asking precise questions by knowing a bit
more about the problem.
As for the literature,I got my informations from textbooks and from the
following articles (that cannot be considered exhaustive of course, just
to say they weren't my personal opinions). As you we'll see, most of the
ref. are from 1992, the year when I was getting interested in neonatal
herpetic infections for professional reasons. Now I'm not following the
topic anymore, so forgive me if I'm missing recent developements.

Pediatric Annals 23 (3) 131-136 (1994)
J. Am. Acad. Derm. 27 (5) 817-821 (1992)
Arch. Dis. Child. 67 (10) 1137-1138 (1992)
NEJM 327 (11) 782-789 (1992)
NEJM 327 (9) 647-648
NEJM 327 (14) 916-920 and 946-947 (1992)

G.Maga, PhD
Institute of Veterinary Biochemistry
University of Zurich-Irchel (CH)



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