INTRODUCTION
The incidence of herpes, a sexually transmitted disease, varies across the world. Among pregnant women with herpes, nearly 75% can expect at least one flare‐up during their pregnancy. Transmission of the virus from mother to baby typically occurs by direct contact with the virus during birth. It is often recommended that a cesarean should be offered to women with active lesions to reduce the risk of transmission to the baby. In addition, several antiviral agents are available for use both for therapy and for preventing a flare‐up. These antiviral drugs include acyclovir, penciclovir, valacyclovir, and famciclovir. The review assessed whether antiviral drugs given to pregnant women with herpes before a recurrence might be effective in reducing transmission to the baby. Seven studies were identified involving 1249 women. Giving antiviral drugs reduces viral shedding and recurrences at labor and birth. They also reduced the use of cesarean, but there is no evidence of reduction in neonatal herpes. Women should also be informed that the risk of the baby getting herpes during birth is low.
FACTS TO KNOW ABOUT GENITAL HERPES
1. Most people with genital herpes do not know it.
About 16% of people aged 14-49 in the U.S. are infected with the herpes simplex virus-2 (HSV-2) that causes genital herpes, but as many as 81% of them had not received the diagnosis.
2. Genital herpes is very common, infecting at least 45 million people aged 12 and older in the United States.
3. About one in five women between the ages of 14 and 49 have genital herpes caused by HSV-2, while about one in nine men in that same age range are infected.
4. Genital herpes is caused by a virus, so antibiotics will not help resolve the infection. There is no cure for herpes, but treatment is available to reduce and prevent outbreaks and decrease the risk of transmission to a partner.
5. As with other sexually transmitted diseases, herpes can be spread by close contact or sexual activity. It is highly unlikely to be spread by a toilet seat or other objects.
6. Genital herpes can be transmitted even if the infected partner has no symptoms or visible signs or doesn’t know he or she is infected.
7. Washing the genital area doesn’t help prevent any sexually transmitted disease (STD), including genital herpes. The best way to prevent any STD is to abstain from sex or engage in sex only with someone you know is not infected. Condoms are not guaranteed to prevent infection, but research has shown that they provide some protection.
The estimated number of pregnant women infected with HSV-2 is 880,000. Most transmission to newborns occurs during vaginal delivery. If a woman had genital herpes before getting pregnant, her baby may be infected but the chance is very low -- less than 1%. However, the risk of infecting the baby is much higher (25% to 50%) when a woman is newly infected late in pregnancy.
8. If you are pregnant and think you may be infected, tell your doctor right away. Women with genital herpes are examined carefully for any symptoms before giving birth. If sores or signs that an outbreak is coming are present at the time of delivery, the baby may be delivered by cesarean section (C-section).
9. To find out if you have genital herpes, a doctor can take a sample from a sore and test it in the laboratory. There is also a blood test that looks for antibodies to the virus that your immune system would have made. HSV-2 almost always infects the genitals, so if antibodies to HSV-2 are detected in your blood, you probably have genital herpes.
A blood test that shows antibodies to HSV-1 means you could have genital or oral herpes. That's because oral herpes, typically caused by HSV-1, can be spread to the genitals during oral sex.
10. When a person is first infected with the herpes virus, if symptoms occur they usually develop within the first two weeks of virus transmission. Symptoms can include fever and flu-like symptoms, genital itching, burning and discomfort, vaginal discharge, swollen lymph nodes, and a feeling of abdominal pressure.
11. The classic symptom of genital herpes is small fluid-filled blisters that break, forming painful sores that crust and heal. These may appear four to seven days after the initial virus transmission.
12. Genital herpes typically causes several outbreaks (four or five) within a year of the first outbreak, with fewer and less severe outbreaks over time.
13. Some commonly reported triggers for genital herpes outbreaks include stress, illness, surgery, vigorous sex, diet, and menstrual periods.
14. Once inside the body, HSV-2 travels to the nerve roots near the spinal cord and settles there permanently.
15. About half the people who have recurrent outbreaks of genital herpes feel an outbreak coming a few hours to a couple of days before it happens. They may feel tingling, burning, itching, numbness, tenderness, or pain where the blisters are going to appear. This is called the prodrome.
