Herpes Simplex Virus Type 2

Herpes simplex type 2 (HSV-2) is a cause of a common viral infection of the genital area also known as genital herpes. HSV-2 is passed on through sexual contact and, although the infection can cause small blisters, the infection can potentially be passed on where the skin appears normal.

Most people with HSV-2 do not have symptoms from the infection or only very mild symptoms. The first time the blisters appear, the woman can also feel unwell with fever, aching muscles and/or headache. The blisters last about 2 to 4 weeks and then heal but then they can appear again. The first time the symptoms are normally more severe and then the following episodes are generally milder. HSV-2 can be diagnosed by sending a swab of the blister for testing.  There are also blood tests which can detect HSV-2.

The virus can be transmitted from a pregnant woman to her baby during pregnancy or during delivery. If a pregnant woman has her first episode of HSV-2 during the last trimester of pregnancy then the chances of passing on the infection to her unborn baby are over 30%, whereas if the episode is not the first one then there is a 3% chance of passing the infection on.

A pregnant woman with genital herpes can also pass on the infection to her unborn baby during vaginal delivery if she has an outbreak around the time of labour.

When HSV-2 is passed on to the unborn baby during pregnancy or during labour and delivery, the baby may suffer from the following medical conditions:

• Premature birth;
• Blindness;
• Deafness;
• Recurrent skin lesions, scarring and changes to the pigmentation of the skin;
• Brain injury.

The key to reducing the risks associated with transmission of HSV-2 to the baby is in clear communication. It is important that the pregnant woman share details of her medical history and any signs and symptoms of HSV-2. It is also important that the health care provider informs the pregnant woman of the risks of HSV-2 transmission to her baby and appropriate treatment to reduce the risks.

All pregnant women should be asked if they have had HSV-2.

If a pregnant woman has not had HSV-2, her physician should discuss with her practices to avoid acquiring HSV-2 during pregnancy. A pregnant woman who has not had HSV-2 but has a partner with HSV-2 should be advised to avoid infection by either using condoms or from abstaining from sex and should be offered a blood test to check for HSV-2 and to be checked again at between 32 and 34 weeks of pregnancy.

If a pregnant woman has had an episode or episodes of HSV-2 before her pregnancy, then she can be offered antiviral medication late in pregnancy.

At the time labour begins, or when planning for delivery, a pregnant woman with a history of HSV-2 should be asked about any current symptoms. If any blisters are present or the woman has the warning signs of a new episode, then a caesarean delivery is recommended as this reduces the chance that the infection will be passed on to the baby at the time of delivery. There are other precautions that should be taken during delivery as well, including avoiding taking a blood sample from the baby’s scalp or performing an instrumental delivery.

After birth, the baby should be monitored closely for any signs of infection and should have their nose, eye and mouth swabbed to test for HSV-2. If a baby tests positive then they should be treated with antivirals even if they appear well and are feeding normally. Where a pregnant woman has had her first episode of HSV-2 during pregnancy, has symptoms at the time of delivery and whose membranes have ruptured before delivery, then her baby should be started on antiviral treatment after birth.

If your baby developed HSV-2 infection in the first days or weeks of life and has a brain injury and you have concerns over how your pregnancy, labour or your care was managed, then please contact us – we would like to help. We have a team of experienced lawyers and medical specialists who can review the medical care you received and help answer your questions. We will provide you with the information and advice you need to make informed decisions about your child’s future and ensure your child’s rights are protected. Rest assured – the consultation is confidential and free of charge.