Question:
Thanks for the info on my previous questions. I'm especially glad to know that the baby won't be isolated. I had read that on line. Anyway, I still have some questions. First, why is a primay infection so much worse? I do understand about the antibodies. But why is it worse if the baby is premature and why is there a greater risk of the baby being premature? By what I described previously, does this sound like a recurrent infection to you?

I also have another baby - are there any precautions besides washing my hands that I need to take to not pass this to him or anyone else in my family? Im starting to freak out over bathing, towels, bathroom, etc. I've never had any cold soars so I'm assuming this is type 2. Assuming that, does that mean I can ONLY give it to others through sexual contact?

I meet with My OB again tomorrow to ask all of my questions. I do know that plan to give me suppresant meds once I'm 36 weeks along. I just really want to find out if this is primary or not.

Thanks to all. So glad I found this site.

Answer:
Primary infections are more dangerous for several reasons. First of all, as you mentioned, is the concern about antibodies. It takes time for your body to develop sufficient antibodies and pass them onto the baby. In recurrent infections, the antibodies are already established in your body and are generally considered to be passed to the baby by 28wks or so. Babies born to mothers with primary infections (especially within 8wks of delivery) frequently have not had opportunity to acquire sufficient antibodies.

The risk is also increased because of the nature of the primary outbreak. During a primary infection, the shedding involves more of the virus and the shedding occurs for longer durations than during a recurrent outbreak. The increased presence of the virus and the increased duration increase the chance that the baby will be exposed.

There seems to be a correlation between herpes infections in mothers and premature delivery and/or IUGR (intrauterine growth restriction). There aren't enough studies on it yet to have good info on it yet though, so I wouldn't be concerned about it right now. The reason I mentioned prematurity is that IF this is a primary infection, delivery within about 8 wks will increase the risk of transmission. The majority of babies who are infected are born to mothers who contracted herpes within approximately 8 wks of delivery. If I remember correctly, the actual statistic is 70-80% are born to moms with primary outbreaks within that time frame. Typically, docs are most concerned when the primary infection occurs during the third trimester, but IF you were to deliver prematurely (I delivered at 34wks) then a primary infection at say 27wks for example would still increase the risk of transmission to a baby born at 35wks. Does that make sense?

You could have oral herpes and not have cold sores. You could also have genital hsv-1. I don't remember how you were tested, was it a culture? A culture can tell you which type of herpes you have. There are also type specific blood tests, I believe the HerpeSelect is one of them. The standard IgM is not, though. If you only have genital herpes, then yes, you will only expose others through sexual contact. Of course, you should wash your hands and practice good hygiene, but you don't need to do anything special. Just continue with good hygiene like you normally would (assuming you normally do ;) ). It's a good idea to avoid sharing towels, there's some evidence that the dampness of a towel could allow the virus to survive slightly longer outside the body. But you don't need to worry about bathing or toilet seats or anything like that. Also, don't share your personal items, like razors. But that is also just a matter of good safe personal hygiene.

Let me know if I missed a question! And try to remember, that neonatal herpes is very uncommon. Many, many moms with herpes deliver beautifully healthy children and have great vaginal deliveries. I think you are absolutely doing the right thing by getting as much info as you can, but don't let it concern you too much. It's hard for me personally to forget that part, since I have two boys who contracted it. But it really is uncommon and if your infection IS recurrent, then the odds are really great that you baby will be perfect!