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    Herpes prevention in everyday life   Herpes Simplex Virus typically spreads by skin to skin contact and it is unlikely to be transmitted without it, however the possiblity can't be ruled out and if you have a reason to believe you are at risk, it's better to be safe than sorry. Herpes can also be transmitted via secretions or saliva that come into contact with an active outbreak, but not for very long. There have been very few claims of being exposed to Herpes without contact, none of which have been scientifically proven. However, here we'll cover some general precautions you can take to avoid transmission of HSV in your everyday life.   It's important to remember that the Herpes virus is fragile and cannot live for very long outside of the body, and while there are studies that show it can be detected up to 7 days on certain inaminate objects, it's ability to infect degrade very quickly (usually within a few minutes) and the chance of becoming infected is low without skin to skin contact with an infected person. [2]    You can’t get herpes from a toilet seat or furniture, or from sharing a bed or hugging someone with herpes. Unless there is an active outbreak and an item, like a spoon or a towel, is going directly from one person’s mouth or genitals to another person, there is no need to worry about sharing household items. [6]   Oral Herpes (HSV-1 or HSV-2)     One of the most important things to prevent transmission is paying attention to active outbreaks, yours or someone you interact with. An active outbreak is usually presented by cold sores around the mouth, but can be more difficult to idenitfy if the outbreak is inside the mouth. This is the time when the virus is highly active due to viral shedding and presents the best chance of transmission. If you are a carrier, you should also pay attention to prodromal symptoms as you can anticipate an oncoming outbreak.   It's estimated that people with eight or more herpes outbreaks per year shed infectious virus ~ 31% of the time. People with one to seven herpes outbreaks a year shed infectious virus ~ 19% of the time. People who are asymptomatic still experience viral shedding about 10% of the time.[1]   If you or someone you know has an active outbreak, it is recommended to avoid any of the following:   Kissing, which is not limited to the lips. The virus can be passed by kissing other areas of the body. It is typically spread through mucous membranes in the oral or genital area, but can also infect tiny cuts or scrapes in the skin. This is especially important with young children which could cause Neonatal Herpes.   Sharing any items that may come in contact with the affected area. This includes but not limited to: Food, Drinks or eating utensils  Smoking devices (cigarettes/vape etc...) Chapstick, lipstick, lip gloss Toothbrushes Razors   Touching There may be a possibilty of transmission by touching cold sores, and then touching the mouth or genital area of yourself or another person. It's recommened to disinfect your hands immediately after touching an active outbreak.     You should also be aware that while rare, there might be a possibility for the virus to be transmitted in some public places that you wouldn't normally think about. Many places use shared products, tools, and applicators for consumers to test before purchase and during beauty services. You probably never think about the amount of people who have used it before you and how long it has been since the last use.       Department Stores / Beauty Salons Avoid using any shared/public applicators like lipstick testers, open/shared containers of makeup etc... Anything that could have come in contact with an affected area that could have oral secretions or saliva left on/in it. Even items that are spread by hand. There could be infected saliva on someone's hand from applying makeup around the mouth, which is then dipped back into the container. If used very soon after, there might be a chance of transmission. It's best to avoid it. Shared makeup or eyeliners that are used on or around the eyes could cause an Ocular Herpes infection if they contain fluid from a herpes eye infection. Always use your own personal applicators and/or ask the store to open a new product for you to test.               Nail Salons Similar to shared products from beauty stores, Nail salons may re-use products and applicators.  Due to the nature of this business, the hands, feet, fingernails or toenails may become wet, chaffed and have minor cuts that present an easy path for transmission. This could stem from or cause a Herpetic Whitlow infection. [3] Look around to see if the nail salon is clean and make sure that licenses and health inspection notices are displayed prominently on walls.[3] All tools for disinfecting should be completely immersed in disinfectant.[3] Any equipment that cannot be disinfected should be discarded. That includes nail buffers, emery boards, toe separators, orange sticks, etc...[3] Do not allow the technician to re-use any tools that were not properly disinfected.[3]       Healthcare workers are generally the most at-risk for being exposed to the Herpes virus due to direct contact with lesions, oral/vaginal secretions and infected amniotic fluid. The main route of transmission is by contaminated hands after direct contact with the lesion. Handwashing, and disinfection before and after patient contact are the most important methods for preventing transmission to patients.[4] Personnel may develop an infection of the fingers (Herpetic Whitlow) which could be transmitted to other areas of the body through self spread. Such exposure is a distinct hazard for nurses, anesthesiologists, dentists, respiratory care personnel, and other personnel who may have direct (usually hand) contact with either oral lesions or respiratory secretions from patients. [5] Less frequently, personnel may develop infection of the fingers from exposure to contaminated genital secretions or lesions on skin or mucous membranes.[5] Personnel can protect themselves from such infections by 1) avoiding direct contact with lesions, 2) wearing gloves on both hands or using "no-touch" technique for all contact with oral or vaginal secretions, and 3) thorough handwashing after patient contact. [5]   Genital Herpes (HSV-1 or HSV-2)     There is a much lower risk of genital Herpes transmission in everyday life due to the location of outbreaks and limited exposure. However, we'd still like to go over some things to consider.    Sharing items There is a very low risk here (nearly impossible), as in order for the virus to be transmitted there would need to be infected secretions from an active outbreak on the item being shared, and it would need to go directly from the genitals of that person to the genitals or mouth of another. However, this cannot be ruled out so it is recommened to not share towels/clothing or other items that come in contact with the genital area if you believe there may be a risk for transmission. You can't get genital Herpes from bed sheets, furniture etc... or sharing shower items either. The Herpes virus dies very easily with soap and water.   Non-Sexual skin to skin contact Sleeping in the same bed with someone who has genital herpes should not pose a risk for transmission, assuming you are clothed. However, there is a risk for transmission through direct genital to genital contact even if you are not having sex. Transmission may also be possible through genital to oral (or vice versa) contact via hands. It's best to always disinfect your hands after contact with the genital area or any active outbreak.   Sources     BACK (Prevention) (Safe Sex Practices) NEXT
    Safe Sex Practices   Whether you have herpes, are dating someone who does, or are concerned about your risk of being exposed by a potential parter (since up to 90% of carriers don't even know they have it!), it's important to follow safe sex practices.   Genital herpes is primarily spread from sexual skin-to-skin contact with someone who has it — including vaginal, anal, and oral sex. HSV-1 & 2 can be spread to either location (oral or genital) so the only way to avoid genital herpes is to not have any sexual contact with another person but most people have sex at some point in their lives, so knowing how to be safe is critical to preventing exposure.[1]   While these practices may not completely prevent transmission, being safe can significantly decrease the risk.   Communication     The first step in practicing safe sex is communication. It can feel awkward to bring up herpes and other sexually transmitted infections (STI's), but it’s important. Talking about your health, including STI's shows you care about your partner, and it can even make you closer.[2]  Couples who have effective communication and can openly talk about anything tend to form a much stronger bond and if your partner has a problem talking about staying healthy, you might want to reconsider whether they are the right person for you.   The best time to talk about STI's, is BEFORE you start having sex (including oral sex). More than 1 in 6 americans and over 400 million people worldwide have HSV-2. Almost 90% of those aren't aware they have it.[3]  It's best to bring it up in a non-sexual context, when you both are thinking clearly. Waiting until you start to get intimate makes it difficult for either of you to have an open conversation about it and could lead to frustration. If this is someone you just met and you plan on going home with them, that doesn't leave you much time to talk about it. You should bring it up at some point before deciding to leave together and definitely use protection.   If you already have herpes, you should understand the moral and legal obligations for disclosure and want to make sure your partner is educated so they have the freedom to make the best decision for their life. Herpes isn't really that big of a deal, and if they really care for you, they won't think so either.   If your partner has just told you about their H+ status, take the time to listen and educate yourself before making any decisions. The vast majority of people are uneducated about herpes, and the social stigma surrounding it makes it very scary at first, but in reality, it's a skin condition. A rather mangeable one at that. It's also worth keeping in mind that no one is perfect. We all have flaws. If we really care for someone, we accept them and herpes shouldn't change that.   Whatever your situation, there are plenty of videos, blogs, and educational content here on H+ life that you can share with your partner to make it easier to talk about.     Testing     Regardless of the scary pictures you can find online, the majority of people who have Herpes do not have symptoms, and the CDC does not recommend routine Herpes testing without clinical symptoms[4] so it isn't typically included on a standard STI panel unless specifically requested by you. You could have Herpes for years and not know it. So you can see how so talking about it, and actually getting tested is important if you want to practice safe sex.   Herpes testing can be tricky and getting tested may not guarantee that you or your partner do not have it, but it's another important tool to use BEFORE having sex with a new partner to significantly reduce the risk of exposure.   Here are some important notes about Herpes testing:   The CDC doesn't recommend routine testing without clinical symptoms.[4] You usually need to specifically ask your doctor for the test. The two most widely used tests are Herpes IgM and IgG blood tests. There is also the Western Blot IgM and IgG blood tests which are the Gold Standard for Herpes blood testing, although they are expensive and can only be done at the University of Washington. These tests are typically used to confirm a questionable IgM or IgG test as the Western Blot is considered more accurate. While most people develop antibodies within a few weeks, it could take up to 6 months or more before they reach a detectable level in many individuals. Unless you have not had sex in 6 months or more (or have been in a monogamous relationship), and you (and your partner) have a negative test result AFTER that period of time, you cannot guarantee that you don't have it.  If you do get a positive result, it can be tricky to determine where you got it from due to these factors. If someone tells you they have been tested and aren't willing to share the results, you shouldn't take their word for it. Anyone who has been tested and has nothing to hide shouldn't have a problem sharing their results if they are interested in pursuing a relationship with you.   Here are some ways you can approach the subject of getting tested:   "Hey, I know this is a random but have you been tested recently for STI's?" "I'm a little nervous to bring this up, but I like you and want to see where this goes. Would it be ok if we went and got tested together?" "I don't mean to sound weird, but I think it's important we talk about getting tested before having sex. STI's are extremely common and I just want to be safe"   It's best to avoid shame filled language when bringing up the conversation of STI's. Saying things like "Are you clean?" or using words that portray people with STI's as "dirty" could be taken offensively. These infections don't discriminate on whether someone is "clean" or "promiscuous". They affect everyone and it's best to keep the conversation positive.[5]   You could also find some educational content or videos about STI testing and share it with them. You could say it came across your feed and made you think. This is an easy way to start the conversation as it will typically provide the facts and information in an easy to process format and since most people are uneducated about STI's, it's likely to make them much more interested in getting tested.     Protection     Once you've got the awkward conversation out of the way and you've both been tested, it's still a good idea to use protection until you've been in a monogamous relationship for a while. Some newly acquired infections, like Herpes, may not show up STI testing for up to 6 months or more.   Tell your partner that you want to use condoms and/or dental dams for a while and if they care about you, they'll understand. If they don't respect your concerns, that's a red flag you should pay attention to.    It's important to note that Herpes, and some other STI's, are primarily spread by skin to skin contact, and condoms may not completely prevent exposure since they do not cover all areas where the virus may be present, with or without symptoms (viral shedding). However, these barrier methods can significantly reduce the risk of exposure. It's estimated that the use of condoms 100% of the time can lower the risk of HSV-2 acquisition by 30%.[6]   A final note about safe sex practices to remember is that while non-skin to skin methods of transmission are unlikely, they can't be ruled out. Theoretically, in a perfect case scenario, Herpes could be transmitted without skin to skin contact. Remember that the Herpes virus dies quickly outside of the body, however it may live long enough to infect if it is contained in infected secretions that are passed to someone else in a short period of time. Due to this, sharing any items such as sex toys, razors, etc... should be avoided.   Sources     BACK (Herpes Prevention in Everyday Life) (Breastfeeding) NEXT  
.Posted in Breastfeeding with Herpes
    Breastfeeding with Herpes   There are many benefits to breastfeeding your newborn, from providing the ideal nutrition and antibodies that help your baby fight off viruses and bacteria to helping your baby bond with you and feel secure through physical closeness and eye contact.[1] Although, if you have Herpes Simplex Virus 1 or 2 you may be wondering if it's safe without risking exposure, which could cause a very serious condition called Neonatal Herpes. In newborn infants, HSV infections are often severe and result in high rates of mortality and morbidity and every precaution needs to be taken to prevent infants from being exposed to the herpes virus.[2]   Herpes is primarily spread by skin to skin contact with an affected area (usually oral or genital) and it isn't contained in breast milk, so the good news is, with caution, breastfeeding your baby shouldn't be a problem. Although you should be aware that Herpes can spread to any part of your breast, including your nipple and areola, and Herpes can be transmitted to your infant by direct or indirect contact with lesions. Touching an outbreak and then holding your baby could pass the virus to them. Always disinfect your hands before touching your newborn, especially if you have an active outbreak.[2]   Depending on where your outbreaks typically occur, your baby may be more at risk. We'd like to outline some special precautions that should be taken to prevent Herpes exposure to your newborn.   Breastfeeding without an active outbreak   Always disinfect your hands before holding your baby   It's important to pay attention to your body and symptoms that might help you identify an upcoming outbreak.   Pay close attention to your chest area, especially on your breast and areola or any other part of your body that your baby may come in contact with.   If you feel any prodromal symptoms, notice changes in your skin, or lesions appear stop breastfeeding immediately.   Lesions on the breast could easily be mistaken for impetigo or eczema. Questionable lesions should be tested promptly for HSV so that if positive, acyclovir (safe to use while breastfeeding) can be administered quickly and breastfeeding can be discontinued until the lesion has healed.[2]   You should consider storing and freezing some breast milk in advance, in case of an outbreak and you need to stop breastfeeding.    Freshly expressed breast milk can be stored in the back of a deep freezer for up to 12 months, but using the frozen milk within six months is optimal.[3]   You may consider discussing with your doctor about antiviral supression medication to help prevent future outbreaks while breastfeeding.   Breastfeeding with an active oral or genital outbreak   In addition to standard precautions you should take without an outbreak, extreme caution should be taken if you are breastfeeding and do have an active oral or genital outbreak.   Always disinfect your hands before holding your baby   Breastfeeding is acceptable if no lesions are present on the breasts and if active lesions elsewhere on the mother are carefully and fully covered.[2]   This includes being fully clothed to cover any genital lesions and fully covering any oral lesions or cold sores so your baby may not accidentally come in contact with them. NEVER kiss your baby if you have an oral herpes outbreak.   If you feel any prodromal symptoms, notice changes in your skin, or lesions appear stop breastfeeding immediately.   Breastfeeding with an active outbreak on one or both breasts   Breastfeeding is NOT acceptable if lesions are present on the breasts.   In cases where herpetic lesions appear on one breast, temporarily refrain from breastfeeding from the affected breast until lesions have fully healed.[2]   Discard any recently expressed breast milk from the affected side and thoroughly disinfect breast pumps and accessories.   Expressing breast milk will be important for maintaining milk production while not directly breastfeeding from the affected breast. If you choose to continue expressing milk from the affected breast, it must be immediately discarded and any pump or accessories should be disinfected after each use.[2]   If breast milk comes in contact with herpetic lesions it could become contaminated, therefore it cannot be used.[2]   You may continue breastfeeding or expressing milk from the unaffected breast but take extra precautions to ensure that the lesions on the affected breast are completely covered to avoid transmission.[2]   Some mothers may need additional support to maintain their milk production. You can supplement with expressed milk that you froze in advance or use formula while herpetic lesions on the breast are healing.[2]   You should talk with your physician to determine if the lesions have healed and you can resume breastfeeding or expressing milk from the affected breast.[2]       As you can see, with some extra care and awareness, you can still provide the best nutrition for your baby without exposing them to infection. If at any time you notice any symptoms of Neonatal Herpes in your baby, contact you healthcare provider immediately as this is an extremely dangerous infection in newborns.   Sources     BACK (Safe Sex Practices) (Symptoms) NEXT