Herpes is back in the news, but the reality is it never left us!  I am only interested in tackling the oral herpes (frequently called cold sores) as the other herpes is a completely different conversation!

Herpes Virus – simplex type 1 causes what are commonly referred to as cold sores

This infection is incredibly common, but can be dangerous in babies and immunocompromised people. immunocompromised people include those on special medications for autoimmune and other disease, patients receiving chemotherapy and other cancer patients, and some people with HIV/AIDS.  It can also cause more severe problems in people with eczema.

This virus is passed by close mucocutaneous contact , meaning contact with another person’s saliva (kissing, sharing drinks, utensil, lip balm, etc).  It is highly contagious.  

60% Of Age 50 And Less Have Herpes

Latest numbers show that by the age of five 20% of kids have been infected and 60% of people 50 and below test positive for the virus.  The virus stays in your body forever and lives in a collection of nerves called a ganglion.  The virus will reactivate from this ganglion and leads to the tingling and burning that often starts before the sore begins.  The virus gets reactivated for a variety of reasons (stress, cold, sun exposure, some medications and many more).

Why are we hearing about these problems in babies?  Babies are born with immune systems that aren’t as robust as an older toddler or preschooler, so they are more susceptible to the virus and they can get much sicker with problems that go beyond a mouth sore.  The same is true for immunocompromised people: patients on many of the medications that treat autoimmune diseases, those receiving chemotherapy, and HIV/AIDs patients.

Cold Sore = Contagious!

If you have a cold sore you are contagious!  Don’t touch it, and if you do wash your hands.  Avoid touching your eyes as you can auto-inoculate (re-infect yourself) in and around your eye and develop sores on your lids and cornea which can cause vision loss.  Avoid sharing drinks, lip balm, utensils and kissing anyone or doing anything that may expose another person.  So for the real bad news… although much less likely, it can be transmitted without sores present!  

The first outbreak is usually the worst and can be associated with fevers, general malaise (think flu-like illness) and lots of sores on the lips, mouth and face that will usually subside in about 2 weeks.  Fortunately, future outbreaks are usually less severe.  Also as fortunate: life-threatening illnesses are rare and occur, typically, in special circumstances as mentioned previously.

Life Threatening Infections Can Occur

Life threatening problems in Herpes simplex 1 infections can be severe and include:  pneumonia, esophagitis (sores can pop up in your esophagus causing severe pain), encephalitis and meningitis (infection of the brain and the membranes that surround the brain), destruction of the adrenal glands disseminated herpes (spread throughout the body) and liver damage, such as hepatitis.

A young child (or immunocompromised individual) with cold sores on the lips, mouth, face, or anywhere else who has never experienced them before or are associated with fevers, difficulty eating or drinking, have abnormal behavior or any other concerns should be seen by a physician as they may need treatment with antiviral medications.