Author: Marian Nicholson

“Mothers who need to have C-sections (for any reason) should not be alarmed by these tragic rare cases – a repeat is almost impossible”, says Herpes Viruses Association

For a woman to be infected with herpes simplex during a Caesarean-section is one of the rarest possible medical accidents. For it to happen twice in the same geographical area required a unique set of circumstances that are unlikely to be repeated. Lessons have been learned and treatment guidelines will be updated to prevent another similar tragedy.

The Herpes Viruses Association was shocked to hear that two women died from internal herpes simplex infections following disease transmission via C-section. We extend our condolences to the families affected.

Herpes is common – for most it is a minor skin condition

Herpes simplex (HSV) infections are common and in almost every case are caught during direct skin on skin contact. It is almost unheard of for these viruses to be caught during any kind of medical procedure and strict protocols are adopted to prevent this.

Herpes simplex is universal. More than two thirds of the world’s population carry the most common type, known as HSV-1^[1] which places it close behind chickenpox as an almost universally acquired virus in humans. The other type is HSV-2.^[2] Either type may be caught facially (cold sores) or genitally (genital herpes). It is also possible for either type to infect the hand or finger. This is called a herpetic whitlow and is seen less often than infection in other parts of the body.

More than half of pregnant women will have come into contact with HSV-1 before
conceiving. Their babies, from month 7 onwards, will acquire all their mothers’ antibodies which will protect them during birth and for several months.

If a herpes simplex infection is suspected in either a mother or her baby, prompt use of antiviral treatment should ensure a positive outcome.

In the tragic cases in Margate and Ashford, Kent, neither woman had a prior HSV-1 infection. This means that neither of them had herpes simplex antibodies. This made them both vulnerable to the accidental internal acquisition that turned out to be fatal.

Why was a common cold sore infection fatal in these cases?

Herpes simplex is normally a virus that infects skin and nerve cells. Typical symptoms are painful skin blisters and sores that make diagnosis straightforward. These women were infected internally, so there were no observable symptom. Therefore, the virus was able to spread without affecting the skin.

Without the telltale blisters on the skin, herpes simplex was not suspected, and the antiviral treatment was not given.

Future improvement to guidelines

The Herpes Viruses Association is pleased to learn that the Royal College of Obstetrics and Gynaecology is going to recommend treatment with antiviral medication for any ‘mysterious’ illness in mother or baby. This is a highly safe precaution and should prevent any similar tragedy in the future. See their pregnancy-with-herpes leaflet.

– ENDS –

NOTES TO THE EDITOR

The Herpes Viruses Association exists to promote better mental and physical health with regard to the family of herpes viruses.  Its aims are:

1. To provide information to the public, to medical professionals and to the media.
2. To encourage the development of new treatments for herpes simplex.
3. To tackle stigma and the unnecessary trauma associated with the condition.

References:

1. WHO report on herpes simplex type 1: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0140765
2.  WHO report on herpes simplex type 2: https://www.scielosp.org/article/ssm/content/raw/?resource_ssm_path=/media/assets/bwho/v86n10/a17v8610.pdf

For more information contact Marian Nicholson MBE, Herpes Viruses Association 02076079661 or [email protected]

The question “does the shingles vaccine help with herpes simplex” is perhaps relevant. Herpes zoster is the medical name for shingles, or it can be called humanherpes virus ‘type 3’. It is enough like herpes simplex, that it is treated with aciclovir or other antiviral drug. If you do think you may have shingles, it is important to get the drug for shingles very quickly, within 3 days. Only prompt treatment will help control the duration of symptoms.

Shingles is the name for a recurrence of chickenpox (herpes varicella). Following infection, chickenpox virus remains in the body, hiding in neural ganglions. Shingles can happen when you are run down, ill, stressed, or following a physical or emotional trauma (a fall or the loss of a loved on). Although chickenpox affected the whole body, luckily shingles just appears in one small area, usually the back or chest. See more on our Shingles Support Society website.

A vaccine for shingles, Zostavax, is been provided to people in their 70s for the last ten years. This is because in older people the is a greater risk that nerve pain will continue after the shingles blisters have cleared up. So plenty of people who get repeated herpes simplex symptoms will have benefitted from Zostavax. If it does help control herpes simplex virus, these people will have noticed that their recurrences have stopped.

Some people have found it helps

And we have indeed had people tell us that following the shingles vaccine, their herpes simplex symptoms are noticeably less frequent (or have stopped). Now, that could just be coincidence. We know that over time, recurrences are expected to become less frequent. But it is nice to think that the shingles (herpes zoster) vaccine is helpful against herpes simplex.

Let us know (at [email protected]) if you notice that you are having more outbreaks since Zostavax, or fewer…

In any case, if you are offered the shingles vaccine – take it!

A story in the Daily Express on 2^nd August 2022 described how a facial infection can reactivate in the eye. This ocular herpes needs to be treated.

“Ocular herpes usually occurs when a previous infection with the virus reactivates and spreads to the eye. Most people will catch the herpes simplex virus as children, but will not notice it as there are often no symptoms.”

Continue reading Eyesight: getting a ‘gritty feeling’ could be a ‘serious’ eye condition – do not ignore

We are getting a lot of calls about herpes medication and the COVID vaccine. (And see lower down for the Covid vaccine and a herpes simplex outbreak.)

Even if I am having herpes symptoms, can I have the vaccine?

Short answer: Yes. You can take herpes medication and the COVID vaccine will be OK.

Longer answer… A herpes simplex outbreak (a ‘cold sore’) is minor problem for the body to deal with. It can certainly manage to control the outbreak and deal with the new ‘flu vaccine’ that is the Covid vaccine. And taking medication to control herpes outbreaks will not affect it. These antivirals do not work on any flu virus at all. (If they did, be sure they would be selling them for treating flu!)

It is generally said that being unwell is meant to be a trigger factor for an outbreak. This is where the names cold sores or fever blisters come from – people noticed they pop out when a person is unwell. Most interestingly we know of people who get a lot of outbreaks but no colds or flu, while people around them are getting these ‘normal’ illnesses.

In fact, since having Covid, or flu, could trigger an outbreak, you could say that the vaccine will help with herpes too!

It is perfectly safe. We recommend that people with herpes have the COVID vaccine – or any vaccines offered. Do the best for yourself, get yourself protected against COVID: a serious, life-threatening virus. The vaccines approved for use in UK do not contain egg or any other animal products. Like the antiviral drugs for herpes, all the vaccines are safe for any religious group.

“Having had herpes is not a contraindication for COVID vaccination. As most of the population have been infected with herpes type one or type 2 if there were any complication, we would have seen it by now. There is no scientific basis for thinking there would be any problem. Indeed, I had my first Covid jab yesterday. My past history of oral herpes type one (‘cold sores’) did not concern me.” Professor Colm O’Mahony MD. FRCP. BSc. DipVen.

Because ‘everyone’ has herpes they can have the COVID vaccine.

Well over half the adult population has herpes simplex, though most don’t know it. The NHS wants everyone, regardless of whether or not they get cold sores on face, fingers or genitals to be vaccinated. Take advantage of these medical breakthroughs. They have been subjected to meticulously conducted clinical trials. Such clinical trials are essential to test the safety and effectiveness of experimental treatments and vaccines. (I’ve just received either a vaccine or a salt water injection. I’m taking part in a trial for Novovax.)

After a promising therapy is developed in a lab, it goes through three separate studies to ensure that it won’t cause any serious harm and will be of real medical benefit. Only if it passes all three stages is any new therapy evaluated by a group of independent experts. They assess if it’s safe and effective and can receive a licence for use in the general public. The Novovax vaccine is now on the verge of such approval.

Marian is taking part in a COVID vaccine trial

By the time I joined the trial, the study was already in its final ‘phase 3’ research involving over 15,203 volunteers recruited in record time. The participants were divided at random into two equal groups. Researchers made sure the composition of the groups was comparable in terms of age, gender, race and underlying health conditions. One group received the experimental vaccine and the other a placebo. (A dummy therapy, in this case salt water). Rates of side effects and COVID were then compared between the two groups. At the outset, the researchers set strict criteria to ensure that the new treatment really if safe and works. This is so that they couldn’t be accused of moving the goal posts if their study flings up some unexpected or unwelcome findings.

If you are a person with herpes have the COVID vaccine – where it is the one from Oxford/Astra Zenaca, Pfizer/BioNTech, Moderna or, when it is available, “my” Novovax vaccine!

Our patron, Professor Simon Barton, was asked to do a short presentation telling doctors about genital herpes, for a conference in Bucharest. Or really, he was asked to record a short video for the IUSTI virtual conference (about 700 delegates in 46 countries). He invited Marian Nicholson, our director, and Ceri Evans, the senior health adviser from Hammersmith, to join him for this ‘lecture’. He took as the topic: “how we support patients in UK.” (Recording no longer available… Sorry! But we will have something new soon.)

Marian must have been saying the right things, as she has been invited to talk again at further conferences, in England and in other nations.