BBC South East reports that “Raffy Holliday, from Deal in Kent, tested positive for the HHV6 strain in hospital, and he died in March,” but this was not herpes simplex: parents don’t need to be worried about this.
The reporters don’t explain that HHV-6 – commonly called roseola – is not ‘herpes’ in the usual sense. When anyone says ‘herpes’ people think of genital herpes. The reporters didn’t check to find that there are 9 different conditions caused by 9 different herpes viruses. Other well-known herpes viruses are chickenpox (HHV-3) and glandular fever (HHV-4).
Infections with human herpesvirus 6 (HHV-6) are very common. In fact, almost 100% of us will have encountered it. There are two types of HHV-6 (A and B) and the one Raffy had will have been HHV-6B, not herpes simplex. Roseola is common childhood disease expected to resolve without treatment. The child may have high fever for a few days, and a mild skin rash may develop. Sometimes, paracetamol or ibuprofen might be given.
But Raffy had leukemia. This means his immune system was not able to function in the normal way. Parents of children (who do not have such a serious condition) do not need to worry if their children develop roseola. They will be well in a few days or so…
“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:
To provide information to the public, to medical professionals and to the media.
To encourage the development of new treatments for herpes simplex.
To tackle stigma and the unnecessary trauma associated with the condition.
She adds ”The likelihood of developing Alzheimer’s disease is 12 times greater for Apoe-e4 carriers who have HSV1 in the brain than for those with neither factor.”
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!
Herpes helpliners were invited to talk to the doctors at the annual conference of the British Association of Sexual Health and HIV in Sheffield in 2022.
A story in the Daily Express on 2nd 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.”
We are getting a lot of calls about herpes medication and the COVID vaccines. (And see lower down for the Covid vaccine and a herpes simplex outbreak.)
Even if have a herpes outbreak, can I have the vaccine?
Short answer: Yes you can.
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.
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.
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.
Our patron, Professor Simon Barton, was asked to do a short talk 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.)
Helpline callers often ask whether any food or vitamin can help improve resistance to herpes simplex and prevent symptoms. Despite many claims, no ‘magic’ food or vitamin is guaranteed to do this.
Now people are asking what they should eat to make sure they don’t catch Covid-19. Or if they do catch it, how they can have a milder case. Medical experts (Covid Symptoms Study) are giving the same response as us: there is no single answer.
As you will have seen in the news, people with serious underlying health conditions are most at risk of having a bad case of Covid-19. It is difficult, if not impossible to make a long-term health problem disappear, so what can be done?
As you may know, people with serious underlying health conditions are more at risk from Covid-19. What can be done?
Medical reports suggest that people with low vitamin D levels may be harder hit with Covid-19, although experts are not agreed on how much it matters and why.
We have previously written about “Vitamin D for herpes” in SPHERE 34-1. Vitamin D can be a useful supplement for immune function and to reduce outbreaks.
Dark skin? Over 65? Vitamin D is the supplement for you
You get it naturally by sitting in the sun, (but not overdoing it). For people with light skins this means around 20 minutes’ exposure between 10 am and 3 pm in the summer months. At other times of the year the sun isn’t strong enough to help much. Darker skinned people will need greater sun exposure to benefit.
The NHS has long been advising that, amongst others, people over 65 and those with darker skin should be taking supplements of vitamin D. Our director, Marian Nicholson, has! She takes the recommended dose of 10 mcg (400 i.u.) of vitamin D to lessen the chance of an outbreak. And it does not just help with herpes simplex, she rarely gets a cold. If she does, it is gone in a day or so.
In addition, the Department of Health and Social Care recommends a daily supplement containing 10 micrograms of vitamin D throughout the year if you:
• are not often outdoors – for example, if you’re frail or housebound
• are in an institution like a care home
• usually wear clothes that cover up most of your skin when outdoors
• you have dark skin – for example you have an African, African- Caribbean or south Asian background.
