WEBVTT - 131. Herpes in Pregnancy

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<v Speaker 1>The information in this podcast is provided for education and

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<v Speaker 1>research information only. It is not a substitute for professional

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<v Speaker 1>health advice.

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<v Speaker 2>Welcome to the Kick your Expert led podcast, helping you

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<v Speaker 2>explore and learn everything about getting pregnant, pregnancy, birth, and

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<v Speaker 2>becoming a parent.

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<v Speaker 1>On the podcast and our online pregnancy program grow My Baby,

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<v Speaker 1>we share my experience of helping more than four thousand

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<v Speaker 1>babies to be born and.

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<v Speaker 2>Our experience of running a women's health clinic and parenting

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<v Speaker 2>for boys.

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<v Speaker 1>We're here to help everyone to feel empowered in pregnancy

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<v Speaker 1>and birth with real life, practical information.

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<v Speaker 2>Welcome everyone. I'm Bridgid Maloney.

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<v Speaker 1>And I'm obstetrician doctor Patrick Maloney.

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<v Speaker 2>And today we've got a topic that I think is common.

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<v Speaker 1>Yep.

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<v Speaker 2>Yeah, people know about herpes, but do they really know

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<v Speaker 2>about herpes in pregnancy.

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<v Speaker 1>Yeah. I think it's really relevant because you know, herpies

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<v Speaker 1>infections can be recurrent and the same person who's struggle

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<v Speaker 1>with a few recurrences of the virus over there teens

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<v Speaker 1>and twenties, one of they might want to be pregnant.

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<v Speaker 1>It does have important manifestations in pregnancy that we need

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<v Speaker 1>to discuss.

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<v Speaker 2>I want to start by asking what is the difference

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<v Speaker 2>between a cold saw and genital herpes.

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<v Speaker 1>We normally use the word cold saw to describe the

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<v Speaker 1>lesions on your lips, right on your face, and they

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<v Speaker 1>are typically caused by subset one of the virus, Herpy's

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<v Speaker 1>simplex virus one, but not always. And then there's the

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<v Speaker 1>genital sorts, which are usually herpy simplest virus two, but

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<v Speaker 1>there's some there's some interactions. Sometimes the facial ones are

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<v Speaker 1>two and the gentle ones are.

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<v Speaker 2>One, and you wouldn't really know the difference unless you've

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<v Speaker 2>got it tested. There's no difference in the legions, No,

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<v Speaker 2>not really no.

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<v Speaker 1>So anyone who's had the herbies cold saw virus on

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<v Speaker 1>their lips knows that it can be recurrent, that they're

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<v Speaker 1>irritating and painful, that they can pop out when you

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<v Speaker 1>run down or overexposed to sun or to me late

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<v Speaker 1>nights or when I was a hospital doctor treating a

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<v Speaker 1>patient in the emergency department who had a really bad

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<v Speaker 1>case of Col's horse and she was telling me about

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<v Speaker 1>how she'd been not looking after herself, to me late

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<v Speaker 1>night's drinking too much, And I said, oh, well, you know,

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<v Speaker 1>should stop that.

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<v Speaker 2>How old were you when you said.

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<v Speaker 1>There, yeah, and I was like an intern and one

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<v Speaker 1>of my mates was listening from the next cubicle in

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<v Speaker 1>Wench went so, you know, they're kind of part of

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<v Speaker 1>life for young people. But for today's purposes, we're really

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<v Speaker 1>talking about the genital lesions and there and their importance

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<v Speaker 1>in pregnancy.

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<v Speaker 2>I want to just tell people about my UNI days.

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<v Speaker 2>And I was just probably like an eighteen year old,

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<v Speaker 2>straight out of home and going to the doctor by

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<v Speaker 2>myself for the first time. Abo's something totally unrelated to

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<v Speaker 2>the cold salt on my lip, and all of a sudden,

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<v Speaker 2>I had this GP talking to me about you do

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<v Speaker 2>realize that you can't be giving oral sex because of

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<v Speaker 2>the colds are on my lip, and I just was

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<v Speaker 2>so embarrassed. I think I just picked up all my

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<v Speaker 2>pieces of paper or whatever and just left.

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<v Speaker 1>If I know that that was going to be mentioned,

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<v Speaker 1>I would not have known. Look, the relevance of the

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<v Speaker 1>facial lesions to pregnancy is really just that if you've

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<v Speaker 1>got one of those when you're at full term and

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<v Speaker 1>the baby coming, the baby's susceptible to the to the

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<v Speaker 1>virus within the first month and can become seriously unwell.

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<v Speaker 1>So the problem with having a facial lesion when the

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<v Speaker 1>baby comes is really shouldn't be kissing the baby, and

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<v Speaker 1>that is you know, sad, yeah, and and upsets people,

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<v Speaker 1>And it can be worth discussion of suppressive therapy laid

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<v Speaker 1>in pregnancy for someone who's had multiple out outbreaks of

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<v Speaker 1>facial herpes to prevent it happening at turn, you know,

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<v Speaker 1>avoiding kissing the baby even though it's even though it's sad,

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<v Speaker 1>it's something we we could also do. The genital allegions

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<v Speaker 1>are more serious because if the baby comes out through

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<v Speaker 1>the gentle tract and picks up herpose from a lesion

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<v Speaker 1>on the volver, it can be very very serious.

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<v Speaker 2>All right, And I do want to get into that

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<v Speaker 2>just to highlight how common this is. The who says

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<v Speaker 2>that about sixty four percent under the age of fifty

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<v Speaker 2>have the HSV virus HSV one virus, and about thirteen

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<v Speaker 2>percent age between fifteen and forty nine have the HSV two.

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<v Speaker 2>So that's that's really common, isn't it yea super common

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<v Speaker 2>and people, as you said, it can have both. So

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<v Speaker 2>tell us why are we nervous about herpes in pregnancy?

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<v Speaker 1>Well, often the legions we're talking about are are recurrent.

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<v Speaker 1>So just as you could be if you've been exposed

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<v Speaker 1>to purpose in the past and had a couple of

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<v Speaker 1>little blisters on the labia and then they went away,

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<v Speaker 1>they tend to come back at times when you are

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<v Speaker 1>run down, overworked, too tired, poor sleep and so forth,

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<v Speaker 1>And a lot of those conditions apply to late pregnancy,

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<v Speaker 1>so a recurrence in advanced pregnancy is a real possibility.

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<v Speaker 1>The thing with herpoes is the diagnosis is often not

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<v Speaker 1>that difficult because they hurt and painful. Genentitle lesions are

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<v Speaker 1>unlike most of the other genitle elections. If it really hurts,

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<v Speaker 1>that needs.

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<v Speaker 2>To be checked for herbs, and it would make someone

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<v Speaker 2>go to the doctor there take.

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<v Speaker 1>A swab and get diagnosis. But you know, if you're

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<v Speaker 1>prone to recurrences and you might get one at term,

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<v Speaker 1>then the danger is that you could have a subtle lesion.

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<v Speaker 1>Baby could get pick up the herbies on the way

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<v Speaker 1>out during the birth process and become seriously unwell.

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<v Speaker 2>And what does seriously unwell mean?

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<v Speaker 1>You know, in a high risk situation, the pedatricians would

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<v Speaker 1>look at things like, you know, babies that were had

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<v Speaker 1>any sign of any serious illness like listless or abnormal

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<v Speaker 1>observations of fevers or an actual rash with blisters.

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<v Speaker 2>Oh wow.

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<v Speaker 1>And you know, the pedatricians do amazing job, because sometimes

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<v Speaker 1>that the sign of a baby becoming significantly unwell as

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<v Speaker 1>something as subtle as poor feeding.

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<v Speaker 2>Yeah right, yeah, and gosh, it could be so many

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<v Speaker 2>different things.

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<v Speaker 1>And you can't ask them. So so this mostly comes

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<v Speaker 1>down to history. This is us saying to the pedatricians,

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<v Speaker 1>this person is at risk.

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<v Speaker 2>Yeah, and is it like CMV the episode that we

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<v Speaker 2>did a few months or weeks ago where the act

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<v Speaker 2>if it's your first time, it's.

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<v Speaker 1>Worse, it's worse. Yeah, definitely. Yeah. Yeah, so you got

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<v Speaker 1>a much higher viral load and much more likely to

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<v Speaker 1>have virenemia the first time around. So that means that

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<v Speaker 1>it's actually virus circulating your whole body in bloodstream. So

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<v Speaker 1>the woman in a primary episode is much more likely

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<v Speaker 1>to have sevige and allegions and be systemically unwell with

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<v Speaker 1>fevers and dehydrated and sick, whereas recurrences are painful and

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<v Speaker 1>irritating but typically confined to the area where the where

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<v Speaker 1>the recurrence is located. Yeah, yep, so, and I think

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<v Speaker 1>the viral load is much higher in a primary episode.

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<v Speaker 1>So the pediatricians are much more concerned with someone with

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<v Speaker 1>the first episode of herpees happening during at the end

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<v Speaker 1>of the pregnancy than they are typically with a recurrence.

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<v Speaker 2>And does that go for like the HSB one, the

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<v Speaker 2>cold soil type.

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<v Speaker 1>I guess so, although that you know, that's much easier

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<v Speaker 1>to manage because you can cover the lesion on the

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<v Speaker 1>on the face and you can avoid kissing the baby,

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<v Speaker 1>and that I think those changes to baby, those interventions

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<v Speaker 1>are typical, whether it's first or whether it's first or

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<v Speaker 1>subsequent YEP infection.

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<v Speaker 2>And also those type conversations that you have with people

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<v Speaker 2>that kiss your baby.

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<v Speaker 1>Yes, well this is one of the reasons why we

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<v Speaker 1>don't why we shouldn't do that. Yeah.

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<v Speaker 2>Yeah, I just can't think of kissing somebody else's baby, Like,

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<v Speaker 2>you know, I've got to that point that I just

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<v Speaker 2>I find it boring, Like I don't want to do

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<v Speaker 2>it as much as my whole body's going, oh my god,

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<v Speaker 2>what a goodout baby.

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<v Speaker 1>Yeah. I just think COVID's done a fear of it

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<v Speaker 1>to recalibrate our tolerance for connection with other people. Yeah,

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<v Speaker 1>I honestly think that I think it's done a bit

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<v Speaker 1>to calibrate it back the other way, you know, away

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<v Speaker 1>from that super close contact with people. Whether it's not strictly.

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<v Speaker 2>Necessary, Yeah no, it's just a boundary that my body

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<v Speaker 2>just recoils from.

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<v Speaker 1>Now.

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<v Speaker 2>Yeah, So paid, let's go on to when when the

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<v Speaker 2>baby's do and someone has an active lesion. What are

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<v Speaker 2>the discussions that they're having with a care team at

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<v Speaker 2>that time about delivery.

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<v Speaker 1>I want to take you back a little bit further

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<v Speaker 1>than that, because the name of the game is to

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<v Speaker 1>prevent the active leasion term. So if we go back,

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<v Speaker 1>if someone's had multiple recurrences across their early life or

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<v Speaker 1>multiple recurrences within that pregnancy, then I would be talking

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<v Speaker 1>to that passion about being on suppressive therapy to dramatically

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<v Speaker 1>reduce the chances of them getting that leasion at term.

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<v Speaker 1>And you can take a drug called a cyclovia and

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<v Speaker 1>antiviral drug that's that's very safe for use in pregnancy.

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<v Speaker 1>It has no known risks in pregnancy, and you have

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<v Speaker 1>to take the pills a lot. There's like wife doses

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<v Speaker 1>a day or something, but it's very effective at reducing

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<v Speaker 1>the activity. And that's that's our best defense against getting

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<v Speaker 1>an episode at term. But if you get an episode

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<v Speaker 1>at term nonetheless, then the baby's better to come by

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<v Speaker 1>since aaron section.

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<v Speaker 2>So is there any way of treating So that's taking

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<v Speaker 2>it just to prophilectically, But is there anything if you've

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<v Speaker 2>actually got an active lesion? Are there other medications that

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<v Speaker 2>you can take?

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<v Speaker 1>Well, you can take pain relief and you can take

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<v Speaker 1>a cycle of it to shorten the hon us. But

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<v Speaker 1>if we're talking at term, yeah, it needs to be

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<v Speaker 1>totally resolved if you're going to be back on track

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<v Speaker 1>for a vaginal.

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<v Speaker 2>Birth, And totally resolved means that there is no lesion presence,

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<v Speaker 2>isn't Yes.

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<v Speaker 1>And even then I'd be getting expert advice if it

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<v Speaker 1>was close to the delivery, because viral shedding from things

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<v Speaker 1>can go on longer than your pew do to have recovered. Yeah,

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<v Speaker 1>And the problem is that an infection in a newborn

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<v Speaker 1>from some of these viruses that they're serious.

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<v Speaker 2>Is it only through delivery that a baby can get

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<v Speaker 2>purpies or can the baby get herpies in utero?

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<v Speaker 1>Yeah, there isn't a utero form. It's not very common,

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<v Speaker 1>but in particular for one's got a primary episode during

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<v Speaker 1>pregnancy and is particularly unwell that there is a possibility

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<v Speaker 1>of baby catching it well during the pregnancy, and like

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<v Speaker 1>some of those other viruses that we can get during pregnancy,

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<v Speaker 1>like rubeller and CMV, they can cause all sorts of

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<v Speaker 1>problems with the developing baby. So there's a thing called

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<v Speaker 1>a torch screen, which is a blood test done during

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<v Speaker 1>a pregnancy if there appears to be a chance that

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<v Speaker 1>a baby might have picked up something during the pregnancy.

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<v Speaker 1>So it looks for antibodies for toxoplasmosis, Rubellas, c MV,

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<v Speaker 1>and herpes. So we would do that test if we

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<v Speaker 1>were investigating a baby that had died in euter or

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<v Speaker 1>was way too small, or had ultrasound evidence for example,

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<v Speaker 1>of abnormal organ development or calcification within in internal organs.

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<v Speaker 1>The things that would show up on an ultrasound and

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<v Speaker 1>the torch screen would be used to see if infection

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<v Speaker 1>was behind that, and occasionally some of those would be

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<v Speaker 1>would be in neutro herpes.

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<v Speaker 2>If someone that you suspect their baby's been affected by

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<v Speaker 2>herpes and in utero, would you send them to, say

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<v Speaker 2>a maternal fetal medicine specialists.

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<v Speaker 1>Yeah, So go to our episode where we discussed maternal

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<v Speaker 1>fiedal medicine services with Professor Joan's fantastic, that's one. That's

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<v Speaker 1>so these are services that give expert advice on these

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<v Speaker 1>rare things.

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<v Speaker 2>Yeah, so absolutely.

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<v Speaker 1>If I if I saw one of my patients and

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<v Speaker 1>baby looked too small and we did an ultrasound and

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<v Speaker 1>that looked like they could have been in utro infection,

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<v Speaker 1>what does this mean? You know? It is my baby

0:12:20.120 --> 0:12:22.160
<v Speaker 1>going to be affected by this? Die? Is my boby

0:12:22.240 --> 0:12:24.480
<v Speaker 1>going to be going to be physical or mentally affected

0:12:24.480 --> 0:12:27.600
<v Speaker 1>by this infection? Where do I get this information? Rare

0:12:27.600 --> 0:12:30.440
<v Speaker 1>thing like that? Be on the phone to Joanne, say,

0:12:30.840 --> 0:12:33.480
<v Speaker 1>here's the situation I need. I need your expert at

0:12:33.480 --> 0:12:37.600
<v Speaker 1>guidance and to be able to appropriately counsel my patient.

0:12:37.960 --> 0:12:40.200
<v Speaker 2>What advice would you give to people that, perhaps in

0:12:40.400 --> 0:12:44.559
<v Speaker 2>a couple, the partner has purpose, Yes, what can they

0:12:44.559 --> 0:12:47.760
<v Speaker 2>be doing to prevent any sort of infection to their baby?

0:12:47.880 --> 0:12:50.960
<v Speaker 1>Yeah? I think that it's different for the partner. Let's

0:12:50.960 --> 0:12:53.360
<v Speaker 1>say we've got a couple with it. There's a male

0:12:53.440 --> 0:12:57.559
<v Speaker 1>partner who's had some my current jentle herpes. The medications

0:12:57.640 --> 0:13:00.760
<v Speaker 1>to be used by a non pregnant person to suppress

0:13:00.800 --> 0:13:04.240
<v Speaker 1>outbreaks are easy to take this one stately dacing and

0:13:04.320 --> 0:13:06.560
<v Speaker 1>so these are very very effective medications that you can

0:13:06.559 --> 0:13:08.840
<v Speaker 1>just take one dose to day forever and have very

0:13:08.880 --> 0:13:13.160
<v Speaker 1>few or no outbreaks. And that's definitely something that somebody

0:13:13.200 --> 0:13:15.800
<v Speaker 1>should be considering if they've had more than about an

0:13:15.800 --> 0:13:20.240
<v Speaker 1>outbreak a year, because they're painful and awkward. So some

0:13:20.280 --> 0:13:22.199
<v Speaker 1>people are just on suppression they never get an attack

0:13:22.200 --> 0:13:25.480
<v Speaker 1>in they fine. If they're not on suppression and they

0:13:25.520 --> 0:13:28.040
<v Speaker 1>get an attack, then obviously I want to avoid intercourse

0:13:28.120 --> 0:13:32.560
<v Speaker 1>until that episode has resolved, because if the partner's never

0:13:32.600 --> 0:13:35.760
<v Speaker 1>been exposed, then they want to be exposed now. So

0:13:35.760 --> 0:13:38.719
<v Speaker 1>that advice would be standard in or out of pregnancy

0:13:39.000 --> 0:13:42.000
<v Speaker 1>to respect the safety of your partner and try and

0:13:42.000 --> 0:13:43.160
<v Speaker 1>avoid the transmission.

0:13:43.800 --> 0:13:47.880
<v Speaker 2>So, Patty, if the baby has unfortunately been diagnosed with

0:13:48.000 --> 0:13:51.640
<v Speaker 2>having purpies at birth, what would the parents expect in

0:13:51.679 --> 0:13:52.400
<v Speaker 2>terms of treatment.

0:13:53.280 --> 0:13:56.920
<v Speaker 1>Yeah, so it's a serious situation and the pediatricians are

0:13:56.960 --> 0:14:02.840
<v Speaker 1>going to be managing this very diligently, and there's a

0:14:02.880 --> 0:14:05.520
<v Speaker 1>list of things that they would look at to work

0:14:05.559 --> 0:14:08.560
<v Speaker 1>out how significant the risk to the baby really was.

0:14:09.600 --> 0:14:12.040
<v Speaker 1>So they need to know whether the whether the mother

0:14:12.200 --> 0:14:15.800
<v Speaker 1>was having a primary or a secondary episode. The primaries

0:14:15.800 --> 0:14:20.560
<v Speaker 1>are obviously worse. Whether the mother had developed mature antibodies

0:14:20.600 --> 0:14:25.080
<v Speaker 1>to the herpes virus herself, whether the baby was born

0:14:25.360 --> 0:14:29.040
<v Speaker 1>snuck out vaginally, or born by a cesarean section, How

0:14:29.040 --> 0:14:32.080
<v Speaker 1>long the membranes were ruptured in labor is highly relevant,

0:14:32.560 --> 0:14:38.640
<v Speaker 1>and also the integrity of the skin. So if the

0:14:38.720 --> 0:14:40.840
<v Speaker 1>baby came out with no damage at all to the

0:14:40.840 --> 0:14:43.320
<v Speaker 1>skin on the head, that's batter because the skin provides

0:14:43.360 --> 0:14:47.200
<v Speaker 1>a barrier to infection. Whereas if we've breached that membranes

0:14:47.240 --> 0:14:50.080
<v Speaker 1>by that integrity, by the use of a fiddle scalpe

0:14:50.120 --> 0:14:54.320
<v Speaker 1>electrode or a vacuum cup with tear on the skin,

0:14:55.320 --> 0:14:58.520
<v Speaker 1>then that's worse. And whether the genital vision on the

0:14:58.520 --> 0:15:00.920
<v Speaker 1>mother was type one or type two, all of those

0:15:00.920 --> 0:15:04.920
<v Speaker 1>things irrelevant in the mind of the neo natologist as

0:15:04.960 --> 0:15:08.000
<v Speaker 1>to how risky the situation is. And then obviously they

0:15:08.000 --> 0:15:12.520
<v Speaker 1>work through protocols and treat the babies with antiviral drugs

0:15:12.760 --> 0:15:14.840
<v Speaker 1>in a low risk situation for a matter of days

0:15:14.840 --> 0:15:16.640
<v Speaker 1>and in a higher situation for months.

0:15:16.920 --> 0:15:19.800
<v Speaker 2>Yeah, and so when you say they have to work

0:15:19.800 --> 0:15:23.000
<v Speaker 2>out whether it's HSB one or two, if they've had

0:15:23.000 --> 0:15:26.160
<v Speaker 2>an active lesion before the actual delivery. Would you be

0:15:26.200 --> 0:15:28.040
<v Speaker 2>taking Would it be routine to take a swab to

0:15:28.040 --> 0:15:28.280
<v Speaker 2>find it?

0:15:28.360 --> 0:15:29.720
<v Speaker 1>Yeah? We ideally we would know that.

0:15:30.040 --> 0:15:33.000
<v Speaker 2>Yeah, to have as much information as possible for that

0:15:33.040 --> 0:15:35.960
<v Speaker 2>woman as she goes in. Okay. Would it be useful

0:15:36.000 --> 0:15:38.040
<v Speaker 2>if I made a little summary of what I've heard

0:15:38.080 --> 0:15:39.440
<v Speaker 2>and can you tell me if I've got it right?

0:15:39.520 --> 0:15:39.960
<v Speaker 1>Sounds good?

0:15:40.000 --> 0:15:44.760
<v Speaker 2>Okay. So, firstly, if you've never had herpes, watch and

0:15:44.800 --> 0:15:48.880
<v Speaker 2>it's your first infection, watch out for like systemic problems

0:15:48.880 --> 0:15:52.120
<v Speaker 2>like body aches and fevers. Yep, to see if it's

0:15:52.120 --> 0:15:55.480
<v Speaker 2>an active because the active one is more of an issue.

0:15:55.600 --> 0:15:56.360
<v Speaker 1>Yes, yep. Good.

0:15:59.440 --> 0:16:03.360
<v Speaker 2>If you have I've had recurrent recurrent herpes, then you

0:16:03.400 --> 0:16:05.240
<v Speaker 2>might talk to your doctor about an anti viral during

0:16:05.240 --> 0:16:06.560
<v Speaker 2>your pregnancy, yes, yep.

0:16:07.080 --> 0:16:09.360
<v Speaker 1>To decrease the chances of you having a lesionate term.

0:16:09.520 --> 0:16:14.320
<v Speaker 2>Yep. Good. If you've got an active general lesion, you

0:16:14.400 --> 0:16:17.080
<v Speaker 2>might be advised to have while you will be advised

0:16:17.080 --> 0:16:21.040
<v Speaker 2>to have a cesarean section. Absolutely good, And prevention is

0:16:21.120 --> 0:16:23.640
<v Speaker 2>key in the first place. So I don't know how

0:16:23.720 --> 0:16:28.520
<v Speaker 2>impregnancy you stop the stress and the diadness and the fatigue, but.

0:16:28.520 --> 0:16:31.280
<v Speaker 1>In my experience, most of people affected by this problem

0:16:31.800 --> 0:16:34.640
<v Speaker 1>I have had a primary episode when they were nineteen

0:16:34.760 --> 0:16:37.360
<v Speaker 1>or something, and they've had a couple of occurrences since then. Yeah,

0:16:37.400 --> 0:16:39.200
<v Speaker 1>and they know what they feel like. They're familiar with

0:16:39.200 --> 0:16:41.840
<v Speaker 1>a little tingling and the pain, and they'll bring it

0:16:41.920 --> 0:16:45.280
<v Speaker 1>to your attention. So take Our message is if you

0:16:45.360 --> 0:16:48.280
<v Speaker 1>think you are getting a recurrence of a gentle herpe

0:16:48.280 --> 0:16:51.640
<v Speaker 1>solusion in advanced pregnancy, bring that to the immediate attention

0:16:51.720 --> 0:16:52.720
<v Speaker 1>of your caregivers.

0:16:52.800 --> 0:16:56.120
<v Speaker 2>Yeah, don't hide herpes. No, that might be the slogan

0:16:56.160 --> 0:17:00.360
<v Speaker 2>don't hide herpes are super important also, and this is

0:17:00.400 --> 0:17:04.840
<v Speaker 2>difficult if you've got a cold, saw, don't kiss the baby. Yeah, yeah,

0:17:04.960 --> 0:17:08.320
<v Speaker 2>be careful when you're like breastfeeding, it's sort of easy

0:17:08.359 --> 0:17:11.680
<v Speaker 2>just to brush your face up against your baby.

0:17:12.200 --> 0:17:14.280
<v Speaker 1>It seems. With newborns, you know, they've just come out

0:17:14.320 --> 0:17:18.480
<v Speaker 1>of sterile environment inside their mother, and they have an

0:17:18.520 --> 0:17:21.359
<v Speaker 1>immune system that works okay for lots of things. They're

0:17:21.400 --> 0:17:24.639
<v Speaker 1>immediately exposed to dirt and god knows what, and you know,

0:17:24.720 --> 0:17:26.840
<v Speaker 1>they cope very well with all of those pathogens that

0:17:26.880 --> 0:17:30.000
<v Speaker 1>they're exposed to in the early days of life. But

0:17:30.040 --> 0:17:31.879
<v Speaker 1>there are a couple of problems. There are things that

0:17:31.880 --> 0:17:34.119
<v Speaker 1>can be that a vaccine preventable, but they don't get

0:17:34.119 --> 0:17:37.560
<v Speaker 1>the vaccines untill later on. I'm thinking hooping cough, for example.

0:17:37.880 --> 0:17:41.080
<v Speaker 1>And then there are things that they're just really bad

0:17:41.080 --> 0:17:45.159
<v Speaker 1>at fighting off GBS in which we've discussed in the past,

0:17:45.359 --> 0:17:48.800
<v Speaker 1>and this family of viruses that can cause overwhelming infections

0:17:48.840 --> 0:17:49.399
<v Speaker 1>and so on.

0:17:49.440 --> 0:17:51.920
<v Speaker 2>The kissing of the baby. You know, sometimes you have

0:17:51.960 --> 0:17:54.880
<v Speaker 2>to have those difficult conversations with your near and dear

0:17:55.359 --> 0:17:57.000
<v Speaker 2>to say, please, don't kiss my baby.

0:17:57.160 --> 0:17:59.760
<v Speaker 1>Yeah, so I think that device we give family members

0:17:59.760 --> 0:18:01.719
<v Speaker 1>to come visit the baby if you've got a cold

0:18:02.080 --> 0:18:04.440
<v Speaker 1>one hundred percent. That also includes if you've got an

0:18:04.800 --> 0:18:06.760
<v Speaker 1>rol abial herpi is lesion on your face.

0:18:07.440 --> 0:18:11.040
<v Speaker 2>And if you like me, I can predict within a

0:18:11.160 --> 0:18:13.760
<v Speaker 2>day if I've got a little bit of sunburn on

0:18:13.760 --> 0:18:16.120
<v Speaker 2>my face, I will get a lesion on my lip.

0:18:16.720 --> 0:18:21.920
<v Speaker 1>Yeah. It seemed to be particularly promoted by sunburn.

0:18:22.080 --> 0:18:25.080
<v Speaker 2>Yeah, so that's another way you can prevent it. All right,

0:18:25.080 --> 0:18:25.919
<v Speaker 2>how did my summary go?

0:18:26.080 --> 0:18:26.639
<v Speaker 1>That's pretty good?

0:18:26.680 --> 0:18:29.040
<v Speaker 2>Ah? Good, okay, all right? Everyone. Well, I hope that

0:18:29.359 --> 0:18:32.840
<v Speaker 2>gives you enough information about herpes. It's such a common virus.

0:18:33.720 --> 0:18:36.880
<v Speaker 2>You know, two thirds of the population has HSV one.

0:18:37.400 --> 0:18:39.480
<v Speaker 2>So I hope they give you enough information that you

0:18:39.640 --> 0:18:42.400
<v Speaker 2>can be the full bottle when it comes to herpes

0:18:42.440 --> 0:18:43.280
<v Speaker 2>in pregnancy.

0:18:43.440 --> 0:18:43.760
<v Speaker 1>Perfect.

0:18:43.880 --> 0:18:44.720
<v Speaker 2>That's it for this week.

0:18:44.800 --> 0:18:45.440
<v Speaker 1>Thanks for listening.

0:18:45.440 --> 0:18:47.600
<v Speaker 2>Everybody, have a fabulous week. By for nour