HPV, HSV, etc

[adoptionacres]

So I know that without an "active" herpes outbreak, a woman can deliver lady partslly w/o complications. How are y'all doing in your facilities with HPV? It has been shown to cause throat polyps in lady partslly birthed kids. One case I know of led to speech problems during the child's early developmental period and resulted in surgery to remove the polyps that can return at any time. I personally know of a man with throat cancer caused by HPV. Changing sexual practices mean this virus is no longer limited to causing just cervical cancer. I don't think we're going to get an "active" or "non-active" decision on this one. I have talked with my docs about this and we are thinking it's not going to be long before we are vaccinating both boys and girls against HPV. Any policies anywhere?

[BabyLady, BSN, RN]

The problem with herpes is that you can be active and contagious and there be NO appearance of the tell-tale blisters.

The location of the normal outbreak starts to shed cells that can transmit the herpes virus 2 to 3 days or longer, and blisters do not necessarily have to form in order for transmission to take place.

I was floored to find out recently that many OB-GYN's do not test for herpes as part of routine prenatal care...mine sure as heck did.

The problem with HPV is that there are over 90 different types. We don't know everything about all of them. Some types cause cervical cancer, others cause venereal warts, others have few to no symptoms, some go away spontaneously...so just because a woman has an HPV test come up positive during an abnormal pap, they can have another one that comes back perfectly normal...and they do not understand why.

The Gardasil vaccine only protects against the 7 types of HPV that cause cervical cancer....but HPV is not the only cause of cervical cancer, and it also doesn't mean your daughter will never get HPV.

[Elvish, BSN, DNP, RN, NP]

Far as I know, we don't screen for HPV, and we birth babies lady partslly to moms with HPV all the time. We note it and watch the kids, but nothing else.

The worst case of neonatal HSV I have ever seen was with a mom that didn't have her sentinel outbreak until after she delivered - lady partslly, of course. That baby started out fine but in about 24 hours, started decompensating and ended up with severe neuro deficits.

[Aneroo, LPN]

I was floored to find out recently that many OB-GYN's do not test for herpes as part of routine prenatal care...mine sure as heck did.

The problem with HSV testing is that there either needs to be an active outbreak, or else it is not specific (a history of oral herpes/cold sores can cause a positive).

I have talked with my docs about this and we are thinking it's not going to be long before we are vaccinating both boys and girls against HPV. Any policies anywhere?

What age groups are you talking about? Gardasil is not indicated for males. They are working on a male version, but it will still be a while (talking years) before anything is ready and has gone through the FDA.

[chgoreid]

The Gardasil vaccine only protects against the 7 types of HPV that cause cervical cancer....but HPV is not the only cause of cervical cancer, and it also doesn't mean your daughter will never get HPV.

Actually it only protects against 4; 2 that cause cancer and 2 that cause the warts. Usually the ones that cause the warts don't cause cancer. From the gardasil website: "GARDASIL is the only cervical cancer vaccine that helps protect against 4 types of human papillomavirus (HPV): 2 types that cause 70% of cervical cancer cases, and 2 more types that cause 90% of genital warts cases." Just wanted to clarify for everyone.

[Aneroo, LPN]

Gardasil Vaccine Info Sheet for those interested:

http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-hpv.pdf