HSV-1 Whitlow

[ana010]

There is a special needs student on one of the campuses in our district with an HSV-1 Whitlow. He is treated with oral ani viral. He is non verbal, rather drooly and keeps his hands in his mouth. When there is an outbreak on his finger, it is most difficult to keep it covered.

Suggestions on how to handle this? The nurse on his campus has a good rapport with his mother and they are working together to creatively follow universal precautions with this.

That being said, the non licensed professionals in the classroom are completely beside themselves and want him sent home with any obvious sign of a lesion.

Nurse on said campus is checking with our local health unit (Dept of Health) for further clarification and direction.

Anyone with similar experience or helpful suggestions?

[Eleven011]

I'm not familiar with that particular virus (will have to google), but if there are lesions on his fingers, couldn't you use a dressing, followed by a rubber glove to protect from the mouth secretions?

[MrNurse(x2), ADN]

followed by a rubber glove to protect from the mouth secretions?

Good thinking on the glove.

[abc123RN]

I'm not familiar with that particular virus (will have to google), but if there are lesions on his fingers, couldn't you use a dressing, followed by a rubber glove to protect from the mouth secretions?

That's what I was thinking, dressing and glove. Would he leave the glove in place or pull it off?

[Flare, ASN, BSN]

if he is treated with a daily oral anti viral, then the liklihood of transmission is fairly low to begin with, but that being said, it's still a good idea for people working with the child to be very mindful that they should be extra cautions to wash their hands carefully and cover any open sores on hands. If he does have an outbreak, then it may be beneficial to keep him out of school at least until cleared by a physician.

Without knowing this child, i would be surprised if he'd keep on gloves on his own - but he may. That's another possibility if he's compliant and having an outbreak.

[kidzcare]

My concern on the glove is that it could create a choking hazard if he has his hands in his mouth frequently

[OldDude]

As Flare mentioned, it will be very difficult to keep an impermeable glove on a child like this. I don't know how big he is but you might try a latex/nitrile glove over a dressing and then cover all that with something like a batting glove - something you can cinch at the wrist during the outbreaks. He can still have the oral stim and the outer glove should be able to take it. Just a maybe.

And...I'm sure the the aides are beside themselves because they are not being selfish but are worried about the other kids in the class.

[ana010]

That's what I was thinking, dressing and glove. Would he leave the glove in place or pull it off?

He will pull it off.

[ana010]

And...I'm sure the the aides are beside themselves because they are not being selfish but are worried about the other kids in the class.

Exactly.

And thanks for batting glove idea

[Jedrnurse, BSN, RN]

I have absolutely NO idea if this is clinically valid, but what about the "paint-on" band-aids, e.g. "Nu Skin"? Might they provide a barrier to help prevent virus from shedding?