Genital Herpes: Prevention

To prevent genital herpes, attention must be paid to reducing risk factors.

Behavioral risk factors

  • Close physical contact
  • Sexual transmission
    • Promiscuity (sexual contact with relatively frequently changing different partners).
    • Prostitution
    • Men who have sex with men (MSM).
    • Sexual contacts in the vacation country
    • Unprotected coitus (condom does not protect 100% against transmission, but should be used preventively).
  • Sexual practices with high risk of mucosal injury (eg, unprotected anal intercourse).

Prophylaxis of herpes neonatorum (neonatal herpes)

  • Examination of the immune status of pregnant women in the first trimester (third trimester): hygienic precautions should be taken if the expectant mother is seronegative and her partner is seropositive:
    • Observation of general hygiene measures – especially genital hygiene (see below “Further therapy/general measures).
    • Genital contacts exclusively by means of condoms; prohibition of orogenital contacts in case of herpes symptoms of the partner. These measures apply especially in the third trimester.
  • Staff affected by herpes (doctor. midwife, nurse) should be excluded as far as possible in the care of the patient and the newborn. If this is not possible, extreme caution is required (adherence to all necessary hygiene measures).
  • If necessary, for relapse prevention peripartum (“around birth”): Aciclovir, 2 x 400 mg/d p. o. or 3 x 200 mg/d p. o., starting 4 weeks before the expected date of birth.
  • Primary Sectio caesarea: This is only required in acute prodromes (eg, pruritus (itching), hyperesthesia (increased sensitivity of the affected region) or neuralgia (nerve pain), pain, general feeling of illness) or lesions/positive virus detection immediately peripartum (“around the due date”).
  • Breastfeeding phase: breastfeeding is allowed if the breast is free of lesions and other lesions (e.g., mouth region) are covered. Breastfeeding is also allowed while taking aciclovir.