Testing for kids

[Thinkingrunning]

I have ohsv1 since my childhood (classic cold sores) and possibly ghsv1 (there are sores in my genital area that I am gettingpcr swab tested). Tested neg for hsv2 igG antibodies. I have a 3 year old and 5 year old. 3 year old had some redness that lasted about 3 days on her lower vermillion border. It didn’t look like the classic cluster of blisters but the location concerned me. She had a couple small red sores on her upper lip that lasted about 5 to 6 days a couple months later. Never got it swabbed bc we were out of town. Now she’s having red folluculitis type sores repeatedly every month or so on her but on right side. The area is pretty red and Gerd better in about a week. Pediatrician does not want to swab but I am worried she accidentally got infected with my ohsv1 by accident bc it has been recurrent and red. I get cold sores and try to take precautions but maybe I didn’t wash hands when changing diaper, applying diaper cream to her vulnerable spots, or accidentally spit in the area so viral particles got on her butt or vulva.. I want to test my kids blood for hsv igG or can I do western blot since it is more accurate. This is really upsetting me to the point I’m really nervous to check and let my kids share a bathroom. I don’t want it to spread. I know the chances are low but I think definitive answer by testing would be very helpful for me to move forward and stop worrying. I am extra extra careful needless to say around my kids.

[Terri Warren]

I am pleading with you not to do this to your children.
IgG tests are never recommended for children because they have a 50% false positive rate. If you have concerns about some physical presentation, you should get them swab tested. If their doctor refuses, you could find another clinician or obtain one yourself online b ut please – do NOT request or demand an IgG blood test.

I have concerns that this focus on HSV could be challenging for your children. I know you are doing your best to be a good mom but this focus may not be ideal.

Terri

[Thinkingrunning]

1. I will not ask for IgG test since you said they are not accurate and have 50% false positive rate. I would like to get testing done to see if my kids have HSV1. What about the western blot, is this test accurate for children?

2. I know you say that i should get any concerning spots swabbed for pcr testing, but swab testing seems dependent on good timing and proper sample collection technique (unroofing the blister to obtain adequate fluid sample) that I worry I will “miss the window” or get a false neg. It is also difficult for me to go to the doctor’s office as I have to take leave from work (full time). I think it would be easier and I would feel more confidant to have a western blot result for my kids to give me the final answer. Given how much this has caused me to worry about my kids, I am really considering going forward with western blot testing for them so I can have an answer and be able to move forward rather than worry about every little red bump. I have no intention to put them through anything difficult which is why i think it would probably be better to get the blot done than have to take my daughter in repeatedly to the doctor’s office. How do I go about getting western blot test for my kids?

3. I had what looked like a cluster of 5 spots on red base that turned into red ulcers that got larger and scabbed on upper right part of my buttock. I am not on AV and swabbed aggressively on the first day the red dots appeared using 24/7 lab kit and shipped it out on March 30th. Apparently there was a delay in the lab-I did not get my final result (neg for HSV 1 and 2) until 4/13 (2 weeks later). Can I trust this result or is a neg result more likely to be false if the sample was sitting there and not tested for 2 weeks? The lab told me that HSV stability is around 36 days before it can be determined unqualified and said to me that my result is accurate. However, on the website it said that testing is time sensitive and needs to be shipped immediately.

[Terri Warren]

I can’t order the western blot for your children because I am an adult nurse practitioner only. I’ve never had a parent ask me to order this, but you could certainly talk to your pediatrician about it.

Because the PCR sample is looking for genetic material and not trying to grow something, the swab test is stable for a long time. UW would disagree that it is unstable after 36 days – they would say far, far longer. it sounds like you were aggressive in your collection of the sample, which is good. You could repeat it once more if you question the results.

You could also consider this for your children, you know. Talk to your pediatrician about it -they might be willing to give you swabs to take home for the kids as well.

Terri

[Thinkingrunning]

Thank you for taking my unusual questions seriously.

1 If I wanted the ped to order the WB, do I just ask them to contact U of Washington or what are they supposed to do exactly? I doubt has ordered WB before so I thought i should have some idea of what it is I am asking them to do.

2 Have you ever seen or heard of a case of parent accidentally infecting their child’s genitals with parent’s oHSV1 -spreading it with their hands during diaper changes or by spit droplets while talking during a diaper change? I have oHSV1 and wonder if it is possible to infect my children’s genitals during a diaper change if say I hadn’t washed my hands properly or accidentally some spit from my mouth flew into their genital region when I was changing their diapers. Have you ever seen or heard of a case like this? This is my worst fear. I understand it is easy for children to get oral HSV from me by kissing.

3 The reason I worry so much is because my daughter has reoccurring areas of red irritation or what looks like folliculitis on her butt and genitals. Peds said that it looked like irritation but didn’t seem to know for sure and said that there was no fluid to swab. I don’t know why my 3 year old who wears underwear and only diapers at night would have reoccurring folliculitis and red marks of irritation down there. She takes baths daily and we clean her well. How many cases have you seen of kids where parents thought kids might have caught gHSV and it ended up being something else? what did it end up being instead?

4 Good to know that PCR test swab sample is stable for long time. I swabbed the first day I noticed the little red sores on my upper butt when they were just forming and did get a little blood when swabbing. The next few days the sores grew in size and looked like ulcers. It took a long time to heal and left a scar. I really thought it was HSV and the PCR (24/7 labs) result came back neg. Is it possible I swabbed the blisters too early? Should I swab test again?

[Terri Warren]

1 If I wanted the ped to order the WB, do I just ask them to contact U of Washington or what are they supposed to do exactly? I doubt has ordered WB before so I thought i should have some idea of what it is I am asking them to do.
yes, they could contact UW directly, 206-685-6066

2 Have you ever seen or heard of a case of parent accidentally infecting their child’s genitals with parent’s oHSV1 -spreading it with their hands during diaper changes or by spit droplets while talking during a diaper change? I have oHSV1 and wonder if it is possible to infect my children’s genitals during a diaper change if say I hadn’t washed my hands properly or accidentally some spit from my mouth flew into their genital region when I was changing their diapers. Have you ever seen or heard of a case like this? This is my worst fear. I understand it is easy for children to get oral HSV from me by kissing.
Never, ever, no

3 The reason I worry so much is because my daughter has reoccurring areas of red irritation or what looks like folliculitis on her butt and genitals. Peds said that it looked like irritation but didn’t seem to know for sure and said that there was no fluid to swab. I don’t know why my 3 year old who wears underwear and only diapers at night would have reoccurring folliculitis and red marks of irritation down there. She takes baths daily and we clean her well. How many cases have you seen of kids where parents thought kids might have caught gHSV and it ended up being something else? what did it end up being instead?
It could be fungal, bacterial, many things. Herpes wouldn’t even be on my list unless sexual abuse has occured.

4 Good to know that PCR test swab sample is stable for long time. I swabbed the first day I noticed the little red sores on my upper butt when they were just forming and did get a little blood when swabbing. The next few days the sores grew in size and looked like ulcers. It took a long time to heal and left a scar. I really thought it was HSV and the PCR (24/7 labs) result came back neg. Is it possible I swabbed the blisters too early? Should I swab test again?
Yes, you could. I would say if you have 5 negative swabs it’s not herpes

Terri

• This reply was modified 4 weeks ago by Terri Warren.

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