Cold sores, also known as fever blisters or oral herpes, are a common viral infection caused by the herpes simplex virus (HSV). While often considered a minor inconvenience for adults, babies can indeed contract cold sores, and the infection can pose serious health concerns for them. The primary cause is typically herpes simplex virus type 1 (HSV-1), though herpes simplex virus type 2 (HSV-2) can also be responsible. The immature immune systems of infants make them particularly susceptible to severe complications from this virus.
How Infants Contract Cold Sores
Infants primarily contract the herpes simplex virus through direct contact with someone who has an active cold sore, often via close physical interactions like kissing or touching. The virus is highly contagious and can spread even when a cold sore isn’t visibly oozing, though it is most contagious during the blistering stage. Sharing personal items like utensils or towels can also facilitate transmission. While the virus can shed in saliva without an active sore, direct contact with a lesion poses the highest risk. Newborns can also acquire the virus during vaginal birth if the birthing parent has active genital herpes.
Identifying Cold Sore Symptoms in Babies
Cold sore symptoms in babies can initially appear as small, fluid-filled blisters, often around the mouth and lips. They can also emerge on the nose, chin, cheeks, or inside the mouth. These blisters may merge, burst, and then crust over. The healing process typically takes one to two weeks.
Beyond visible sores, infants with a cold sore infection may exhibit other systemic symptoms. These include fever, irritability, and difficulty feeding. Swollen glands in the neck might also be present, and a baby may seem more lethargic than usual. Symptoms typically begin one to three weeks after exposure.
Why Cold Sores Pose a Risk to Infants
Cold sores are considerably more serious for infants, particularly those under six months, due to their developing immune systems. Unlike older children or adults whose immune systems can typically contain the virus, an infant’s body is less equipped to fight the infection effectively. This limited immune response increases the risk of the virus spreading beyond initial skin lesions.
When the virus disseminates, it can lead to disseminated HSV, where the infection spreads to multiple organs throughout the body. Organs like the liver, lungs, and adrenal glands can be affected, leading to severe illness and potential organ failure. A particularly severe complication is herpes encephalitis, where the virus infects the brain and central nervous system. This can result in significant neurological damage, long-term developmental problems, or be life-threatening.
Seeking Care and Preventing Transmission
Immediate medical attention is important if a baby exhibits any signs of a cold sore or has been exposed to someone with an active cold sore. Prompt diagnosis and treatment can significantly improve outcomes and reduce the risk of serious complications. Doctors may diagnose the infection through tests of samples from blisters and often prescribe antiviral medications like acyclovir. These medications are typically administered intravenously, especially for newborns, to prevent the virus from spreading and causing severe illness.
Caregivers can take several steps to prevent cold sore transmission to infants.
Avoid kissing a baby if you have an active cold sore.
Practice strict hand hygiene, washing hands thoroughly with soap and water before touching the baby.
Avoid sharing eating utensils, towels, or other personal items that might come into contact with the virus.
Cover an active cold sore to reduce inadvertent contact and transmission.