I was recently diagnosed with herpetic whitlow. I am a dental hygienist, and I imagine that is how I contracted this. How long am I considered contagious? I am also pregnant, so is there any risk of spreading this to the baby? Any information you could give me would be appreciated.

Fran

Herpetic whitlow is an infection of the finger by the herpes simplex virus (HSV). There are two types of herpes simplex viruses, HSV-1 and HSV-2. Herpetic whitlow is typically caused by HSV-1, the type that generally causes oral herpes. Herpes can infect any site on the skin, but the finger is probably the most common. Children newly infected with oral herpes can spread it to their thumbs during sucking. In adults, it also can be spread from an oral lesion, almost always after a primary (new) infection rather than recurrences.

Health care workers such as dental hygienists frequently develop herpetic whitlow after caring for patients with oral herpes. A person infected with HSV can transmit it to others even if he or she has no active lesions, so you may have contracted it from any one of your patients. This infection is just one more reason to wear gloves with every single patient.

Unlike oral and genital herpes, which the infected person can transmit even when he or she has no visible lesions, herpetic whitlow probably is less likely to spread in the absence of lesions. You are probably contagious as long as you have a wet, open lesion. Since you have it only on your finger, you are probably not infectious as long as you have gloves on. But to be safe, I would probably advise you to avoid treating patients while you have the lesion. Herpetic whitlow can recur, though usually not as often as do oral or genital herpes.

As far as your baby is concerned, you are probably okay. It is really genital herpes that causes the most problems for newborns. Women who become infected shortly before delivery and have genital lesions at the time of delivery are most likely to transmit the infection to the baby, although individuals with recurrent herpes lesions also can infect the baby during delivery.

Far less common is infection during pregnancy, long before delivery. Infection of the fetus can result in stillbirth and congenital anomalies. Most of the data on transmission to the fetus involve genital herpes, not oral herpes. Since whitlow is far less common than either oral or genital herpes, I would guess that the risk of transmission to the fetus in someone with this condition would be very low. Acyclovir (Zovirax) is thought to be safe during pregnancy and is often given to pregnant women with a primary herpes infection. We don't know if it reduces the rate of fetal infection, however, because infection during pregnancy is too rare to study in a controlled manner.