A Familiar Childhood Infection

Oral herpes typically appears first in early childhood. In fact, at least 70 percent of youngsters under the age of 14 may carry the virus. Once infected, a person carries oral herpes indefinitely. In many carriers, however, the virus stays dormant in the body and does not cause problems. Children often contract the oral herpes virus through direct contact with someone who has cold sores, often by kissing or sharing eating utensils. The tendency of toddlers to put everything in their mouths makes them more likely to catch the virus. But because carriers with no symptoms can also transmit the infection, you cannot prevent every case of oral herpes—no matter how careful you are. Even so, you can minimize your children's risk of catching or spreading oral herpes by taking these precautions:

• Do not allow people with cold sores to kiss your children.
• Discourage children from sharing eating utensils, lip balm, and towels.
• Keep children at home when they have cold sores.
• Make sure that your child's dentist or hygienist sterilizes all instruments before using them.

Many children contract the oral herpes virus without showing obvious signs of illness. With other children, however, symptoms resembling those of a strep infection or infectious mononucleosis appear from two to 20 days after being exposed to the virus. Symptoms of a first-time oral herpes infection may include the following:

• a blister or cluster of blisters on the lips, tongue, floor, or roof of the mouth
• oral pain or irritation
• sore throat
• swollen gums and lips
• headache
• chills
• mild fever
• enlarged glands
• poor appetite

Call your child's health care provider if you suspect that the child has oral herpes. Treatment to reduce the child's discomfort may include rest, non-acidic cool drinks such as apple or apricot juice, mild pain relievers, and prescription ointments, mouth rinses, or gargles. Avoid using creams and ointments containing cortisone or other steroids, because these preparations may spread an oral herpes infection.

The fever and pain of a first outbreak may last up to one week. The irregularly shaped sores that appear after the blisters burst may take as long as two weeks to disappear completely.