Father's deadly kiss

The tale of an accidental infant death from herpes should raise alarms for the public as well as the city's government about the severity of herpes

A doting British father's affectionate kiss on his baby boy proved deadly as he died of multiple organ failure resulting from cold sore infection.
Born prematurely, two-month-old Kaiden McCormick had been put on life-support for six weeks before his parents reluctantly decided to have him taken off the machine upon doctors' advice in early March this year.

However, according to Dr Yeung Chi-keung, a clinical associate professor of the Department of Medicine at Hong Kong University, baby McCormick's death is a "rare" and "tragic" outcome of herpes infection due to a weak immune system.

This implies that cold sore, the most obvious symptom of the herpes simplex type one virus characterised by blisters around the mouth area, is generally not fatal. It should therefore not be confused with type two herpes simplex, which takes the form of a sexually transmitted disease (STD)—genital herpes.

In his argument against the general belief that herpes is uncommon in Hong Kong, Dr Yeung points out that about 90 percent of the population have been infected with the virus, with around 50 percent of them being oblivious to the disease as they tend to mistaken the mild symptoms for bacterial infection or ulcers.

He adds that children are usually first exposed to herpes when they attend kindergarten, mainly through skin contact with eye, nasal or oral mucous discharge of peers carrying the virus.

Despite the prevalence and highly contagious nature of the disease, particularly when it comes to infants and children, the government has made fairly minimal effort to raise public awareness of it when compared to other industrialised countries, such as the United States.

Dr Kwan Yat-wah , associate consultant and sub-specialist in Paediatric Immunology and Infectious Diseases, says public awareness of herpes could be reinforced by providing late primary and early secondary school children with greater access to basic health information, as well as strengthening health education for expectant mothers visiting clinics for prenatal check-up or parents having their babies vaccinated at Maternal and Child Health Centres.

Dr Sally Ferguson, a British gynecologist with 24 years of medical practice in both Hong Kong's public and private medical sectors, proposes that besides bolstering public education in personal hygiene, the city should adopt health education courses provided regularly to students in America.

Having said that, although herpes simplex is a very common and, in most cases, harmless disease, it should be dealt with cautiously.

According to Dr Kwan, extreme cases of herpes may occur when the virus has entered the brain. Complications triggered by the disease can lead to meningitis or memory loss in the long term. If the virus has spread to the mouth and ear nerves, it could cause long-term defects and permanent damage to the child's hearing or speaking abilities.

Another dangerous infection of herpes takes place when the virus interacts with another common skin disease eczema, which may lead to a potentially life-threateningcomplication known as eczema herpeticum.

Dr Yeung points out that herpes simplex is divided into two stages – primary and secondary. The former means that the individual has caught the virus for the first time without any immunity from the past, and symptoms present at this stage are most noticeable as pain sores will surface around the mouth, gums and lips and often last for a week or so; children infected with the disease may also develop rashes.

The dermatological specialist adds that the secondary stage appears as a recurrent phase with tiny blisters that erode the skin and form dry scalp.

There is currently no cure for the illness as the virus will become dormant within one's nervous tissues and a relapse could take place when the immune system of the patient is weak.

On cases where the parent has sores around their mouth, Dr Kwan suggests consulting a doctor to be certain that they are not blisters before making any physical contact with children to avoid herpes transmission.

"Presently there are no official epidemiological study on the overall prevalence of herpes infection among the population in Hong Kong," said Kwan.

Reported by Karen Lee

Edited by Brian Yap