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	<title>Symptom Advice .com &#187; medical question</title>
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		<title>STEVEN KALAS: Fine line between protecting children and overreacting to health problem</title>
		<link>http://symptomadvice.com/steven-kalas-fine-line-between-protecting-children-and-overreacting-to-health-problem/</link>
		<comments>http://symptomadvice.com/steven-kalas-fine-line-between-protecting-children-and-overreacting-to-health-problem/#comments</comments>
		<pubDate>Sat, 10 Sep 2011 06:51:09 +0000</pubDate>
		<dc:creator>Symptom Advice</dc:creator>
				<category><![CDATA[herpes symptoms]]></category>
		<category><![CDATA[amarillo texas]]></category>
		<category><![CDATA[medical question]]></category>
		<category><![CDATA[oral herpes]]></category>

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		<description><![CDATA[I enjoy reading your column and hope &#121;&#111;&#117; &#099;&#097;&#110; offer me insight. I have a 9-year-old daughter &#119;&#104;&#111; has a playmate &#119;&#105;&#116;&#104; herpes simplex 1. The outbreak is predominantly located &#111;&#110; &#104;&#101;&#114; lip. I have educated my daughter &#097;&#098;&#111;&#117;&#116; herpes &#8212; e.g., wash hands, &#101;&#116;&#099;. However, I &#119;&#111;&#110;&#100;&#101;&#114; if I should politely pass &#111;&#110; a [...]]]></description>
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<p>I enjoy reading your column and hope &#121;&#111;&#117; &#099;&#097;&#110; offer me insight. I have a 9-year-old daughter &#119;&#104;&#111; has a playmate &#119;&#105;&#116;&#104; herpes simplex 1. The outbreak is predominantly located &#111;&#110; &#104;&#101;&#114; lip. I have educated my daughter &#097;&#098;&#111;&#117;&#116; herpes &#8212; e.g., wash hands, &#101;&#116;&#099;. However, I &#119;&#111;&#110;&#100;&#101;&#114; if I should politely pass &#111;&#110; a play date when the child has an outbreak.</p>
<p>&#8211; Y.F., Amarillo, Texas</p>
<p>This is both a medical question and a sociocultural question. &#097;&#115; a parent, this is, &#116;&#104;&#101;&#110;, a delicate question. A balancing act.</p>
<p>A review of medical information websites is both &#117;&#115;&#101;&#102;&#117;&#108; and frustrating. The public information I&#8217;ve researched agrees &#111;&#110; the following:</p>
<p>Herpes simplex 1 (oral herpes) is a virus. &#109;&#111;&#115;&#116; people contract the virus &#105;&#110; infancy &#111;&#114; childhood. &#111;&#110;&#099;&#101; contracted, the virus remains forever. Person to person, however, &#116;&#104;&#101;&#114;&#101; is great variability &#105;&#110; how the virus &#116;&#104;&#101;&#110; behaves. Lots of people are permanently asymptomatic. &#111;&#116;&#104;&#101;&#114;&#115; have occasional outbreaks. Some have frequent outbreaks. When the virus is dormant, the risk of contagion is virtually nil.</p>
<p>During a herpes outbreak, the virus is contagious. More troublesome is the occasion of asymptomatic viral shedding, when a patient is contagious but shows no symptoms of outbreak. &#105;&#110; a world of public school and play dates, &#116;&#104;&#101;&#114;&#101; is no &#119;&#097;&#121; to be alerted to this situation.</p>
<p>The frustrating part is the wide range of medical opinions &#097;&#098;&#111;&#117;&#116; the &#8220;where and how&#8221; of catching this virus. The obvious situation is easy to avoid: no mucous membrane contact &#119;&#105;&#116;&#104; a contagious person. &#115;&#105;&#110;&#099;&#101; children don&#8217;t tend to kiss &#101;&#097;&#099;&#104; other, &#119;&#101; &#099;&#097;&#110; breathe easy. But my research turned &#117;&#112; conflicting opinions &#097;&#098;&#111;&#117;&#116; other risks of transmission. &#111;&#110;&#101; doctor writes: &#8220;Despite &#112;&#111;&#112;&#117;&#108;&#097;&#114; myth, &#105;&#116; is &#097;&#108;&#109;&#111;&#115;&#116; impossible to catch herpes &#102;&#114;&#111;&#109; surfaces, towels, &#111;&#114; washcloths.&#8221; Another medical site &#115;&#097;&#121;&#115; that &#121;&#111;&#117; &#099;&#097;&#110; catch the virus &#116;&#104;&#114;&#111;&#117;&#103;&#104; skin-to-skin contact. And &#115;&#116;&#105;&#108;&#108; another &#115;&#097;&#121;&#115; &#121;&#111;&#117; &#099;&#097;&#110; catch the virus &#102;&#114;&#111;&#109; &#8220;eating &#102;&#114;&#111;&#109; the &#115;&#097;&#109;&#101; utensil &#111;&#114; sharing a towel.&#8221;</p>
<p>So, medically speaking, we&#8217;re stuck between what &#119;&#101; &#8220;know &#119;&#101; know&#8221; &#8212; remind your children &#110;&#111;&#116; to make &#111;&#117;&#116; &#119;&#105;&#116;&#104; children &#119;&#104;&#111; have open &#099;&#111;&#108;&#100; sores! &#8212; and sorting &#111;&#117;&#116; the equation of other relative risks we&#8217;re willing to assume.</p>
<p>Enter the sociocultural factors &#8230;</p>
<p>In quality parenting, there&#8217;s a line between faithfully educating and protecting our children &#102;&#114;&#111;&#109; risk/harm and teaching them to be obsessive &#097;&#098;&#111;&#117;&#116; germs, cleanliness and the normal risks of living. I&#8217;m &#110;&#111;&#116; &#115;&#097;&#121;&#105;&#110;&#103; &#097;&#110;&#121;&#098;&#111;&#100;&#121; made me The Decider &#097;&#098;&#111;&#117;&#116; this line. Just &#115;&#097;&#121;&#105;&#110;&#103; that &#116;&#104;&#101;&#114;&#101; is a line. &#111;&#110; the &#111;&#110;&#101; hand, I want my children to be safe, to live responsibly and to value their health. &#111;&#110; the other hand, I want them to thrive, to live well and happily. This requires risk.</p>
<p>I &#116;&#104;&#105;&#110;&#107; the option of &#8220;politely passing&#8221; &#111;&#110; a play date &#119;&#105;&#116;&#104; a child &#119;&#104;&#111; has a herpes outbreak is &#110;&#111;&#116; &#111;&#110;&#101; of the options. I&#8217;m &#110;&#111;&#116; &#116;&#114;&#121;&#105;&#110;&#103; to be funny, but, &#105;&#110; our culture, &#105;&#116; is &#117;&#110;&#108;&#105;&#107;&#101;&#108;&#121; that you&#8217;d call another parent to inquire &#097;&#098;&#111;&#117;&#116; the children &#103;&#101;&#116;&#116;&#105;&#110;&#103; together, but &#8220;tag&#8221; the invitation &#119;&#105;&#116;&#104; &#8220;but &#102;&#105;&#114;&#115;&#116; let me &#097;&#115;&#107; if your child has herpes simplex 1 and is he/she &#099;&#117;&#114;&#114;&#101;&#110;&#116;&#108;&#121; &#104;&#097;&#118;&#105;&#110;&#103; an outbreak?&#8221; I&#8217;m &#115;&#097;&#121;&#105;&#110;&#103; you&#8217;re &#110;&#111;&#116; going to know &#097;&#098;&#111;&#117;&#116; this unless and &#117;&#110;&#116;&#105;&#108; &#121;&#111;&#117; &#115;&#101;&#101; that the child is &#104;&#097;&#118;&#105;&#110;&#103; an outbreak. Which is when you&#8217;re going to have to deal &#119;&#105;&#116;&#104; &#105;&#116;, &#101;&#105;&#116;&#104;&#101;&#114; by assuming the risk, &#111;&#114; by taking the child back home and explaining to the parent(s) your grounds &#102;&#111;&#114; doing &#115;&#111;.</p>
<p>If &#105;&#116; matters, here&#8217;s how the equation works &#111;&#117;&#116; &#102;&#111;&#114; me &#097;&#115; a father:</p>
<p>If a parent delivered a child to my house and I observed an obvious oral herpes outbreak, I&#8217;d probably gather both kids together and &#103;&#105;&#118;&#101; them an educational review of the matter: Both of &#121;&#111;&#117; avoid hand contact &#119;&#105;&#116;&#104; the sore &#8230; don&#8217;t share lollipops &#111;&#114; gum &#8230; no spitting &#111;&#110; &#101;&#097;&#099;&#104; other &#8230; and absolutely no kissing! &#109;&#097;&#121;&#098;&#101;, just &#109;&#097;&#121;&#098;&#101;, I&#8217;d call the other parent and back-end a segue by &#115;&#097;&#121;&#105;&#110;&#103;, &#119;&#105;&#116;&#104; all compassion: &#8220;I notice that your daughter has a &#099;&#111;&#108;&#100; sore. Is &#116;&#104;&#101;&#114;&#101; anything I should know &#097;&#098;&#111;&#117;&#116; &#105;&#116;, should she complain of discomfort, &#101;&#116;&#099;.?&#8221;</p>
<p>I want my children to be safe. But I don&#8217;t want them assuming responsibility &#102;&#111;&#114; my own social discomfort &#111;&#114; undue anxiety. I don&#8217;t want to teach them to be all &#8220;hoity toity&#8221; &#097;&#098;&#111;&#117;&#116; life.</p>
<p>But, &#115;&#116;&#105;&#108;&#108;, you&#8217;ll draw &#116;&#104;&#111;&#115;&#101; &#115;&#097;&#109;&#101; lines &#119;&#104;&#101;&#114;&#101; you&#8217;re comfortable. Talk to your pediatrician, and make sure &#121;&#111;&#117; have the &#098;&#101;&#115;&#116; information &#112;&#111;&#115;&#115;&#105;&#098;&#108;&#101;.</p>
<p>Steven Kalas is a behavioral health consultant and counselor at Las Vegas Psychiatry and the author of &#8220;Human Matters: Wise and Witty Counsel &#111;&#110; Relationships, Parenting, Grief and Doing the Right Thing&#8221; (Stephens Press). His columns also &#097;&#112;&#112;&#101;&#097;&#114; &#111;&#110; Sundays &#105;&#110; the Las Vegas Review-Journal. Contact &#104;&#105;&#109; at 227-4165 &#111;&#114; skalas@reviewjournal.&#099;&#111;&#109;.</p></p>
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