STEVEN KALAS: Fine line between protecting children and overreacting to health problem

— Y.F., Amarillo, Texas

This is both a medical question and a sociocultural question. As a parent, this is, then, a delicate question. A balancing act.

A review of medical information websites is both useful and frustrating. The public information I’ve researched agrees on the following:

Herpes simplex 1 (oral herpes) is a virus. Most people contract the virus in infancy or childhood. Once contracted, the virus remains forever. Person to person, however, there is great variability in how the virus then behaves. Lots of people are permanently asymptomatic. Others have occasional outbreaks. Some have frequent outbreaks. When the virus is dormant, the risk of contagion is virtually nil.

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. In a world of public school and play dates, there is no way to be alerted to this situation.

The frustrating part is the wide range of medical opinions about the “where and how” of catching this virus. The obvious situation is easy to avoid: no mucous membrane contact with a contagious person. Since children don’t tend to kiss each other, we can breathe easy. But my research turned up conflicting opinions about other risks of transmission. One doctor writes: “Despite popular myth, it is almost impossible to catch herpes from surfaces, towels, or washcloths.” Another medical site says that you can catch the virus through skin-to-skin contact. And still another says you can catch the virus from “eating from the same utensil or sharing a towel.”

So, medically speaking, we’re stuck between what we “know we know” — remind your children not to make out with children who have open cold sores! — and sorting out the equation of other relative risks we’re willing to assume.

Enter the sociocultural factors …

In quality parenting, there’s a line between faithfully educating and protecting our children from risk/harm and teaching them to be obsessive about germs, cleanliness and the normal risks of living. I’m not saying anybody made me The Decider about this line. Just saying that there is a line. On the one hand, I want my children to be safe, to live responsibly and to value their health. On the other hand, I want them to thrive, to live well and happily. This requires risk.

I think the option of “politely passing” on a play date with a child who has a herpes outbreak is not one of the options. I’m not trying to be funny, but, in our culture, it is unlikely that you’d call another parent to inquire about the children getting together, but “tag” the invitation with “but first let me ask if your child has herpes simplex 1 and is he/she currently having an outbreak?” I’m saying you’re not going to know about this unless and until you see that the child is having an outbreak. Which is when you’re going to have to deal with it, either by assuming the risk, or by taking the child back home and explaining to the parent(s) your grounds for doing so.

If it matters, here’s how the equation works out for me as a father:

If a parent delivered a child to my house and I observed an obvious oral herpes outbreak, I’d probably gather both kids together and give them an educational review of the matter: Both of you avoid hand contact with the sore … don’t share lollipops or gum … no spitting on each other … and absolutely no kissing! Maybe, just maybe, I’d call the other parent and back-end a segue by saying, with all compassion: “I notice that your daughter has a cold sore. Is there anything I should know about it, should she complain of discomfort, etc.?”

I want my children to be safe. But I don’t want them assuming responsibility for my own social discomfort or undue anxiety. I don’t want to teach them to be all “hoity toity” about life.

But, still, you’ll draw those same lines where you’re comfortable. Talk to your pediatrician, and make sure you have the best information possible.

Steven Kalas is a behavioral health consultant and counselor at Las Vegas Psychiatry and the author of “Human Matters: Wise and Witty Counsel on Relationships, Parenting, Grief and Doing the Right Thing” (Stephens Press). His columns also appear on Sundays in the Las Vegas Review-Journal. Contact him at 227-4165 or skalas@reviewjournal.com.