In Reply.—Dr Gushurst's comments underscore the major issues we presented in our article. We appreciate her documentation of two additional cases of genital HSV in prepubertal children. The three-year interval between the first HSV episode and the social investigation in the first case and the young age of the patient in the second case are both factors that decrease the likelihood of uncovering sexual abuse. As has been shown for other sexually transmitted diseases,1,2 the most thorough investigation of children with genital HSV infections will inevitably fail to elicit a history of sexual abuse in some cases even if the degree of suspicion is high. This knowledge cannot deter us from investigating each case: the evidence suggests that the majority of cases of genital HSV in American children are sexually transmitted.3
Researchers have shown that HSV can survive in formites4,5 but have not demonstrated that virus from
KAPLAN KM, FLEISHER GR, PARADISE JE, FRIEDMAN HM. The Problem of Genital Herpes in Prepubertal Children-Reply. Am J Dis Child. 1985;139(6):543–544. doi:10.1001/archpedi.1985.02140080012008
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