I'm afraid that I have infected my baby with herpes. Symptoms and treatment of herpes in an infant

There are many viruses in our environment that can infect both adults and children, and people often do not know that they themselves are carriers of any viral infections. One of the most common is herpes infection. When its manifestations occur in an adult, it does not surprise anyone, but when it appears in a baby, it undoubtedly frightens parents. Let's try to figure out what the features of this are in children.

What is herpes

Herpes is the general name for a whole complex of different herpes viruses that arise as a result of one of the many herpes viruses entering the body. The specificity of the virus is that it can infect any human organ. There are about 200 types of virus in total, but only 8 of them are found in humans. Adults are equally susceptible to infection with herpes, but in children the disease can be more acute.

Herpes is extremely widespread among the world's population: about 90% of people are carriers of the virus. The virus usually enters the child’s body from infected parents, and since he does not yet have antibodies, we are talking about primary herpes, the manifestations of which are more dangerous for children than relapses.

Did you know?The herpes virus first became known after its symptoms were described by the doctor of Louis IV; in the 18th century, most of the king’s courtiers suffered from the disease.

Types of childhood herpes

Of the existing 8 types of herpes, only 6 have been well studied:

• herpes type 1, commonly known as fever. Occurs on the lip or in the oral cavity;
• Type 2, the most common among the adult population, manifests itself on the human genitals; a child can become infected with it from a sick mother when passing
• Herpes virus type 3 is known to almost everyone - it is a virus that causes common chickenpox in children during primary infection. In adulthood, with relapses, it manifests itself as shingles.
• Type 4 is not the most common, it can manifest itself as a dangerous infectious disease -
• Type 5 of the virus is called. The vast majority of people are asymptomatic during childhood and remain carriers;
• Herpes type 6 causes a disease characteristic of children under 2 years of age - roseola.

Sources, routes of infection

The main way of transmitting any type of herpes virus is contact with a virus carrier. How do children become infected? The following paths are available:

1. The first place in these statistics belongs to the infection of a child from a mother during an exacerbation of her herpes infection during childbirth or during the neonatal period.
2. Contact with anyone who has ever had symptoms of herpes, since the spread of the virus is possible even if the carrier has no symptoms.
3. The household route of infection is possible through the use of shared utensils, personal hygiene items, and toys.
4. Airborne droplets are a rather rare but possible method of transmission of the virus; it occurs only through close contact with a sick person.
5. Intrauterine infection. The most dangerous type of herpes transmission is when the mother becomes infected with the virus and suffers the primary disease. In such cases, the consequences for the fetus can be sad, even severe.

Important! In a woman who has already suffered a primary infection previously, the consequences of relapses during pregnancy are not so dangerous for the fetus, since it is protected by maternal antibodies.

Incubation period and main symptoms

The symptoms of herpes infection in children and adults do not differ significantly, with the exception of some specific points. However, in general The disease in children can occur in a more acute form.

The incubation period lasts up to 26 days, but in most cases the first symptoms appear within two weeks from the moment of infection.

During primary infection, the disease is most often accompanied by a deterioration in general condition, weakness, muscle pain, in some cases the temperature rises, signs of intoxication appear, and the lymph nodes become enlarged. Then rashes appear that are ulcerative in nature. The favorite localization of herpes is the lips, chin, oral mucosa, including the throat. The rash looks like a cluster of small blisters with liquid; as they mature, the blisters burst and a crust forms that cannot be removed to avoid additional infection.

When infected with certain types of herpes virus, for example, chickenpox (type 3), rashes appear throughout the child’s body, in many they spread to the oral cavity and genitals.

In all cases, the disease ends with the healing of ulcers and restoration of the skin.

Which doctor should you contact?

Basically, herpes infection in children manifests itself in the traditional way, so it will be enough to consult a pediatrician who will prescribe adequate treatment. If you have shingles, your pediatrician may refer you to a dermatologist for consultation.

In cases where relapses occur very often or are accompanied by deterioration of the condition, consultation with an infectious disease specialist and an immunologist may be necessary in order to correct the treatment regimen and strengthen the immune system.

Diagnostic methods

It is not difficult to recognize herpes even at home - almost everyone is familiar with a “cold on the lips”, however, there are standard methods for diagnosing the disease:

1. Visual inspection of areas affected by rashes. Most often, after this, additional diagnostic measures are no longer required, since the manifestation of herpes is very typical.
2. Enzyme-linked immunosorbent assay (ELISA) does not show the virus itself, but the presence of antibodies to it. Depending on the type of antibodies, you can determine whether there is an infection and at what stage it is.
3. Polymerase chain reaction (PCR) is a molecular biological method for diagnosing herpes types 1 and 2. This method can only detect the presence of the disease during a relapse.
4. Immunofluorescence reaction (RIF) is a quick and simple test that is effective when a large number of infected cells are present. It is usually used in combination with other methods, as it is less accurate.
5. The cytological method, or scraping, is taken from the site of the rash. It is effective even in the absence of symptoms, but does not indicate the development phase of the disease.

How to cure a child

When parents encounter “lip fever” in a child for the first time, very often they have no idea what it is, what it is, how dangerous it is, and whether it needs to be treated at all. Nevertheless, for a small organism, primary infection is a rather difficult ordeal, so you should definitely consult a doctor.

Did you know? It turns out that the insidious virus not only causes illness and rashes, but also penetrates the human nervous system: about 15% of brain diseases are caused by herpes infection!

Local treatment of rashes is not enough - a complex effect on the virus is needed. It is important to note that therapy begins within the first three days of the disease: at a later stage, treatment has a very low effect, and helping the patient is reduced to alleviating symptoms.

The drug treatment regimen is standard:

• antiherpetic drugs based on acyclovir are currently recognized as the most effective drugs in the fight against herpes. It is worth knowing that the tablets cannot be used in newborns, but are allowed for children older than one year after consulting a doctor and agreeing on the dosage;
• to stimulate the immune system based on human interferon. They allow you to compensate for the lack of the body’s own interferon and stop the spread of the virus;
• act in combination with immunostimulants, increase the body’s resistance, and replenish the lack of nutrients;
• antipyretic drugs are used in acute cases; for children, antipyretic drugs based on ibuprofen or in the form of syrup or rectal suppositories are recommended;

• topical medications. Usually the doctor prescribes ointments based on the same acyclovir, which are applied to the affected areas several times a day. If a child has herpes directly in the mouth, natural remedies, such as a decoction of chamomile, sage, and calendula, will help treat it. Rinsing with furatsilin solution helps a lot;
• It is imperative to adhere to a diet. During illness, a child should receive warm, soft or liquid food. Spicy, fried, salty, hot and cold foods should be excluded.

. To avoid complications, when the first symptoms of the disease appear in children, you need to consult a doctor for advice and urgently begin treatment for herpes.

If there is a carrier of HSV of any type in a family with small children, it is necessary to strictly adhere to preventive measures:

• compliance with personal hygiene rules. The child must have separate dishes, a towel, and a toothbrush;
• strengthening the baby’s immunity, taking vitamin complexes, hardening, proper and rational sleep patterns;
• If we are talking about a pregnant woman, then throughout her pregnancy she needs to monitor the manifestations of the disease and receive timely treatment in order to avoid a relapse by the time of birth. If a relapse does occur after 36 weeks of gestation, it is recommended to carry out delivery by
• if the mother is a carrier of herpes, the best method of preventing the disease for newborns will be long-term - with the mother’s milk, the child will receive antibodies to the pathogen;
• in cases where the disease has already made itself felt, itching or the first rashes have appeared, immediate local application for herpes, approved for use for children and prescribed by your doctor, is necessary;
• regular examination of the child by an ENT doctor and dentist to exclude inflammatory diseases in the oral cavity, since they can also trigger a relapse.

After getting acquainted with the information about the herpes virus, we can say with confidence that it is dangerous for the child’s body. However, timely treatment and taking preventive measures significantly reduces the risk of complications.

It is known that herpes is transmitted in different ways; both men and women can become infected at any age. You can often become infected with the virus through contact with someone who is sick. Once a pathogen enters the body, it remains in the body for life. The pathogen is able to move into nerve cells and remain there in an inactive state. The latent form persists for a long time until the immune system weakens.

Herpes pathogens

There are 8 types of virus. Each herpes simplex virus causes a specific disease. The causative agents of herpesvirus and disease are described in the table:

Herpes viruses have their own ways of transmitting herpes from person to person. The pathogen is resistant to the environment. It exists outside the carrier and settles on everyday objects. It is possible to become infected with the herpes virus on the street and at home. Most often, infection occurs by airborne droplets. Considering all types of herpes transmission, you can see that they are not significantly different. Once herpes enters the body, it remains forever.

Herpes virus on lips

The most contagious type of disease for others. Transmission is likely because the pathogen has good persistence outside the body for a short period of time. Any method of infection is possible. Herpes on the lips is transmitted in the following ways:

• Direct contact. The patient touches the site of infection on the lip, the virus gets on the hands, handshakes, hugs, contact sports.
• Domestic. Under the same conditions, the virus gets onto public items and hygiene items. The virus gets onto dishes, furniture or skin, through the mucous membrane of the mouth and nose.
• Airborne - through sneezing and coughing.

Infection through a kiss in the early stages of the disease, when there are no clinical symptoms yet, is also possible. After recovery, kissing is not recommended for 1-2 weeks.

On the genitals: how not to infect your partner

Transmission of the virus to the genitals occurs in most cases through sexual contact. Women are more likely to be infected by a partner than men. Ways of infection with herpes:

• Airborne transmission is extremely rare.
• Contact household - almost never.
• Through sexual contact - occurs in any type of sexual relationship (oral, vaginal, anal).

The virus from the mucous membranes is transmitted through blood vessels if there are damaged areas on the skin, for example, if kissing. Possible transmission in utero to the fetus during pregnancy. In 50% of cases, after birth, a child is diagnosed with a disease if the virus has penetrated the placenta. If transmission of the pathogen in utero does not occur, the child may become infected through contact with infected skin areas during childbirth. Herpes simplex virus type 2 is very dangerous for a newborn, as it primarily affects the child’s nervous system.

Herpes on the body

HSV-3, which causes contact skin diseases, chickenpox and shingles, is no less contagious. Infection with the virus is possible through saliva, sweat, and tears. In children, chickenpox causes a mild form of the disease; 90% of children's groups (kindergartens, schools) become ill. In such conditions, it is possible to get sick while in the same room with a sick person. After 10-14 days, the disease becomes latent and the virus ceases to be infectious.

In adults, cutaneous herpes is transmitted in the form of lichen; it is possible to infect a person through close contact with a sick person. It is unlikely to get sick in any other way, since this virus is extremely unstable outside the host’s body. It can be transmitted through blood if it gets on the mucous membrane or exposed parts of the skin of a healthy person. Herpes in the blood is in a reactive phase when clinical symptoms appear and remains for several days after recovery.

Herpes is the general name for a number of diseases that are caused by different types of herpes virus. Such a virus can infect any organ in the human body. Children often get herpes because their immune system is not yet fully developed, and the virus is transmitted by airborne droplets.

Herpes on a child’s body is accompanied by pain and itching, sometimes fever. Symptoms depend entirely on the type of herpes that the child has contracted.

Types of Herpes

There are several varieties of this virus, however, most often, children get primary herpes. Moreover, from birth, young children, as a rule, receive immunity from their mother, and until the age of 3-4 years, the likelihood of getting sick is very low.

Modern doctors identify 6 types of viruses that children can become infected with:

Routes of transmission and symptoms of herpes

Experts state that by the age of 5-6 years, the herpes virus is already in the body of 85% of children. Therefore, all parents should know how herpes is transmitted, what contributes to its manifestation and what its first symptoms are.

The most common routes of transmission of herpes virus infection in children:

• contact with a carrier of the virus;
• while using utensils or any clothing of a sick person;
• during pregnancy and childbirth from mother to child;
• during breastfeeding, in case of relapse of herpes in the mother.

Factors contributing to the frequent manifestation of herpes in children:

• general condition of the body and immunity;
• stressful situations;
• the presence of an infectious disease and weakening of the body;
• injuries;
• active sun (summer is the season of exacerbation of such diseases);
• elevated temperature, drying of mucous membranes (for example, when a child is dehydrated or overheated).

Symptoms of herpes in children depend on the stage of the disease and the age of the child. They look like this:

Types of herpes and their manifestations in children

Typically, the virus stays in the body for a long time without manifesting itself, and is activated only after a decrease in protective forces due to illness, overwork, stress, and hypothermia. In this case, group rashes appear on the mucous membranes of the mouth, nose, and genitals.

Genital herpes

It is considered especially dangerous for pregnant women due to the possible transmission of the virus to the baby at birth. Genital herpes in a child can appear in the first days of life with varying degrees of severity. There are such forms:

For treatment and ridding the body from HERPES, many of our readers actively use the well-known method based on natural ingredients, discovered by Elena Malysheva. We recommend that you check it out.

Genital herpes in a baby can cause significant complications and unpleasant consequences, such as:

• eye and hearing complications;
• disorders of cardiovascular activity;
• neurological lesions;
• diseases of internal organs;
• defects in the subsequent development of the child.

In adolescence, herpes in the intimate area can appear in the form of rashes: in girls - on the vaginal mucosa, in boys - on the penis. It is transmitted only through sexual contact.

Signs of genital herpes:

• feeling of heaviness and pain in the lower abdomen;
• rashes in the intimate area;
• pain when urinating;
• poor sleep, headache, overwork.

How to treat herpes in this form in a teenager should be recommended by a doctor after examination and diagnosis. The main task is to maintain personal hygiene and complete the full course of treatment.

Herpes encephalitis in children and its complications

Among viral diseases that negatively and deeply affect the nervous system, about 6% belong to the herpes virus. The consequences of penetration of such a herpes virus into a child can be the most severe: from disturbances in brain function to death.

Herpes encephalitis in children begins to develop during primary infection, penetrating directly into the brain and causing severe disturbances. Mortality from this type of virus is up to 80% of cases, and the remaining 20% ​​lead to disability (epilepsy, pronounced dementia, hydrocephalus).

At the beginning, the disease is expressed by a sharp jump in temperature, and the rash on the skin is similar to ordinary herpes. But after 2-3 days, convulsions, loss of consciousness, and vomiting (not related to food intake) may appear. If herpes is suspected in children, such symptoms clearly indicate the herpetic form of encephalitis.

When such a diagnosis is made, treatment occurs only in a hospital setting, sometimes the child ends up in intensive care.

Treatment for this form of herpes in children is carried out using complex therapy with Acyclovir and immunobiological drugs. At the same time, therapy is carried out to help reduce brain swelling and detoxify the body.

To improve the child’s condition, the following are subsequently carried out additionally:

• massage;
• physical therapy exercises;
• physiotherapy;
• treatment in special sanatoriums.

Labial herpes

The location of the rashes in the area of ​​the nasolabial triangle is most common in both children and adults and they are caused by HSV-1 and HSV-2.

Herpes on a child's face can be on the cheeks, lips, eyebrows, chin, forehead, in the child's nose, near the ears and eyes. The nature of the pain and the blisters themselves are usually similar, the difference being the size of the affected area of ​​skin. Symptoms also vary from child to child: toothache or high fever may occur.

Herpes on or near the child's nose is manifested by the same rashes, but some parents may mistake it for a manifestation of dermatitis. Treatment is carried out with ointments and medications, as with other forms of herpes.

If the herpes is located in the nose (inside on the mucous membrane), the rash differs in appearance and resembles abscesses. All rashes should be lubricated with ointment. The child needs to be provided with separate towels and handkerchiefs, and his close contacts with other people should be limited.

Feedback from our reader - Alexandra Mateveeva

I recently read an article that talks about Father George’s Monastic Collection for the treatment and prevention of Herpes. With the help of this drug you can FOREVER get rid of HERPES, chronic fatigue, headaches, colds and many other problems.

I’m not used to trusting any information, but I decided to check and ordered a package. I noticed changes within a week: in just a couple of days the rash went away. After almost a month of taking it, I felt a surge of strength and my constant migraines went away. Try it too, and if anyone is interested, below is the link to the article.

Each time after blowing his nose, he should wash his hands with soap. Additionally, to soften the crusts and relieve itching, you can use folk remedies: lubricating the nose with fir oil or propolis tincture.

Herpes caused by the Varicella-Zoster virus

Rashes on other areas of the skin are less common in medical practice; for example, herpes on a child’s leg occurs only after touching someone else’s things or objects, or due to touching first the sore spot and then the leg.

If the rash is located on the feet or toes, the likely cause is the chickenpox virus. To accurately determine the type of virus, you need to take your child to the doctor and get tested. This is important because therapeutic treatments for different types of virus differ.

The effect of this type of virus on a child depends on the state of his immune system. With low immunity in children (as well as in adults), herpes zoster is characterized by severe pain.

Another unpleasant pattern is that this virus can spread throughout the body (that’s why it’s called shingles).

A sign of such a virus is also unilateral herpes on the child’s cheek, or on other parts of the body (also on one side). The rashes usually tend to cluster together and form very painful patches. It is very difficult to treat.

Treatment of herpes infection

Every parent should know exactly how and how to treat herpes in children in order to begin treatment in a timely manner and eliminate the possibility of serious consequences for the child’s body. The treatment process should begin after the first suspicion of herpes - this will speed up the healing process.

Herpes infection in children in advanced forms develops into a chronic disease and can cause serious complications.

Treatment of herpes in children involves the use in combination of:

Let us refute the misconception of some parents who ask whether it is possible to smear herpes with brilliant green or alcohol? This should not be done under any circumstances, because... these substances contain alcohol, which causes burns to the skin and mucous membranes. It is completely useless to smear herpes with any cauterizing agent - it will not affect the virus in any way.

Prevention of herpes

Parents asking the question of how to cure herpes completely can only answer one thing: it is impossible to eliminate such a disease forever; any treatment for this disease is aimed solely at preventing or reducing the number of relapses (repeated manifestations).

Preventive measures depend on the form of herpes:

It is also necessary to teach the child to follow these rules:

• personal hygiene;
• prohibition of using other people's things;
• avoid communication with sick people;
• during epidemics, use antiviral ointments in the nose.

The most effective rule aimed at preventing herpes in children is to constantly monitor the health and condition of the child’s skin, so that at the first signs of herpes, seek advice from a pediatrician as soon as possible and begin treatment immediately.

Do you still think that it is impossible to get rid of herpes forever?

Doctors are confident that almost the entire population of the earth is infected with the herpes virus. However, half of the people do not know about this, since the disease is in a passive state. The first contact with the virus occurs in childhood and manifests itself in the form of the well-known chickenpox. A long-known treatment always effectively helps against this disease, removing all the symptoms, while the virus never leaves the body, it settles in the nervous system and it is impossible to recover from it.

Often the disease may never bother you again until certain negative factors appear.

These include the following situations:

• frequent stress;
• strong temperature changes;
• infectious diseases;
• exacerbation of chronic diseases;
• complication of diabetes mellitus;
• taking medications.

Knowing that the problem cannot be gotten rid of, many wonder whether herpes on the body is contagious to others when the patient is in close proximity. In order to figure this out, let’s consider what types of diseases are known, as well as what can lead to this problem.

Types of herpes on the body

The main factor in the activation of herpes is weakening of the immune system. Today the disease is divided into the following 8 types:

• 1 type. It manifests itself as a rash on the lips, most often called a “cold.” Sometimes such redness occurs on the genitals, eyelids and neck. It is quite easy to become infected with the virus;
• Type 2 It is called genital, as it manifests itself specifically on the genitals. Dangerous for people with weakened immune systems;
• Type 3 The chickenpox virus, which causes inflammation on the body. It is most often called shingles. It can be infected by airborne droplets. In the process of development, it leads to the appearance of rashes throughout the body and fever;
• 4 type. It occurs much less frequently and is provoked by lymphogranulomatosis and mononucleosis. This type is the most dangerous, since the presence of such an infection in the body can lead to the development of cancer cells. As medical statistics show, almost every 3rd infected person does not know about the presence of the problem, since the disease does not manifest itself in any way. At the same time, doctors recommend identifying the presence of herpes at an early stage, since at this time it is not dangerous and can be treated. Otherwise, a complication in the form of damage to the cellular structures of the brain is possible;
• 5 type. The official name is cytomegalovirus. The disease is considered a sexually transmitted infection, although there are known cases of infection during blood transfusion and even through airborne droplets. This type in an active state can lead to a large number of diseases;
• The last three types 6,7,8 are not yet fully learned today. Exposure leads to neurological disorders.

Common first manifestations of herpes

Herpes on the body causes the greatest number of problems for a person; in this case, not only aesthetic problems appear, but also unpleasant symptoms.

The most obvious symptoms of the disease are the following:

• Rashes on the body. It appears as a cluster of bubbles, which are often filled with colorless liquid. Sometimes the bubbles merge into one continuous spot, and the skin around it acquires a red or pink tint. 4 days after the rash appears, the blisters rupture, resulting in painful ulcers. With proper treatment, they subsequently become crusty, and after complete healing, light spots remain in their place;
• Soreness of the skin of the body and increased sensitivity. The unpleasant sensations are explained by the fact that the virus lives in the nervous system and spreads along the path of nerve impulses. Painful sensations appear when touched and rubbed. They continue until the ulcers are completely healed;
• General weakness, fever and chills.

Less commonly, herpes manifests itself with the following symptoms: muscle weakness, severe headache, nausea and even vomiting, change in taste or fainting. All this points to complications. In such a situation, you cannot do without medical help.

Is herpes contagious on the body: stages of the disease

Let's consider what stages the infection lives in our body and how herpes is transmitted on the body:

• The first signal that the herpes virus will soon be activated appears on the skin. There is a feeling of itching, tingling, swelling and redness of the affected areas. At this time, herpes is not dangerous to others;
• After a few days, bubbles appear. They grow and gradually fill with liquid. It is in them that the virus is located, which is easily transmitted to others. It is at this time that herpes on the body is contagious. The disease can be transmitted by just touching open sores;
• After the wounds are covered with a film, the virus goes into the nerve plexuses. At this stage, the patient is no longer contagious and can therefore be in the company of healthy people.

Consequences of the virus

As medical practice shows, infection leads to damage to a large number of organs and skin. In this case, not only the appearance of moral and physical discomfort occurs, but also a number of complications. First of all, in addition to the body, the upper respiratory tract, central system and gastrointestinal tract are affected.

The virus is most dangerous for women during pregnancy. This is explained by the fact that at this time the expectant mother transmits an infectious virus to the baby, as a result of which the child is born already infected.

Prevention of herpes infection

Treatment requires a lot of patience and responsibility. In this case, it is better to prevent the onset of the disease than to try to relapse later. Today, a set of effective preventive measures has been developed, the observance of which will help avoid infection, and if this occurs, prevent relapse.

It consists of the following measures:

• Do not neglect chronic diseases. They create good conditions for the development of a viral infection;
• Take care of the immune system, which takes on protective functions and protects a person from diseases. To do this, it is important to consume enough vitamins, eat well and exercise;
• Avoid sexual contact with unfamiliar partners. In addition, it is better to always use condoms. This will avoid infection;
• Carry out a vaccination that suppresses the virus and inhibits its activity in the body. Such vaccination does not cure the disease, but prevents the infection from awakening. Today there are no analogues to this method of prevention;
• Be sure to wash your hands after visiting public places and use only personal hygiene products for the body.

Based on all of the above, it is now clear whether herpes on the body is contagious or not. Knowing what stage the disease is at, and refusing contact with the patient at this time, you can exclude infection.

I will not write in this article about what herpes is. Most likely, many of you know about him first-hand, especially me. Herpes, one might say, is my frequent guest. But I have a small son (7 months), naturally, I am afraid of infecting him.

At all, Is it possible to infect a child with herpes??

I turned to our pediatrician with this question and this is what I found out.

Herpes in an infant- this is a very rare case, since along with breast milk the baby receives maternal antibodies that fight any viruses. That's why , viral herpes in children most often occurs after one year of age.

Usually, we adults rarely pay attention to the bubble on our lip. Well, he jumped out, then he will pass on his own. It's OK. But no! This is a big mistake!

Herpes is a viral infection that is transmitted not only through physical contact, but also through airborne droplets. You sit, talk to the baby, coo with him, and at this time insidious viruses escape from your mouth and infect the baby.

A childhood herpes is a dangerous disease that affects not only the affected area of ​​the body, but the entire body as a whole.

As a rule, a child who gets herpes for the first time experiences an increase in body temperature, headache, general fatigue and drowsiness.

On a certain area of ​​the body, usually the lips and wings of the nose, red spots appear, which then turn into pimples with clear liquid and then, after 5 days, they become covered with a crust. After just 9 days, the crusts disappear and the child recovers.

Sometimes viral herpes in children localized on the forehead, cheeks, fingers and even the genitals. Sounds awful!

How to prevent herpes infection?

Very simple. Whenever your grandparents or other relatives come to visit you, ask them about their well-being in advance. Explain to them that there is no need to be offended by this, because the little one’s health is at stake.

And if their health makes you suspicious, ask them to come next time or, in extreme cases (too touchy mother-in-law), ask them to wear an antimicrobial mask. But if infection does occur, consult a doctor for further treatment.