About Herpes

About Herpes


What it is: Herpes is a viral infection that enters the body through the skin and mucous membranes of the mouth and genitals. Once inside the body, the herpes virus travels through the nerves to the deep nerve centers (ganglia) where it “lives” in a latent state after the initial infection. It may at any time cause a recurrence of herpes symptoms and cannot be permanently cured. The outbreaks most commonly occur at times when the immune system is compromised, such as during an infection, hence the name cold sores for oral herpes.

Herpes comes in two types: simplex 1 and simplex 2. Simplex 1 can be classified as “Oral Herpes”; Simplex 2 is referred to as “Genital Herpes” or HSV-2. It is now known that both strains of the virus commonly affect the genital area, and can be passed on through genital-genital sex and through oral-genital sex. This means that a cold sore on someone’s lip can transmit the herpes virus to someone else’s genitals. In the United States, 45 million people ages 12 and older (1 out of 5 of the total adolescent and adult population) are infected with HSV-2 (CDC 2001).

An even larger number of people, estimated around 70% have oral herpes, meaning a blood test would reveal antibodies for the virus, indicating exposure. In most people the virus is dormant most of the time, and when the infection occurs in the mouth it is often little more than an inconvenience, a few cold sores. However, herpes is less palatable when it infects someone’s genitals so care should be taken during oral sex when cold sores are present.

Symptoms: Symptoms of the first infection usually occur 3-7 days after exposure. The first outbreak of herpes is the most severe. Subsequent outbreaks can have the same symptoms, but are usually milder.

• Mild tingling and burning -- this often precedes the appearance of lesions and watery blisters. Referred to as the “prodromal period,” it may occur several hours or several days before blisters begin to develop. It is during this time that “asymptomatic shedding” occurs when cells around the future blister begin to slough off. Although developing blisters may not be detected at this time, it is possible to spread the virus during this period.
• Watery blisters -- may occur both on external and internal genitalia
• Low-grade fever -- especially with the first outbreak
• Headache
• Generalized muscle aches
• Tender, swollen lymph nodes in the groin or throat

The blisters break down 24-72 hours after their appearance and leave raw, red, ulcer-like sores. These sores crust over and heal without treatment. The entire course of the initial infection may last from two to six weeks, with the recurrent infections lasting three days to three weeks. Recurrence is common, and is often triggered by several factors including fever, menstruation, sexual intercourse, environmental heat, trauma, sunlight, fatigue, and emotional stress. Recurrent infections are usually much milder than the first outbreak.

Testing and Diagnosis: Smears of the lesions can be used to detect presence of the virus. Blood tests can determine whether an individual has been exposed to the herpes virus, but cannot determine whether the disease is currently active.

Treatment: At present, there is no cure for herpes. There are, however, several treatments that may be effective in relieving symptoms.

#Pain relievers, such as aspirin, can be used to alleviate discomfort
#Wearing loose, dry clothing helps the lesions to heal
#Acyclovir, a drug to treat herpes, is available in three forms:
- Ointment -- reduces pain and the period of asymptomatic shedding
- Intravenous -- administered in hospitals, for very severe cases only
- Oral -- May lessen the severity of the symptoms when taken during outbreaks, and reduce the frequency of outbreaks when taken on a regular basis.

#Valtrex, another herpes drug, is usually prescribed in two ways
- Outbreak therapy -- take pills to treat each outbreak
- Suppressive therapy -- take pills on a regular basis to suppress possible outbreaks

Complications: Genital herpes is usually uncomplicated, and outbreaks almost always heal on their own. Infrequently, though, significant complications arise. Herpes throat infections can develop, as can herpes infection of the urethra. Meningitis (infection surrounding the spinal cord) has been reported in as many as 36% of patients experiencing their first outbreak of herpes, but fortunately, usually resolves without treatment. Herpes can be transmitted to babies during childbirth, causing extremely serious complications including death. There is also a possible connection between cervical cancer and herpes.

Prevention:

• Herpes can be transmitted through skin to skin contact, even when no symptoms are obvious (due to asymptomatic viral shedding). Barrier methods such as condoms/dental dams can help reduce this risk, but do not eliminate it due to skin contact beyond area covered by barrier.
• Limit number of sexual partners
• If sexually active, get tested regularly and talk with your partner(s) about testing together
• If active lesions are present, avoid sexual contact
• When no active lesions are present, barrier methods (condoms/dental dams) should be used to reduce likelihood of transmission.
• If you have herpes, be aware of your body and communicate with your partner about prevention, couples have gone years without transmitting the virus from one partner to another. Contact a medical professional