Get the facts about Herpes

What is Herpes?

Herpes simplex is a viral infection that causes sores around the mouth and the genitals. It has probably existed for at least 2000 years. The herpes simplex virus (HSV) is a member of a family of herpes viruses that also cause mononucleosis, chickenpox and shingles. HSV is divided into two types: HSV-I being the virus which generally causes oral herpes, and HSV-II which causes genital herpes. Regardless of which viral type is the cause of infection, the symptoms are identical.

How is Herpes spread?

Genital herpes is almost always transmitted through sexual contact, but transmission can also occur when any part of the body comes in direct contact with a herpes sore. In the case of an HSV-I infection, sores are usually found in or around the mouth and are commonly referred to as "fever blisters" or "cold sores." For HSV-II infections, sores are more commonly found on or around the genitals, but may also appear in the mouth, anus, thigh, buttocks or abdomen, depending upon where the virus entered the body during intimate contact. However, either type can cause herpes sores in the genital area, as well as on other parts of the body.

Herpes is most often spread when the infected person has herpes sores present. It is risky to have sexual contact with someone when they have sores. However, some people occasionally can transmit the virus during sex even when they have no visible signs or sores. These people may not even know that they have herpes but can spread the disease.

What are the symptoms like?

Many herpes patients experience very painful and emotionally distressing initial infections, whereas some people have infections with no symptoms or with symptoms that are so mild that they go unnoticed.

The first outbreak of herpes is usually the most painful, and may begin with a burning, tingling, or itching sensation. After these symptoms occur, if they do, blister-like bumps will appear on or near the genitals. These will soon break open and become painful sores (lesions). The first outbreak will usually begin 2-29 days after being infected with the herpes virus but can be much later.

Often during this initial outbreak, people have enlarged lymph nodes in the groin, fever, fatigue, or headache. Some woman may experience discharge from the vagina or pain while urinating. The initial infection generally will last 14-28 days. The lesions will slowly heal and rarely leave scars.

There is extensive research underway but there is no cure or vaccine for herpes. Once the virus enters the body, it remains there possibly for life. For some patients, the infection remains dormant (inactive) causing no symptoms, but many people will experience recurrent outbreaks. Some people have recurrent outbreaks every few weeks. Others may have 2 or 3 episodes a year and some have no recurrence at all.

Usually recurrent outbreaks are not as painful and are shorter in duration (5-14 days). Often, warning signs will alert the person that a recurrent outbreak is beginning. These signs may include burning, itching, or tingling at the site where the sores are about to appear (usually the same area each time) or pain in the legs or thighs. These signs usually occur 24-48 hours before the sores appear.

It is not known exactly what triggers recurrent outbreaks or why they vary so much among individuals. Emotional stress, fatigue, illness, excessive exposure to sunlight, menstruation, unbalanced diet or even friction from tight clothing or prolonged sexual intercourse may cause recurrent episodes for some people. People with herpes have reported that they have been able to reduce or eliminate further episodes by reducing possible risk factors.

How do I know I have Herpes?

It is very important for anyone who suspects they have herpes to be examined by a doctor while the sores are present. This is especially important in order to rule out other conditions that have similar symptoms but are not herpes. Many physicians will use observation of the sores and history of symptoms as the method of diagnosis. Others will take a sample from the lesion and perform tissue cultures or other laboratory tests for confirmation. The tissue culture is the most reliable method for diagnosing herpes. There is a blood test that detects antibodies to herpes infections, but it cannot be used to diagnose an active case of herpes and will not determine when you are contagious.

How can discomfort be relieved?

To aid the healing process, it is important to keep the lesions clean and dry. Wearing loose clothing and cotton underwear will help keep the lesions dry and thus reduce discomfort. Many patients find that applying ice packs to the lesions and taking aspirin or other pain reliever helps.

Taking 3-4 short (5-10 minute) baths a day in warm water to which a drying agent such as Epsom salts or Burrow's solution has been added may also help.

Drinking lots of water will make the urine less acidic and therefore less painful when urinating. Women may find it reduces pain if the vagina is rinsed with water while urinating. Anyone who suspects that they are developing a secondary infection or who is unable to urinate because of the pain or swelling should contact their physician immediately.

Acyclovir, a prescription drug, is currently the only FDA approved medication being used for herpes patients. This drug may relieve the pain and make the sores heal faster but it does not cure the disease. Your doctor can also provide valuable information about the virus and suggest ways to relieve the discomfort caused by herpes.

How can Herpes be prevented?

The most reliable method of preventing transmission is to abstain from sexual intercourse and oral-genital sex from the time warning signs or lesions appear until the time lesions are completely healed. Condoms and contraceptive foams may offer some protection but do not always prevent transmission of the disease since the virus may be anywhere in the genital area.

Patients with active infections (meaning sores are present) should not share unwashed clothing or towels with other people. Hot water, laundry detergent, and bleach will kill the virus so there is no threat of infection to others once the items have been washed.

It is very important that anyone experiencing an outbreak of herpes practice good personal hygiene: avoid touching the lesions and always wash the hands after using the bathroom. This is important to prevent transmitting the virus to another place on the body. Herpes patients who wear glasses or contact lenses should take special precaution to avoid transmitting the virus to their eyes.

People experiencing an outbreak of herpes often have feelings of despair and hopelessness. Because of their fear of spreading the infection, they often isolate themselves from others. When people have an outbreak, they should refrain from sexual contact, but that does not mean that they cannot be close. Many herpes patients continue to sleep in the same bed with another person but wear some clothing to avoid accidental contact while they are infectious.

What do women need to know?

Pregnant women should tell their doctor if they or their husband/sex partner have or have ever had genital herpes, even if they have not had an outbreak for a long time. It is important that a pregnant woman with a history of herpes or other genital sores has prenatal care and informs the doctor about her history at her first prenatal visit. If the mother has active herpes in or near the birth canal at the time of delivery, the newborn may become infected.

Although only a small percent of babies actually catch herpes at birth, of the infants that do, 50% will die and another 25% will suffer severe brain damage or eye damage. Many physicians now recommend that all women be examined carefully for lesions when they go into labor and at that time physicians can decide whether to do a caesarian section.

Should you inform your sexual partners?

Yes. It is very important for herpes patients to inform their sex partners before they have sex, so that methods, which may help prevent the spread of the virus (such as condoms), can be used. Many persons with herpes fear rejection by their partners but often find them understanding and comforting. Some find that their partners may have the infection themselves. The timing and technique in informing partners vary with each relationship, but honesty and openness are very important.