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Herpes

What is Herpes?

Herpes is a virus, specifically "herpesvirus hominus". Simplex is a sub-category of that family. Simplex falls into five categories, types 1, 2, 6, 7, and 8. Generally type I infects the mouth in humans and type II affects the genital tract, but there is a substantial overlap. Type 6 and 7 cause an infection of infancy and Type 8 has been associated with Kaposi's Sarcoma which is seen in HIV.

Herpes simplex virus (HSV) has a vast presence in humans. It has been estimated that some 80-90% of humans experience oral herpes infections by the age of ten years old. Many will have an acute episode manifesting as infected gums and lips, causing high fevers, but most apparently have few if any symptoms. A substantial portion of the population has recurrent oral herpes infection, showing up as those nuisance little "cold sores" on lips and sides of the mouth, and occasionally elsewhere on the face.

Where is Herpes Found?

Herpes infects the nerve cells of the spinal cord of the pelvis (in the setting of genital herpes) and of the nerve ganglia serving the face at the base of the brain (in the setting of oral herpes). Herpes is a DNA-type virus, inserting its DNA directly into the dendritic nerve endings of the skin, which then leads along nerve fibers to the nucleus of the nerve cell. Once the viral information is inserted into the cell's nucleus, this blending of viral genetic information with human genetic information is permanent. The nerve cell then becomes a factory for making more viral particles.

Thus, herpes is not a "skin infection", but rather an infection of nerve cells, by way of the skin. It is not the "skin" that is infected but rather the nerve cell. When the infection becomes active again in the nucleus of the nerve cell, the viral particles flow back out, down the nerve, and out through little blisters that form in the skin. If the quantity of viral particles coming down the nerve cell isn't enough to form a blister, then a number of viral particles can be excreted through the skin without any symptoms at all.

"Genital herpes" and "oral herpes" refer to the location where the herpes infection is found on the individual. Most genital herpes is caused by HSV-2, but can be caused by HSV-1 in as many as 30% of new cases. Oral herpes is most often caused by HSV-1, and only rarely by HSV-2. Because these locations are often associated with a particular type of herpes (which seem to "take hold" in those particular locations more easily), medical people, websites and literature often equate the location with the herpes type. You might find that people speak of genitally-located herpes infections as HSV-2 and orally-located herpes as HSV-1. However, humans can have either virus in either place, and in fact, potentially anywhere on the body.

Transmission of Herpes Virus

Someone with an HSV-1 lesion on the mouth can certainly transmit the infection to a significant other through oro-genital contact with the genitalia of the other (oral sex), causing a recurrent HSV-1 lesion on the genitalia of the partner. Also, other sites of HSV infection can be produced, such as on a finger (the so-called "herpetic whitlow") or elsewhere.

Symptoms

Herpes infections produce a number of different signs and symptoms. Traditional "first episode" herpes, most commonly described in women, are serious illnesses, with high fever, often large-sized outbreaks, and even inability to urinate. Hospitalizations are sometimes necessary, with urinary bladder catheterization, IV fluids, and intravenous anti-viral medications being required. Most people who present with infection don't describe having such severe symptoms, however, showing up in the office or the ER with a cluster of small blisters surrounded by a red base showing up on the genitalia, in the case of GHI. Often the blisters have already ruptured, leaving behind a cluster of ulcers which scab over and require one to two weeks to heal.

Herpes symptoms are often more subtle, however. Sometimes the skin will just be slightly reddened without obvious lesions. This area is probably contagious, though probably much less so than blistered areas. Sometimes the skin will form tiny red bumps that don't blister, called "erythematous papules". Sometimes there are no signs on the skin at all but rather a "prodrome" (sensory warning symptoms), such as urinary urgency, urinary frequency, AND/OR aching or tingling in the legs. Also, itching, burning, tingling, pain or pressure at a previous or potential outbreak site may occur.

The first step towards managing genital herpes is to speak to your doctor or healthcare provider about treatment options. While there currently is no cure or vaccine for genital herpes, some prescription medicines have been proven to reduce the frequency, severity, and duration of outbreaks. So make an appointment with your doctor as soon as possible, have an honest discussion about your condition, and most important of all, ask questions.

Consider Your Options

Your doctor will probably tell you about the two key ways to treat genital herpes.

Suppressive Therapy

What is it? Suppressive therapy involves taking a prescription medicine every day to help suppress outbreaks of genital herpes before they occur.

Is it right for you?

See your doctor and have an open, honest discussion about your condition. Ask your doctor if daily suppressive therapy is right for you if:

  • You want to increase your chances of being outbreak-free.
  • Your outbreaks are bothersome, annoying, and you don't know when your next outbreak will come.
  • Your partner doesn't have genital herpes.

If any of these statements are true, talk to your healthcare provider about suppressive therapy with VALTREX. If your healthcare provider recommends suppressive therapy, you may find it can be a great way to gain more control in your life because it can help reduce the number of outbreaks you have and may lower the risk of spreading the disease to a partner.

There is a lot of information to take on board with Herpes, if you suspect that you may have got Herpes the first thing to do is to go and see your Doctor who can then help you with further treatment.

If you need more information please contact us at the Brunswick offices and we will do all we can to help.