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Herpes Simplex Virus (Type 1 and 2)

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Herpes on the Hand (picture)
Facial Herpes (picture)
Neonatal Herpes (picture)
Herpes on the Back (picture)

What is Herpes?

Herpes is a common viral infection. It produces vesicular erruptions of the skin or mucous membranes. It causes oral herpes, which can be seen as cold sores or fever blisters (type 1) and genital herpes (type 2). Herpes Simplex Virus (HSV)is a life long infection for most infected human beings.

Symptoms

Symptoms of herpes usually develop within 2 to 20 days after contact with the virus. These symptoms may last up to several weeks, varying from one person to the next. The virus starts to multiply when it gets into the skin cells. The skin becomes red and sensitive, and soon afterward, one or more blisters or bumps appear. The blisters first open, and then heal as new skin. During a first outbreak, the area is usually painful and may itch, burn or tingle. Flu-like symptoms are also common. These include swollen glands, headache, muscle ache or fever. Herpes may also infect the urethra, and urinating may cause a burning sensation.

Transmission

Herpes is spread by direct skin to skin contact. For example, if you have a cold sore and kiss someone, you can transfer the virus to their mouth. Similarly, if you have active genital herpes and have vaginal or anal intercourse, you can give your partner genital herpes. Also herpes can be spread during oral sex. Some people notice itching, tingling or other sensations before any noticable signs of infection can be seen on their skin. These are called "Prodromal Symptoms." Herpes is most likely to be spread from the time these first symptoms are noticed until the area is completely healed and the skin looks normal again. Transmittance of herpes without symptoms is called "Asymptomatic Transmission."

Baby Trouble...

Babies can become infected with the herpes virus (neonatal infection). If no virus is found in the birth canal and there are no symptoms or signs of an outbreak, a vaginal delivery is considered safe. If herpes is present in the birth canal near the time of delivery, a cesarean section might be necessary to protect the newborn from coming into direct contact with the virus. When herpes is aquired at birth from exposure to maternal genital lesions it can be the most disasterous form of Herpetic Disease and is often fatal.

Diagnosis

See a doctor while symptoms are still present. The doctor will look at the area, take a sample from the sore(s) and test to see if the herpes virus is present. The test you should request is a specific virus culture for herpes virus. The test will not work if the sores have healed. Known available tests:

Cell Culture Test

Antigen test

Pap Smear

The virus can be isolated from skin and mucosal lesions or from spinal fluid in central nervous system infections.

Treatments

Although there is no cure for herpes, some drugs have been effective in reducing the frequency and duration of outbreaks. During an outbreak, keep the infected area as clean and dry as possible. This will help your natural healing processes. Some doctors recommend warm showers in order to cleanse the infected area. Afterwards, towel dry gently, or dry the area with a hair dryer on a low or cool setting. To prevent chaffing, some people also find it helpful to avoid tight-fitting undergarments. Most creams and lotions do no good and may even irritate. Diet is a very important factor in keeping herpes in remission.Supplementation with free-form lysine has shown to be beneficial in controlling herpes along with a diet high in lysine and low in arginine.

Vaccines

Herpes vaccines are currently being investigated and it is felt that an effective vaccine may be available in 3-5 years. Vaccines will only function to prevent the infection in new patients. Those who already have the simplex virus disease will probably not gain any benefit. Some vaccines have been tried to prevent the HSV occurrence, but so far had no noticible effects. These include the smallpox, Polio and Lupidon C vaccine. Isoniplex (Isoprinosine) is already available in over 56 countries. Most countries have approved it for use in HSV infections due to its antiviral action, and more significantly, the ability to stimulate the body's immune response. Isoniplex is currently under investigational trials for HSV primary and recurrent cases in the United States.

Precautions

Laboratory studies have shown that the herpes virus does not pass through latex condoms. When properly used, such condoms are likely to reduce your risk of spreading or getting herpes. Even the best condoms don't guarantee safety. Sometimes herpes sores occur in places not covered by a condom. In these cases, the condom is of little help, if any. In fact, condoms and foams should not be relied upon when herpes sores or symptoms are present. Some contraceptive foams contain ingredients (such as nonoxynol-9) that kill the herpes virus and other STDs in test tubes. They are best used along with condoms, not in place of condoms. Many people feel panicked or depressed when they have herpes. Partly as a result of these feelings, the first few outbreaks can cause a great deal of stress. It may be important, therefore, to take additional steps. Get the information you need so you aren't worrying unnecessarily.

References

Boyd, Robert F. Basic Medical Microbiology, 5th Edition. Little, Brown and Company, 1995. pg. 425, 436-437

"Herpes News" http://www.racoon.com/theherpesnews/index.html 2000.

"The Herpes Zone" Comprehensive Information on Herpes Virus. http://www.herpeszone.com/ 1999.

"The Skin Site" Herpes Simplex http://www.skinsite.com/info_herpes_simplex.htm 2001.