Herpes
Genitalis
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- The
virus Herpes simplex causes the familiar "cold sore", "fever
blister" or herpes genitalis outbreak.
- It also
causes the common sexually transmitted disease genital herpes
genitalis.
- This
virus favors warm, moist skin and is readily transmitted by close
contact between individuals, usually sex, but not necessarily..
- A distinctive
feature of this viral herpes genitalis outbreak
is that, following the initial infection, it will remain hidden (latent)
within the body. It is found mainly in the sensory nerves associated
with the affected skin. Whether the virus stays latent in the skin
itself is as yet undetermined, but it has been found in the saliva
and the cervix of pregnant women who have no symptoms.
Course
Most people (over 75 percent) acquire their first herpes
infection in childhood as a mild upper respiratory illness.
Thereafter, it recurs around the lips in the form of cold sores. The
virus is reactivated by conditions such as fever, menses, stress, and
sun exposure. The lesions are infectious and will shed live virus for
three to four days until the sores begin to heal.
- Primary
genital infection usually occurs in adults.
The
incidence in the general population may be as high as 20 percent.
- The
incubation period is thought to be three to seven days after exposure
to the virus, though it may be up to 21 days.
- Symptoms
start with a burning, itching, tingling sensation in the skin. Then
small, fluid-filled blisters develop. The blisters break and form
open sores, or ulcers, that scab over and heal within two weeks.
With the
first herpes genitalis outbreak episode,
there may be extensive involvement of the skin associated with painful
urination, swollen, tender lymph glands in the groin and, in women,
a copious discharge. Fever and malaise, common to viral illnesses, may
also occur. Ninety percent of women will have cervical lesions.
- Recurrences
usually occur within a twelve month period but are much less severe,
with fewer skin lesions that heal faster.
- General
symptoms are unlikely and cervical lesions are less frequent. The
frequency of recurrent attacks is variable, but the intervals between
the attacks become longer and the outbreaks less troublesome so that
over the years the condition resolves.
- Additional
trigger factors are emotional stress and injury to the affected skin.
Transmission
Herpes genitalis outbreaks are a sexually
transmitted disease; however, many people find that they can be sexually
active over a lifetime without infecting their partners.
- Herpes
genitalis lesions shed live virus, so care
must be taken to avoid infecting others or spreading infection to
other sites of the body.
- Intercourse
or close body contact with the herpes sores should be avoided from
the time the warning signs (tingling, burning, itching) occur until
all sores are gone.
- Towels,
soap and washcloths should not be shared. Avoid touching herpes sores,
and wash your hands if you touch the area around the sores.
It appears
that herpes infection can be spread when there are no visible herpes
lesions. The virus has been cultured from healed skin in some people
with herpes. Also, lesions on the cervix are not painful, so a woman
may be unaware that she has an active herpes sore. Honest communication
and regular use of latex barriers such as diaphragms, condoms and dental
dams help prevent the spread of herpes.
Pregnancy
and Herpes
Herpes genitalis
outbreak and infections, or a history of herpes, will not affect
your ability to become pregnant. Inform your health care provider if
you have had herpes. If there is an active infection at the time of
delivery, a cesarean section may be indicated since the virus can otherwise
be transmitted to the baby.
Diagnosis
Usually herpes is diagnosed by evaluating the patient's symptoms and
the appearance of the lesions in the early phases of the infection.
A culture may be done to confirm the diagnosis. It is important to do
a culture early in the course of the infection. If the herpes sores
have been present for longer than a few days, a culture may not be accurate.
Blood tests are not helpful because 90 percent of the population will
have positive results due to childhood infection with herpes virus.
Treatment
The best and simplest herpes
genitalis treatment has just been discovered, tested
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For severe primary infections, or for frequent recurrences, antiviral
drugs are also available in an oral form or as an ointment. They will
not cure herpes permanently, but they will speed healing. Antiviral
drugs must be used early in order to be effective. Ask your health care
provider if an antiviral drug would be appropriate for you.
The following
advice is given to help relieve discomfort and hasten drying and healing
of the blisters.
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