Herpes Outbreak

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• The virus Herpes simplex causes the familiar "cold sore", "fever blister" or herpes outbreak.
• It also causes the common sexually transmitted disease genital herpes outbreak.
• 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 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 outbreak 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 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 outbreaks are a sexually transmitted disease; however, many people find that they can be sexually active over a lifetime without infecting their partners.

• Herpes 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 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
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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.

• Soak the affected area with warm compresses or tub baths two or three times daily for about 15 minutes.
• Wear loose cotton underwear and avoid occlusive, tight outer clothing (pantyhose, jeans, etc).
• Avoid medicated creams and ointments. Simply click Herpes Outbreak for a simple to use healing remedy.
• Urinate in a tub of water, or pour water over the genitals while urinating to decrease pain.
• If the pain is severe, ask your health provider about a topical anesthetic to numb the area.
  Prevention
• Protect lips with a sunscreen chapstick.
• Use condoms or latex barriers every time you have sex, start to finish, with new partners or partners who have herpes simplex virus.
• Avoid oral/genital contact when either you or your partner has a cold sore.
• Take care of yourself with adequate sleep, good nutrition and stress management practices.
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