Herpes

Genital herpes is a sexually transmitted disease caused by the herpes simplex viruses (HSV) type 1 and type 2. Most genital herpes is caused by HSV type 2. HSV-1 can cause genital herpes, but it more commonly causes infections of the mouth and lips or “fever blisters.”

Most infected people do not have symptoms from HSV-1 or HSV-2 infection. Symptoms occur in form of blisters around the genitals or rectum

The infection can stay in the body forever over a period of years. Herpes can be passed through sexual contact whether symptomatic or without any symptoms.

Transmission

The herpes simplex viruses (both HSV-1 and HSV-2) are transmitted through broken skin or a mucous membrane inside the mouth or in the genital area. Virus can be transmitted by means of bodily fluids (such saliva, semen, genital tract secretions) or fluid from herpes sores. The risk for infection is highest with direct contact of blisters or sores during an outbreak. The virus is finally transported within nerve cells to their roots where it remains inactive for some period of time. During latent periods, the virus is not transmissible. However, at some point, it often begins to replicate again without causing symptoms . During shedding, the virus is again transmissible through bodily fluids and can infect other people. Person can transmit the virus and infect other parts of their own bodies .

Oral herpes is easily spread by direct exposure to saliva or even from droplets in breath. Skin contact with infected areas is sufficient to spread it. Transmission most often occurs through close personal contact, such as kissing. Avoid sharing toothbrushes or eating utensils with an infected person.

Genital herpes is most often transmitted through sexual activity.HSVcan also enter through the anus, skin, and other areas.

Symptoms

The symptoms of genital herpes are variable and differ in intensity. Intensity of symptoms vary, such as many painful sores, while others have mild symptoms. Symptoms can develop within two weeks of having sexual contact with an infected person and can last from two to three weeks.

The early symptoms can include - An itching or burning feeling in the genital or anal area, fever, body ache, Swollen glands, pain genital area ,and vaginal discharge

Later symptoms of genital herpes may include:- Small red bumps on the penis, vagina, or wherever the infection began. These bumps may become blisters or painful open sores that can take up to four weeks to heal. Itching or burning in the genital area, Pain in the legs, buttocks, or genital area,vaginal discharge, fever , headache ,Muscle aches,Pain when urinating and enlarged lymph nodes in the genital area.

Specific Symptoms of Oral Herpes

Oral herpes (herpes labialis) is most often caused by HSV-1 but can also be caused by HSV-2. It usually affects the lips and, sometimes mucous membranes in the mouth. Rarely facial herpes infection on the cheeks or in the nose may occur.

The symptoms in oral herpes are-

• Blisters on the lips ,sometimes on the tongue.
• The blisters eventually rupture and turn into painful open sores with development of a yellowish membrane before healing, and disappear within 3 - 14 days.
• Associated difficulty in swallowing, chills, muscle pain, or hearing loss.

Recurrences are usually much milder than primary infections and are known commonly as cold sores or fever blisters .

Diagnosis

Diagnosis is made by looking at visible sores if the outbreak is typical, and by taking a sore swab. Blood tests, which detect HSV-1 or HSV-2 antibodies, can help to detect herpes in people without symptoms or during the time between outbreaks.

Treatment

There is no complete cure for genital herpes; the virus will always be in your body. Few drugs such as acyclovir, valacyclovir, and famciclovir can shorten outbreaks and make them less severe, or stop them from happening. When used along with safe sex practices, Valacyclovir (brand name Valtrex can also help prevent you from passing the infection to someone else. Three drugs are approved to treat genital herpes:

• Acyclovir (Zovirax or generic)
• Valacyclovir (Valtrex)
• Famiciclovir (Famvir)

During outbreak treatment includes, acyclovir taken 5 times a day for 5 days, valacyclovir twice a day for 5 days, or famiciclovir twice a day for 1 daySuppressive treatment requires taking pills daily on a long-term basis.Suppressive treatment may help prevent outbreaks from occurring. It is generally recommended for patients who have frequent recurrences .Acyclovir and valacyclovir are also approved to treat an initial attack of herpes. When a patient has herpes for the first time, the drug is taken several times a day for 10 days.

Foscarnet (Foscavir) is a powerful anti-viral drug known as a pyrophosphate analogue, and is the first choice for treatment for HSV strains that have become resistant to acyclovir and similar drugs. Cidofovir shows promise as a topical treatment of recurrent genital herpes infections, although it can have severe side effects, including kidney damage.

Several simple steps can produce some relief:- Drink plenty of water.Ice packs may relieve the pain and help reduce recurrences .Lukewarm baths may be helpful. Over-the-counter medications such as aspirin, acetaminophen (Datril, Panadol, Tylenol), or ibuprofen (Advil, Medipren, Motrin, Nuprin), can be helpful to relive pain, fever and local tenderness.

Treatment for Oral Herpes

Acyclovir (Zovirax), valacyclovir (Valtrex), and famciclovir (Famvir) -- the anti-viral pills used to treat genital herpes -- can also treat the cold sores associated with oral herpes. In addition, acyclovir and penciclovir are available in topical form .Docosanol cream (Abreva) is the only FDA-approved non-prescription ointment for oral herpes. It is applied five times a day.Over-the-counter topical anesthetics may provide modest relief. They include Anbesol gel, Blistex lip ointment, Campho-phenique, Herpecin-L, Viractin, and Zilactin.

Pregnancy

If women has first outbreak during pregnancy, she is more likely to pass the virus to her baby. In cases of recurrent outbreak, the baby's risk of getting the virus is very low. Babies born with herpes may be premature or may die, or they may have brain damage, severe rashes, or eye problems. It is not yet to be determined if all genital herpes drugs are safe for pregnant women to take. Some doctors may prescribe acyclovir .If you have genital herpes, you can keep breastfeeding as long as the baby doesn’t come in contact with open sores. Herpes is spread through contact with sores and can be dangerous to a newborn. If there are sores on breast stop breastfeeding on that breast.

Preventing Transmission

Wash their hands and nails after contact with the infected area. Keeping personal items separate during an active infection may help to reduce transmission to other family members. The virus can live for up to 2 to 4 hours on objects. If genital lesions are present, infected persons should not indulge sexual intercourse.Wear a condom during any sexual activity, even when symptoms are not present. Condoms are also important during oral sex.The use of condoms doesn’t provide absolute protection against the transmission of HSV-2.