Sexually Transmitted Diseases (STD)
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Human Papilloma Virus (HPV)
Vaginitis
Herpes
Herpes
Symptoms
Herpes is caused by a virus (Herpes Simplex HSV). The most common symptom is a single blister or cluster of painful blister-like lesions. Lesions are generally found around the mouth, nose or genitals. In females the genital lesions appear around the vaginal opening, urethra, anus and buttocks. Local swelling, burning upon urination and unusual vaginal discharge may occur. Males may develop blisters on the penis and/or around the anus and buttocks. The fluid-filled lesions are highly contagious. The lesions may last up to three weeks. They will usually crust over, form a scab and then heal completely without scarring. Other symptoms may include fever, headache, swollen glands, muscular aches and fatigue. These symptoms are most common during the first episode. Some individuals with Herpes develop mild symptoms or no symptoms at all.
Incubation and Transmission
Herpes virus is spread though skin to skin contact from an area where the virus is present to a skin site that is susceptible. The virus may effect mucous membranes and the skin around the mouth, nose, vagina, urethra, anus or eyes. Oral, anal and vaginal sexual intercourse are sexual behaviors or activities that may transmit the virus. Kissing and close skin to skin contact without intercourse can also pass the virus.
Individuals who have sexual contact with an infected partner may develop symptoms within two to ten days or longer.
Can the virus be passed when no Herpes sores are present? What is asymptomatic viral shedding?
Most of the time when Herpes sores are not present on the skin the virus remains in a latent (inactive) state in the central nervous system, where it does no damage.
At times the virus travels back to the skin sites or mucous membranes without causing active symptoms recognizable as Herpes. Once the virus is at these sites its presence there may produce something known as asymptomatic (no symptoms) viral shedding. This shedding creates a risk of spreading Herpes to others through sexual contact or intimate physical contact. There are many unanswered questions about the risk of transmitting Herpes to another person during asymptomatic viral shedding. However, studies seem to agree on the following points:
Asymptomatic viral shedding occurs in a majority of persons who have recurring Herpes.
Asymptomatic viral shedding occurs on the average between 20 and 40 percent of days in the first six months after initial infection and on 5 to 20 percent of days after this time.
The amount of shedding is greatest in the first year after a person acquires Herpes and declines over time.
Fifty percent of shedding occurs within a week before or a week after a recognized Herpes outbreak.
Shedding can be suppressed but not eliminated by antiviral medication (see treatment section).
Will the Herpes recur?
Some people will have no recurrences. The great majority of people will have three or fewer recurrences per year. Some people will have more frequent recurrences. Recurrences are often minor (single, small blisters) but must be recognized because the blisters are contagious. Most people with long term recurrences will notice a decline in the yearly number of recurrences.
For persons with recurring Herpes, certain signs, called the prodrome, indicate the beginning of a new outbreak. People may feel a tingling sensation 24-36 hours before the blisters begin to appear. Herpes virus may be transmitted through direct skin to skin contact during the prodrome. It is believed that recurrences can be triggered by stress, fatigue, poor nutrition, menstruation, sexual intercourse, or illness that reduces the efficiency of the bodys immune system. Oral Herpes may recur from sun exposure.
Diagnosis and Treatment
An evaluation by a physician or nurse practitioner will include visual inspection of the lesions and a brief sexual history. The evaluation may also include a viral culture taken from the Herpes lesion as well as tests for other sexually transmitted diseases.
There is no cure for Herpes at this time. Current treatments center on relieving symptoms. Antiviral drugs such as acyclovir or related compounds such as famciclovir or valacyclovir can hasten the healing process in first episodes. Antiviral treatment can also be used for episodic treatment of recurrences. (Medication can be taken at the first recognition of signs of a recurring Herpes sore.) For those individuals who have frequent outbreaks, daily antiviral medication has been used to suppress recurrences.
To reduce pain and increase comfort:
Soak in a tub of cool water 2 to 3 times daily to help reduce inflammation.
Keep affected area as clean and dry as possible. After a bath or shower use a hair dryer set on cool to dry the area where lesions are present. If you do not use a hair dryer use a soft towel and pat dry. Do not use the towel on unaffected areas of the body.
If you have open cuts on hands or other parts of the body, avoid contact with Herpes.
Washing hands will help prevent the rare possibility of passing the virus from one part of the body to another.
Avoid touching eyes and other mucous membranes that have had contact with Herpes lesions.
Avoid tight fitting underwear, jeans, pantyhose. Wear cotton underwear.
Does Herpes affect the newborn?
If a woman has her first Herpes infection during pregnancy, the virus may affect the developing fetus. If a woman has recurrent Herpes the developing fetus is protected by the mothers antibodies. However, there is a possibility of the baby being infected during delivery if genital sores are present. The woman should inform her medical care provider about her Herpes history so that appropriate tests and follow-up care will be provided. A cesarean birth procedure may be necessary to keep the baby from direct contact with genital lesions. Women who have genital Herpes should have yearly pap smears.
What can I do to reduce the risk of sexual transmission of Herpes?
Avoid sexual contact during periods when symptoms are present. Sexual expression that does not involve physical contact with infected skin areas can be safe activities.
Use condoms between outbreaks to reduce the risk of transmitting the virus during unrecognized reactivation and asymptomatic viral shedding.
Consult with your health care provider about you own specific questions and concerns about safer sex.
How can I feel better about myself after the diagnosis of Herpes?
An estimated 40 million Americans have genital Herpes and another 50 million have oral Herpes. Research data released in 1997 showed that 21.9% of Americans 12 and older are infected with HSV-2 (genital Herpes). Most of these people learn to cope successfully, but the initial diagnosis can be very upsetting and emotional. Many people with a newly diagnosed case of Herpes want to concentrate on when they got the virus and from whom. This is very difficult because the diagnosis of genital Herpes often happens months to years after the person first was infected with the virus.
The first task is to recognize that Herpes does not change who you are. Although some persons with Herpes may at first feel depressed, angry or damaged, Herpes does not make you a bad person or reflect upon your inherent self-worth. Herpes is a treatable skin infection, with a variety of options to help reduce physical pain and emotional stress.
The second task is educating yourself. Almost everyone eventually finds some way to control Herpes or to feel in control. Paying close attention to body signals, recognizing the prodrome of an outbreak and immediately beginning anti-viral treatment, cool baths, pain relievers and stress relief is the start of control. The more you understand yourself and the virus the more in control you will feel. Many persons with Herpes find talking with a counselor or finding a supportive friend or support group is very helpful. Ask your medical provider or Health and Wellness Education (812) 855-7338 for information.
In considering what's best for you, the following resources may be helpful:
National Herpes Hotline
(919) 361-8488
Monday through Friday, 9:00 a.m. to 7:00 p.m. (EST)
National Sexually Transmitted Disease (STD) Hotline
(800) 227-8922
Monday through Friday, 8:00 a.m. to 11:00 p.m. (EST)
Health & Wellness Education
Indiana University Health Center, 4th floor
(812) 855-7338
Monday through Friday
8:00 a.m. to 12:00 p.m. and 1:00 p.m. to 4:30 p.m. (EST)
American Social Health Association
http://www.ashastd.org
(800) 230-6039
P.O. Box 13827
Research Triangle Park, NC 27709-3827
(Provides materials and services related to Herpes)
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