Herpes Simplex Viruses (HSV)

There are currently eight types of the human herpes virus. However, only two of types more commonly known as herpes simplex one and two (HSV 1 & 2) cause the appearance of genital herpes in both men and women. HSV 1 is typically responsible for herpes infections of the nose, mouth and lips causing the skin irritations we know as cold sores. HSV 2 is the type which leads to infections and sores around the genitals and anus. However, in recent years there has been an increase in HSV 1 infections in the genital and anal regions, due to an increase in the numbers of couples taking part in oral sex. The important thing to remember, when dealing with genital herpes, is that the virus can often be difficult to detect. This is because it actually hides in the nerve fibres adjacent to the infected area and can therefore often go unnoticed. HSV 2 is transmitted through unprotected vaginal and anal sex and even then, condoms are only effective if they cover any open sores or areas of infection. HSV 2 can be transmitted through kissing and oral sex.

What are the symptoms?

No symptoms should appear until two to seven days after the initial contact with the virus. However, once they begin, the experience can last up to a month. In instance of genital herpes, an itching or uncomfortable sensation will be experienced in that region of the body. This may be accompanied by blisters that can burst and leave sores around the genital region. Further to this, some discomfort may be experienced when urinating, particularly if any urine comes into contact with these sores. Headaches, back pain and some flu like symptoms like fever or swollen glands, may also indicate the presence of herpes. The initial period of infection is also the point where a sufferer is most infectious and even if these symptoms do not appear, there remains an increased risk of passing them on. Once the initial two week to a month long period of infection has passed, any subsequent outbreaks will be shorter and less painful lasting around three to five days with fewer sores and reduced discomfort. In time, further flare ups, often experienced by those who show none of the previously mentioned symptoms, can experience the sores and discomfort due to increased stress or illness which disrupts the immune system and leads to problems.

What can Herpes lead to?

Once the initial infection period is completed, the condition can effectively disappear, remaining dormant within the skins cells. However, this varies from person to person and while some many experience no more ill effects, other may have up to six periods of herpes aggravation and discomfort within a year. The infection can spread to the tonsils and anus causing further discomfort and problems. Furthermore, the bacteria can infect ulcers and other open wounds around the body. If the infection spreads to the eyes, sight can be damaged. In some specific instances, herpes can cause further complications. For instance, the combination of an HSV and HIV infection can lead to an increase in the number of herpes related episodes and these periods are often more painful than normal. This is due to the suppression of the immune system that these viruses foster. Pregnant women may also face problems. While the infection does not directly affect fertility, if it is transmitted to a pregnant woman within the first three months of the pregnancy they face a minor risk of miscarriage. Infection within the last few months of pregnancy can occasionally lead to premature birth. If the first period of infection is experienced during pregnancy there is an increased risk of transmission to the child in the womb. Though this is rare, it carries a serious danger with potential damage to the nervous systems, skin and internal organs of the child. Therefore prompt testing when pregnant is important. In each of these cases, it is important to remember that such complications are rare.

How is it diagnosed?

As with any suspicious infections, a doctor should begin by examining the genital area of the patient. Then a sample is taken, usually from any area where there are visible sores, using a sponge swab or piece of cotton wool. Doctors should give women a full internal pelvic examination while men require a more straightforward external genital examination. In both instances, a urine sample can be taken and tested for the infection. However, in instances where there are no apparent symptoms, a blood test is the suggested course of action. These blood tests work by searching for the specific antibody in the blood that fights the virus. The results should be returned within two weeks. The only drawback of the test is that because it takes the immune system within the body three months to produce this anti body, it will not be effective until three months since the initial infection have passed.

How can I treat this?

There is no definitive cure for the herpes infection. In many cases treatment is not always required as the problem can effectively clear itself up. However, there are courses of antiviral treatments available from doctors, on the market designed to reduce the discomfort and pain in some severe cases of herpes. They effectively work by halting the multiplication of the viruses’ cells within the body. However, they can only work effectively if taken seventy two hours from the onset on the symptoms and once you stop taking them, all the beneficial effects stop. These are available most commonly in two forms. Firstly as antiviral creams like Zovirax that contains acyclovir and can be applied to areas of soreness and cold sores. Oral tablets are available which also contain acyclovir and help to reduce the spread and severity of the infection. These treatments vary with some used suppressive precaution in other word continuously, each day, to prevent the flare up of herpes and those which are used episodically to reduce to flare up of the infection when it occurs.

While there may not be a set cure for the infection, some simple steps can be taken to reduce pain and discomfort. Aspirin or paracetamol are advised to help reduce pain levels. Sore and skin disorders should be washed in a bath of salt water. The water should ideally have a ratio of roughly one teaspoon of salt per pint of water. Loose clothes can prevent the skin from being aggravated further and well as providing an opportunity to cool the damaged regions. To cool further, ice packs wrapped in clothe can also be applied. Additionally some measures can be taken to combat the discomfort felt when urinating. Firstly, you can try either applying water to the area during urination or simply urinating in a bath of water. Drinking lots of fluids should also help neutralize the urine reducing aggravation experienced. Sufferers are also advised to avoid all forms of sunbathing as these aggravate the skin and can cause a dormant infection to react badly. Rest is also advised during herpes related episodes.

Further precautions are advised to ensure that the spread of the infection is reduced. If your hands come into contact with any sores, make sure to wash them thoroughly with soap. Avoid kissing anyone when you are suffering from HSV 1 cold sores. Oral sex involving partners experiencing genital sores should be avoided as should any anal or genital contact with herpes regardless of contraceptive protection. Furthermore, an infected person should avoid using their saliva to wet contact lenses as this can lead to infection spreading in the eyes. Condoms will only work if they cover or block contact to any sores.

Where can I go?

Your doctor should be able to provide testing for the infection, as do family planning clinics. For younger sufferers, some outreach services such as youth centre and school based clinics, may be available for use. Genito-urinary medicine clinics provide effecting screening tests for all STIs and operate on a walk in basis, with no appointment necessary. If you suspect you may have a herpes infection, your doctor should be contacted as soon as possible. The sooner assessment and any treatments begin the less potential damage done. The Herpes Virus Association has a website which offers information and support for those suffering from the infection - http://www.herpes.org.uk/. They also provide a helpline for sufferers, which is available from their website.

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