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NBC29 HEALTH SEGMENTS |
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HERPES (Genital Herpes and Oral Herpes) There are two types of Herpes Simplex Virus (HSV) that will be discussed: Type I (often known as a Cold Sore on the mouth or Oral Herpes) and Type II (often known as Genital Herpes). Genital herpes is the most widespread sexually transmitted disease in the world (25 - 35% of sexually active adults). There are 500,000 new cases of genital HSV infection every year. Approximately 40 to 60 million North Americans have HSV-2 antibodies; this means that these 40-60 million people have been exposed to genital herpes and have formed antibodies against them. Overall 10 to 40% of people have antibodies to HSV-2. For Oral Herpes, 45 to 98% of adults have HSV-1 antibodies depending on the population looked at. 90% of the time, Genital Herpes is due to HSV-2, and 90% of the time Oral Herpes is due to HSV-1. However, 10% of the time, Genital Herpes is due to HSV-21 and 10% of the time Oral Herpes is due to HSV-2. So it is possible for a person to have a Cold Sore on his/her mouth and spread it to his/her own genitals or to someone else's genitals. Though the 2 viruses are somewhat different, they are transmitted the same way and are treated the same way. HSV is transmitted into a person through mucosa or broken skin. Mucosa is basically moist skin lining of the mouth, vagina, anus, foreskin, etc. As mentioned above, HSV-1 and HSV-2 can be both genital and/or oral herpes. So a person can spread herpes from one place (such as the mouth) to another place (such as the genitals) with a contaminated hand. After a person is infected with herpes, there can be a "Primary" outbreak of herpes. Most people should have this outbreak but many people do not seek medical attention for it and therefore are unaware that they have herpes. After the initial infection, HSV becomes "latent", which means it hides in your nervous system quietly. However, the HSV can then recur throughout the person's lifetime. More than one-third of the world population has recurrent HSV infections, and it is believed that one-third of the US population has recurrent herpes labialis (herpes on the female outer genitalia). This means that there is an annual incidence of 100 million episodes. MANY MARRIAGES MAY HAVE BEEN BROKEN DUE TO THIS PROBLEM WITH HERPES. Because herpes can lie quietly for years, if not decades, a person may not know they have herpes until years later when there is a recurrence. Symptoms of HSV range from having absolutely no symptoms to having life-threatening diseases such as neonatal ("a baby just born") herpes, herpes simplex encephalitis (infection of the brain) and viscerally-disseminated (internal organs) infections in immunocompromised hosts. If untreated, 50% of neonates with HSV encephalitis and more than 80% with disseminated HSV infection will die. HSV encephalitis is a common cause of fatal encephalitis and survivors usually develop permanent neurological impairment. Immunocompromised hosts are much more susceptible to persistent mucocutaneous (inside the mouth) HSV infections, which may progress and involve the oesophagus (throat), respiratory tract or gastrointestinal tract. Before the availability ofaciclovir, HSV infections in these patients caused death or serious morbidity. Herpes begins typically with a "tingling or numb" sensation where the blisters will appear. The tingling usually starts 6-24 hours before the blisters appear. The blisters form with a clear to yellow clear fluid. The blisters are very delicate and usually break within 12-24 hours of appearance. Ulcers then are left after the blisters and remain typically 7-10 days. The blisters and ulcers are painful, especially the first 3-4 days. After the ulcers begin to heal, there will be some brown discoloration and total healing is at day 21. The person may have some other symptoms with the herpes episode, such as mild fevers, feeling tired, swollen lymph nodes, and body aches. Oral herpes usually appears on the lips, gums, soft palate, back of the throat, or the face. Genital herpes in women usually appears on the labia, vagina, cervix, buttocks, and perineum (between the vagina and anus). Genital herpes in men usually appears on the shaft of the penis, head of the penis (glans), buttocks, thighs, and perineum. Studies have shown that patients diagnosed with genital herpes often show high levels of anxiety and depression. Because women who acquire genital HSV late in pregnancy are particularly at risk for passing herpes to the newborn during vaginal delivery, caesarean deliveries are recommended in these circumstances, and for symptomatic recurrences peripartum or at labor onset. There is no cure. There are antiviral medicines that can be effective in shortening the course of an outbreak, but they typically must be used within 48 hours of onset of symptoms. Remember, talk to your doctor about your concerns. Examples (warning, some pictures are graphic): |