Herpes Simplex Type 1 and 2
Researched By Christie LaValley
for Under the Covers on ipmnation.com
***This is in no way is an ad for sex. These are suggestions for your
personal life, not for office visits.
Herpes simplex viruses -- more commonly known as herpes -- are categorized into two types: herpes type 1 (HSV-1, or oral herpes) and herpes type 2 (HSV-2, or genital herpes). Most commonly, herpes type 1 causes sores around the mouth and lips (sometimes called fever blisters or cold sores). HSV-1 can cause genital herpes, but most cases of genital herpes are caused by herpes type 2. In HSV-2, the infected person may have sores around the genitals or rectum. Although HSV-2 sores may occur in other locations, these sores usually are found below the waist.
Amazingly, under a microscope, HSV- 1 and 2 are virtually identical. They share approximately 50% of their DNA. Both types infect the body's mucosal surfaces, usually the mouth or genitals, and then establishes residence in the nervous system. The primary difference between the two viral types is in where they typically establish residence in the body. Both Types of Herpes have a "site of preference." HSV-1 usually establishes residence the trigeminal ganglion, a collection of nerve cells near the ear. From there, it tends to recur on the lower lip or face. HSV-2 usually sets up residence in the sacral ganglion at the base of the spine. From there, it recurs in the genital area . But not everyone who gets the herpes simplex virus develops cold sores. In some people, the virus stays dormant (asleep) permanently.
How common is it?
The disease is very common. According to Wikipedia, Worldwide rates of HSV infection are between 65% and 90%.] HSV1 is more common than HSV2 with rates of both increasing as people age.] Rates of infection are determined by the presence of antibodies against either viral species.[
In the US, 57.7% of the population is infected with HSV-1[64] and 16.2% are infected with HSV-2. Among those HSV-2 positive, only 18.9% were aware that they were infected. About 1 million new cases are reported every year. Millions more likely go unreported.
About one in five U.S. adults and teens have had a genital herpes infection -- and most don’t know it.. Genital herpes is a chronic, lifelong viral infection. At least 50 million persons in the United States have genital HSV infection. One out of four teens in the United States becomes infected with an STD each year and by the age of 25, half of all sexually active young adults will get an STD. Women are more susceptible to herpes.
STDs can increase the risk of HIV. People with genital herpes have at least twice the risk of becoming infected with HIV if exposed to it than those without it. Read more about herpes and HIV infection.
What Causes Herpes Infections and Outbreaks?
Herpes simplex type 1, through sores on the skin, can be spread through kissing or sharing objects such as toothbrushes or eating utensils. In general, a person can only get herpes type 2 infection during sexual contact with someone who has a genital HSV-2 infection. It is important to know that both HSV-1 and HSV-2 can be spread even if sores are not present.
Pregnant women with genital herpes should talk to their doctor as genital herpes can be passed on to the baby during childbirth.
Some things that can trigger (wake up) the virus and cause attacks (or outbreaks) of herpes can be brought on by the following conditions:
- General illness (from mild illnesses to serious conditions)
- Fatigue
- Physical or emotional stress
- Immunosuppression due to AIDS or such medications as chemotherapy or steroids
- Trauma to the affected area, including sexual activity
- Menstruation
- Sun exposure
- Surgery
- Extreme Heat
What Are the Symptoms of Herpes Simplex?
When Herpes wakes up it will leave its home in the ganglion and follow the nervous system to a weakened nerve cell on the skin. As it leave the ganglion it will send out signals it is coming. It can stimulate the neurons along the cytoskeletal highway, engendering a tingling sensation. This is known as prodrome.
Prodrome
A warning sign (prodrome) is experienced by many people in recurring outbreaks. Warning symptoms which indicate the virus is becoming active, and is on its way to the skin's surface may include:
- itching
- tingling
- numbness
- burning
- general fatigue
- flu-like symptoms
- fever
- swelling of the lymph nodes in the area of outbreak
- headache
- painful urination
- pain in the buttocks, back of legs, lower back
Weakened Nerve Cells under the skin- The infected area is usually painful and may itch, burn or tingle, during the outbreak. Symptoms of herpes simplex virus typically appear as a blister or as multiple blisters on or around affected areas -- usually the mouth, genitals, or rectum. The blisters break, leaving tender sores.
The first episode is usually the most severe as most people have not been exposed to the virus before and antibodies will not have been produced to trigger the immune response. When the herpes virus gets into skin cells it reproduces itself and starts to multiply, making the skin red and sensitive. Blisters or bumps may appear on the area of contact, the blisters first opening, then healing with the regeneration of new skin tissue
- usually develop within 2 to 20 days after contact
- could continue up to 2 weeks
- may be so mild it goes unnoticed
- may take longer or be less severe in some people, especially in those with partial immunity to the virus from having another form of herpes
- the first attack sometimes causes visible sores
- last between 10 - 21 days
Other symptoms include:
- swollen lymph glands
- painful inflamed blisters develop around infected area
- headache
- muscle ache
- fever
- vaginal or penis discharge
- infection of the urethra causing a burning sensation during urination
- a burning sensation in the genitals
- lower back pain
- small red bumps may appear in the genital area following earlier symptoms, later developing into painful blisters, which crust over, form a scab, and heal.
How is Herpes Spread?
Herpes is spread by direct skin to skin contact. Unlike other viruses that you can get through the air, herpes spreads by only by direct contact. For example, if you have a cold sore and kiss someone, you can transfer the virus to their mouth. Likewise, if you have active genital herpes and have vaginal or anal intercourse, you can give your partner genital herpes. Finally, if you have a cold sore and have oral sex by putting your mouth on your partner’s genitals, you can give your partner genital herpes.
When Is Herpes Most Likely To Be Spread?
Herpes is most easily spread when a sore is present, but, it is also spread at other times too. Some people notice itching, tingling or other sensations before they see anything on their skin. These are called "Prodromal Symptoms" and they warn that virus may be present on the skin. Herpes is most likely to be spread from the time these first symptoms are noticed until the area is completely healed and the skin looks normal again. Sexual contact (oral, vaginal, or anal) is very risky during this time.
Can Herpes Be Transmitted Without Symptoms? Yes! Sometimes those who know they are infected spread the virus between outbreaks, when no signs or symptoms are present. This is called "Asymptomatic Transmission."
Research also shows that herpes simplex infections are spread by people who don't know they are infected. These people may have symptoms so mild they don't notice them at all or else don't recognize them as herpes. 60% of infected people do not know they are infected. Due to this is are much safer in a relationship with infected person who is familiar with their body and are educated with STDs, then with someone who is uneducated with STDs.
How easily Herpes Spread?
Most people with genital herpes are just as concerned about transmission-the likelihood of spreading the virus to a partner-as about their own health. On the other hand, few people with oral herpes, share this concern. Is this because one type is more contagious than the other?
No!!! Both viral types are easily transmitted to their site of preference, and can also be spread to other sites. Both are most contagious during active outbreaks, but are may be spread through viral shedding when there are no recognizable symptoms. According to Spruance, people with recurrent oral HSV-1 shed virus in their saliva about 5% of the time even when they show no symptoms. In the first year of infection, people with genital HSV-2 shed virus from the genital area about 6-10% of days when they show no symptoms, and less often over time. (Both of these figures reflect shedding as detected by viral culture.) In other words, The longer someone has had herpes the less likely they are to have a shedding period.
However, possible transmission gets more complicated. Acquisition of one type is more difficult-though certainly possible-if you already have the other type. This is because either type, contracted orally or genitally, causes the body to produce antibodies, some of which are active against both HSV-1 and 2. This acquired immune response gives some limited protection if the body encounters a second type. When a person with a prior HSV infection does contract the second type, the first episode tends to be less severe than when there are no prior antibodies present.
This means oral HSV-1 is often the most easily acquired herpes infection. Usually the first herpes simplex virus that people encounter, oral HSV-1, is typically spread simply by the kind of social kiss that a relative gives a child. Because children have no prior infection with any HSV type, they have no immune defense against the virus.
By the time they're teenagers or young adults, about 50% of Americans have HSV-1 antibodies in their blood. By the time they are over age 50, some 80-90% of Americans have HSV-1 antibodies.
How Is Herpes Simplex Diagnosed?
Often, the appearance of herpes simplex virus is typical and no testing is needed to confirm the diagnosis. If a health care provider is uncertain, herpes simplex can be diagnosed with laboratory tests, including DNA -- or PCR -- tests and virus cultures.
How Painful Is Herpes Simplex?
Some people experience very mild genital herpes symptoms or no symptoms at all. Frequently, people infected with the virus don't even know they have it. However, when it causes symptoms, it can be described as painful. This is especially true for the first outbreak, which is often the worst. Outbreaks are described as aches or pains in or around the genital area or burning, pain, or difficulty urinating. Some people experience discharge from the vagina or penis.
Oral herpes lesions (cold sores) usually cause tingling and burning just prior to the breakout of the blisters. The blisters themselves can also be painful.
How often does one have an outbreak?
Just how much of a physical problem HSV poses for a person depends largely on three factors:
The first is how well the person's immune system is able to control the infection. Differences in immune response may be the main reason that some people are plagued by frequent cold sores or genital herpes outbreaks while others are not. It's also the reason that both HSV-1 and 2 can pose serious challenges for infants, who have a limited immune response; as well as for people with compromised immune systems, including people with cancer, AIDS, severe burns, and people taking immunosuppressant medications.
The second factor affecting outbreaks is how long a person has had the infection. Over time, recurrences of both HSV- 1 and 2 tend to decrease, for reasons that aren't entirely clear. In the case of oral HSV-1, many of the approximately 100 million Americans acquired the virus when they were children. By the time they're adults, only some 5% of people are bothered enough to consider oral HSV-1 a medical problem, according to Spruance. Almost all of the approximately 40 million Americans infected with HSV-2 acquired the virus as teenagers or young adults. For those with HSV 2, those who have recurring outbreaks experience an average of four to six episodes in the first year. Over time, as with oral infections, the number of outbreaks usually drops off.
The third factor that affects the frequency of HSV -1 and 2 outbreaks is whether the virus is took up” home” in its site of preference. While either HSV type can infect both genital and oral areas, both types cause milder infections when they are away from "home" territory. When not making “home” in their site of preference, both type 1 and 2 seem to lose most of their punch. For example, most people infected with HSV-1 in the genital area have few, if any, outbreaks after the initial episode, far fewer than is typical with either oral HSV-1 or genital HSV-2. While experts estimate that some 30% of genital herpes infections in the United States may be caused by HSV-1, only 2- 5% of recurring genital outbreaks are caused by HSV-1. Research conducted by Lawrence Corey, MD, and colleagues at the University of Washington in Seattle shows that genital HSV-2 recurs 10 times more often than genital HSV-1.
According to a study by Wald et al. (New England Journal of Medicine, 1995), among 110 women with genital herpes, the average number of recurrences per year for those with genital HSV-1 was zero. Other studies have shown an average of about one outbreak per year (Benedetti, Annals of Internal Medicine, 1994).
Similarly, HSV-2 infection in the oral area-outside its site of preference-very rarely causes problems. First of all, oral, HSV-2 infections are rare, for reasons discussed below. But even when an infection occurs, recurrent outbreaks are uncommon. In one study (Lafferty et al., New England Journal of Medicine, 1987), oral HSV-2 recurred an average of 0.01 times a year in newly infected people. "I've never convincingly seen an oral type 2 recurrence," says Spruance.
A possible fourth factor affecting recurrence rate is viral type. According to the Lafferty study, genital HSV-2 infections were the most frequently recurring herpes infections, followed by oral HSV-1, genital HSV-1, and last of all, oral HSV-2.
Social Views of Herpes
When an infected person first tells someone they have genital herpes, they may start by comparing the infection to oral herpes, or cold sores. Despite of scientific facts, the social stigma and negative emotional attitudes when dealing with genital herpes can make it hard to compare it objectively with an oral infection that most people casually accept. Viewing herpes with the negative assumptions of our society, many still believe there is a "good" herpes virus-HSV- 1, the usual cause of cold sores-and a "bad" herpes virus-HSV-2, the usual cause of genital herpes.
However this is not an absolute. Either type can reside in either or both parts of the body and infect oral and/or genital areas. Unfortunately, many people aren't aware of this, which contributes both to the spread of type 1 and to the misperception that the two types are somehow different.
"People don't understand that you can have type 1 genitally or orally, that the two types are essentially the same virus,' says Marshall Clover, manager of the National Herpes Hotline." One type is associated with stigma, the other is "'just a cold sore"- our society has a euphemism for it so we don't even have to acknowledge that it's herpes.
While HSV is frustrating and can be a painful condition for some people, in general the virus is less a medical problem than a social problem. For most of us, genital herpes is no more dangerous than a cold sore. However, whether we like it or not, there is social prejudice that is a reality against someone with genital herpes, no matter which virus causes it, "People have more trouble explaining to a new partner that they have genital herpes, even if it's HSV- 1, than if they have a cold sore," says Glover. "Just saying the word "genital" is like an anvil that pulls the sentence down".
For people who have trouble dealing with social attitudes toward genital herpes, the blatant double standard society applies to oral herpes can be frustrating, to say the least, but can send many of its infected into isolation, depression or to suicide. Realistically though after reading about HSV, wouldn’t it better to have this disease in your pants than on your face? Understand if others seem freaked by you without taking it personally.
Can Herpes Be Cured?
There is no cure for herpes simplex. Once a person has the virus, it remains in the body. The virus lies inactive in the nerve cells of the trigeminal or sacral ganglion until something triggers it to become active again
Prevention: Ways to Reduce Your Risk
1. Use a condom every time you have sex.
A condom may protect you from the herpes virus if it covers the infected area. Male condoms offer good protection, only if the infected area on the male is covered or contact with the infected area on the female is prevented. Female condoms may offer better protection as they cover a larger area. Protection is lost if a condom slips or breaks and contact is made with the infected. If you touch an infected area, immediately was the area that came in contact with the sores.
2. Ask your partner if he or she has ever had a sexually transmitted disease.
Most people who have genital herpes don't know they're infected, so ask whether he or she has had any other sexually transmitted disease. People with a history of STDs are more likely to have genital herpes.
It may be awkward, but it's important to be honest with each other. Your partner may be afraid to tell you the truth if he or she fears a negative reaction. If your partner feels comfortable talking with you, you'll be more likely to get straight answers.
3. Ask your partner about his or her sexual history.
Someone who has had many sexual partners is more likely to be infected with the herpes virus.
4. Limit the number of sexual partners you have.
The fewer sexual partners you have in your lifetime, the less likely you are to be exposed to the herpes virus.
5. Look with your eyes. Have sex in the light
Don’t go in blind. There is nothing wrong with relishing and looking your partner over for possible issues. You will both thank yourself later.
6. Don't receive oral sex from somebody with a cold sore or without STD Testing.
Oral Herpes which causes sores on the mouth, can be passed to the genitals through oral sex. Plus, who wants gonorrhea of the mouth
7. Ask your partner to be tested for STDs.
If you think your partner is at high risk for genital herpes and other STDs, you may consider asking him or her to be tested. In that case, you should be tested, too.
8. Don't have sex while intoxicated.
Alcohol and illicit drugs lower inhibitions and impair judgment. People tend to be less careful about practicing safer sex while intoxicated and they often regret it later.
9. Wait to have sex.
The only way to be 100% certain you won't get a sexually transmitted disease is to have just one sex partner who has no STDs -- and only if both of you stay monogamous for life. Plus the earlier you have sex the more likely you are to contact herpes or another STD.
10. Try alternate forms of sexual intimacy.
If you don't want to be monogamous or totally celibate until you find a life partner, you could greatly reduce your risk of getting a sexually transmitted disease by doing things that don't involve genital-genital contact or oral-genital contact, such as mutual masturbation.
You ultimately decide what you are willing to deal with. Make an educated choice.
What to Do if Your Partner Has Genital Herpes?
Getting information on genital herpes is one way to deal with your feelings. A partner who has genital herpes needs your support and acceptance. The only way you can do that is to be truly educated. It took a lot of courage for your partner to tell you, and it means he or she cares about your well-being, health, and values your trust. They are telling you because you are special to them or they love you.. A good loving partner never wants to share this part of themselves with you. A person who tells you has integrity. They want you to be safe and to trust them with your life. Telling you is the ultimate sacrifice. For yes, you could reject them. And it is your right. Sometimes, as stated on other Herpes website "No good deed goes unpunished" is often a harsh fact of life. But if you care for this person at all, don't let it be that way in your relationship. Of course, your feelings and concerns matter, too. If you're uncomfortable with the idea of having sex with your partner again, or becoming sexually intimate for the first time, you're entitled to feel that way.
But instead of declaring the sexual part of your relationship is over or out of the question, think of ways you can be intimate without risking infection. You can reduce the risk of becoming infected through sexual intercourse by using condoms and avoiding sex when your partner has symptoms. There will always be some risk, even if you practice safer sex, but you can minimize it as much as possible.
Get Informed About Genital Herpes
Educate yourself about genital herpes if your partner has not explained it to your satisfaction. You'll find out that it's not as serious as it may seem, and that people can and do have wonderful relationships with great sex even though one of them has genital herpes.
Sometimes people in long-term relationships suspect that their partner has been cheating when he or she is diagnosed. That's not necessarily true, so don't make that accusation. Your partner could have been infected years or decades before you met. Remember some people never have an outbreak. Also, consider the possibility that you gave your partner herpes. Millions of people live with genital herpes without having a clue that they're infected. In fact, health experts estimate that 60-90% of those who are infected in the United States don't know it. A herpes infection doesn't always cause obvious sores on the genitals. In many cases, it causes no noticeable symptoms. Health care professionals say that sex partners of people with herpes should be tested, as that is the only way to know for sure if they are infected or not.
Pregnant women with genital herpes should talk to their doctor as genital herpes can be passed on to the baby during childbirth .Delivering a baby via cesarean section can protect an infant from infection with the herpes simplex virus (HSV). Read more about the recommendations for cesarean section and herpes.
How Is Herpes Simplex Treated?
Although there is no cure for herpes, treatments can relieve the symptoms. Medication can decrease the pain related to an outbreak and can shorten healing time. They can also decrease the total number of outbreaks. Drugs including Famvir, Zovirax, and Valtrex are among the medications used to treat the symptoms of herpes. Warm baths may relieve the pain associated with genital sores. There are many ways to treat the disease including: diet, medication, topical ointments, herbs.
First and foremost the disease should be treated by diet. It is possible to significantly reduce outbreaks by eating healthy, avoiding certain foods and taking vitamin supplements to support a healthy immune system.
Diet:
- Avoid alcohol, processed foods, colas, white flour products, surgar refined carbohydrates, coffee, and drugs use.
The following vitamin supplements are recommended by the book Prescription for Nutritional Healing:
Vitamin A
|
50,000 IU daily
|
Vitamin B
|
50mg or more 3 times daily
|
Vitamin C
|
5,000 – 10,000mg
|
Zinc chelate
|
50-100mg daily in divided doses
|
Vitamin E
|
600 IU daily
|
Calcium
|
1500 mg daily
|
Magnesium
|
750 mg daily
|
Medication:
Consult your doctor about the appropriate course of medication for your circumstances. Your doctor will usually prescribe a treatment that follows the CDC recommedations. Their recommended course of treatment depends on whether or not this is the first episode, or a recurring episode. The CDC basic guidelines are as follows:
First episode: Many patients with first-episode herpes present with mild clinical manifestations but later develop severe or prolonged symptoms. Therefore, most patients with initial genital herpes should receive antiviral therapy.
One of the following courses is chosen.
- Acyclovir [Zovirax] 400 mg orally three times a day for 7--10 days
- OR Acyclovir [Zovirax] 200 mg orally five times a day for 7--10 days
- OR Famciclovir [Famvir] 250 mg orally three times a day for 7--10 days
- OR Valacyclovir [Valtrex] 1 g orally twice a day for 7--10 days
Recurring episode: Effective episodic treatment of recurrent herpes requires initiation of therapy within 1 day of lesion onset, or during the prodrome that precedes some outbreaks. The patient should be provided with a supply of drug or a prescription for the medication with instructions to self-initiate treatment immediately when symptoms begin.
One of the following courses is chosen.
- Acyclovir [Zovirax] 400 mg orally three times a day for 5 days
- OR Acyclovir [Zovirax] 200 mg orally five times a day for 5 days
- OR Famciclovir [Famvir] 125 mg orally twice a day for 5 days
- OR Valacyclovir [Valtrex] 500 mg orally twice a day for 3--5 days
- OR Valacyclovir [Valtrex] 1.0 g orally once a day for 5 days
Herbs:
Herbs shown to be effective include mint family herbs such as: lemon balm, oregano, rosemary, sage, and thyme. Herbal teas that include these have shown to be beneficial. Application of lemon balm to sores is reported to be effective at shortening the outbreaks. A popular and effective product containing the essential oil of lemon balm is HBalm. It has positive results for many people.
Another genital herpes fighting product based on essential oils is H-Away from Amoils.com.
One promising study of herbal treatments documents that it was able to cure 49% of the study participants. This is the only mention of a cure in a medical study. This may work for many people with herpes. More info at: http://www.secret-cures.com
Treatment with Dynamiclear has shown amazing results. Most people report that once treated, sores never return. The ingredients are kept a closely guarded secret, but the numerous testimonials prove it is without a doubt one of the most effective products available today. Get it at: http://www.dynamiclear.com
Information for this article was found on these fine websites:
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***This is in no way is an ad for sex. These are suggestions for your personal life, not for office visits.
