Herpes Simplex

Definition

Genital Herpes is a sexually transmitted disease and a highly contagious illness spread primarily through direct sexual contact. It may be caused by either Herpes Simplex type I or Herpes Simplex type II virus (more often the latter).

Description

Herpes can be treated but not cured. Symptoms appear briefly and then disappear; the disease lies dormant in nerve cells, but it may be reactivated by stress or illness. It is believed to be more contagious during active periods when blisters are present, however, it can be transmitted person-to-person without active lesions.

Persons taking drugs that suppress the body's immune system (for example, cancer or organ transplant patients) are at a higher risk of contracting herpes because their bodies are in a weakened state. There is also some evidence that links genital herpes with a higher rate of cancer of the cervix in women.

Herpes is spread primarily by sexual contact. It can also be transmitted to an infant during childbirth, causing brain damage or death. Therefore, if a woman shows signs of the active disease while in labor, the baby will be delivered by Cesarean section rather than through the vagina, where the blisters may be present.

Symptoms

The predominant symptom of herpes is the outbreak of painful, itching blisters filled with fluid on and around the external sexual organs. Females may have a vaginal discharge. Symptoms vaguely similar to those of flu may accompany these outbreaks, including fever and fatigue.

The blisters will disappear without treatment in about two to 10 days, but the virus will remain, lying dormant among clusters of nerve cells until another outbreak is triggered by such factors as stress, a cold, fever or menstruation. Many patients are able to anticipate an outbreak when they notice a warning sign (a tingling sensation, called a prodrome) of the approaching illness.

There are some serious complications of herpes simplex:

Eye infections - the herpes virus may infect the eye and lead to a condition called herpes keratitis. The inflammation results in the feeling that there is something in the eye, pain, sensitivity to light and discharge. Drugs are available that prevent severe scarring of the cornea and in eliminating infection.

Infections in babies - a pregnant woman who has genital herpes at the time of delivery can transmit the virus to her baby as it passes through the birth canal and touches the affected area. The baby can die or suffer severe damage, particularly mental retardation. Women who know that they have had genital herpes or think they might have it during pregnancy should tell their physician so preventive measures can be taken.

A Cesarean section is indicated for some patients. It is estimated that only half of all infants delivered through an infected vagina acquire the disease, but the ones that do are at risk for having a severe infection.

The newborn also is infected by exposure to the virus from non-genital lesions. If the mother or a person working in the nursery has active blisters on the lips or hands, the baby can become infected. Family members and friends with active herpes simplex virus should not handle a newborn.

Pregnant women should avoid sexual contact with a partner with active genital herpes, especially in the later stages of pregnancy. The use of condoms can be suggested for those who will not abstain. There is no evidence to suggest that infection of an infant with herpes simplex virus (HSV type I) carries a different risk than infection with genital herpes HSV type II).

Treatment

Unlike other sexually transmitted diseases, herpes cannot be cured because medication that will attack the virus while it lies dormant in the nerve cells will also damage the nerve cells. However, there is treatment available for acute outbreaks that involves the use of anti-viral drugs (such as Acyclovir or Famcyclovir).

Acyclovir has been found to reduce the reproduction of the virus in initial outbreaks, thus possibly lessening the number of subsequent outbreaks. To be effective, therapy must be started immediately after the first sores appear. Every sexual partner of the infected person needs to be examined, and if necessary, treated.

Famcyclovir has similar effects and may work to prevent a herpes infection from establishing itself if taken soon enough in the course of the illness.

Prevention

Herpes can be prevented by avoiding sexual contact with an infected person. Because the chances of contracting this disease increase with the number of sexual partners a person has, limiting the number of partners is the first step toward prevention. Using condoms also helps to reduce the risk.

Questions to Ask Your Doctor

What type of treatment will you recommend to decrease the symptoms or the length of the active period?

Will you be prescribing any medication? What are the side effects?

Can laser therapy be used?

How is laser therapy performed?

How effective is this therapy?