Herpes

Herpes is an STD caused by a virus instead of a bacteria. The cause of herpes is the Herpes Simplex Virus (HSV). There are two types of HSV: Type I and Type II. In the recent past, it was thought that these different types of HSV caused distinct types of problems. Type I was thought to cause cold sores on the mouth and lips, while Type II was associated with genital herpes (sores forming around the penis or vagina). More recently, however, both type of HSV have been shown to be capable of causing genital herpes. Type II HSV cases tend to have worse symptoms and more frequent outbreaks than Type I HSV cases. Most cases of genital herpes are Type II.

Regardless of virus type, the sign that genital herpes is present is that painful genital lesions or sores that look like little blisters occur from time to time on the genitals. The blisters occur when the herpes virus, which lives deep inside the nerves during quiet periods, travels down the nerves to the skin. Itching or pain can precede the appearance of herpes blisters. The blisters are not permanent, but rather come and go in episodes. When they come it is called an "outbreak".

An outbreak usually lasts about two weeks. An outbreak has several phases. First there is inflammation or swelling, and the area where the outbreak is occurring becomes red, itchy and uncomfortable. Then blisters appear in the inflamed area. The blisters are tiny fluid-filled bumps in the skin. Next, moist raised ulcerated areas appear when the blisters break open. The ulcers then begin to dry out and crust or scab over. Finally the skin heals and returns to normal appearance.

Typically outbreaks occur most frequently during the first year following infection, with the first outbreak becoming apparent within thirty days of infection. However, it is possible (although rare) for someone to be infected and never have an outbreak.

Outbreaks are worsened by stress, and become more likely to occur when your body gets run down. Outbreaks can occur in the wake of physical stresses, such as other illness, sleep deprivation, menstruation, or too much drinking or drugging. They can also occur in response to emotional stresses such as overwork, relationship problems, or other emotional issues.

Like other STDs, herpes is primarily spread though sexual contact with someone who has the herpes virus. Though it waxes and wanes, people with herpes are always potentially infectious. Abstinence or monogamy with a non-infected partner are therefore the only effective means of avoiding herpes. There is simply no good way to avoid getting herpes if you have sex with someone who has herpes. Though it is easier to pass the virus to another person during an outbreak, it is very possible to transmit the virus even when no blisters are present. No amount of condom use can cover all the skin that can pass on the virus, so condoms do not really protect against herpes transmission (although they are better than no barrier at all). Because people with herpes are always potentially infectious, it is important that they take prophylactic (preventive) medicines (described below) to reduce the chance that they will be contagious, in addition to using condoms whenever having sex.

A diagnosis of genital herpes requires a person to become especially careful when choosing sexual partners and to use protection during sexual activity. A herpes carrier can easily transmit their infection to their partner through vaginal or anal intercourse. Through oral sexual contact, it is also possible for a person with oral (mouth) herpes to give a sexual partner genital herpes (herpes around the penis or vagina) or vice versa, for a person with genital herpes to give someone oral herpes.

Herpes cannot be cured by medicine, meaning no medicine can make herpes disappear forever. However, anti-viral medicines can reduce the severity and frequency of herpes symptoms. There is a family of medicines, called the cyclovirs, which are useful in treating genital herpes. These medicines can be taken when an outbreak occurs, shortening the duration of the outbreak to one week or less. There are also certain cyclovir family member medicines that can be taken as a prophylaxis (a preventative measure) to prevent an outbreak from occurring. Herpes prophylaxis medicines must be taken every day even when symptoms are not present. By taking the medicine everyday some outbreaks are avoided. However, even with prophylaxis outbreaks still can occur. Prophylaxis can reduce but not eliminate the likelihood that a person with herpes will pass on the disease.

Becoming infected with the herpes virus seriously complicates your social, emotional and sexual life, but it is not otherwise a terribly dangerous condition to have. Having genital herpes does make it easier to get HIV (and thus AIDS), but otherwise, the condition is not disabling, and does not reduce lifespan.

Herpes and Pregnancy

Genital herpes is of special concern for pregnant women, as herpes can be transmitted from mother to newborn infant during the birth process. Such mother-to-infant transmission is most likely to occur during the mother's first herpes outbreak, and/or if blisters are present. However, herpes can be transmitted to the baby during birth even if the mother has no symptoms. When a baby gets herpes from his or her mother it is called "neonatal herpes". Symptoms of neonatal herpes appear within the first month of life and can be very serious. The most serious type of neonatal herpes infection in the newborn, "Disseminated herpes", causes the death of over half the infants that contract it. Disseminated herpes in the newborn produces a variety of symptoms including seizures, breathing difficulties, rash, and yellow skin (called jaundice). On the other hand, neonatal herpes can be limited to a skin or eye infection. There is no telling what will happen beforehand.

As neonatal herpes can be fatal, it is vitally important to prevent babies from getting their mother's herpes. If a woman has active herpes lesions at the time of her delivery it is generally best for her to undergo cesarean section (c-section) to surgically remove the baby from her abdomen. Importantly, c-section does not guarantee the baby will not get herpes, but it does decreases the chances that this will occur. If a woman does not have a herpes outbreak at the time of labor, she may deliver the baby vaginally. The woman and her doctor may decide to give the woman preventative medicine (prophylaxis) to reduce her chances of passing the virus on to her child during birth.

Common interventions that take place during normal labors such as fetal scalp monitoring should not occur during a birth where there is a herpes risk. Any object that is stuck up the vagina and makes contact with the baby can increase the chance that the baby will get infected with herpes. For these reasons, it is very important for a woman to tell her doctor if she experiences any symptoms of herpes before or during pregnancy.