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Her-pees (virus)

Herpes infections are caused by a virus known as Herpes Simplex.

This is sometimes shortened to HSV. There are two types of Herpes virus, Type1 and Type 2. Type 1 tends to affect the mouth and is other wise known as the common cold sore.

It can also cause infection around the genital area but this is uncommon. It’s currently estimated that 85% of the general population carry Herpes type1 by the time they are 25. In terms of STIs, however, Herpes infection of the genital area is generally caused by Type 2 Herpes Virus.

In Australia, Type 2 Herpes is the most common cause of ulceration (open sores) in the genital area. In fact 20%, or 1 in 5, of sexually active people will have evidence of antibodies to type 2 Herpes Virus, meaning they have, at some stage, been exposed to the virus. And many of these people may not have had any obvious signs of infection from this first exposure to the virus. IMPORTANT NOTE: Do not confuse with “HPV” which is the genital warts virus. This is because it’s possible for the virus to remain dormant or “asleep” in the body for some time before becoming active, resulting in signs and symptoms of infection. Because of Herpes ability to live in the body without any obvious symptoms, it’s not always possible for someone diagnosed with Herpes to know when they first got it and who they first got it from.

Once Herpes is in your body, it’s possible for Herpes outbreaks to reappear again and again. It’s good to know that even though the first infection can be pretty uncomfortable, the symptoms usually become much less severe each time.

It’s also important to note that open ulcers increase the risk of transmission of other STIs, including HIV.

How do you get Herpes?

Type 2 Herpes virus can be spread even when there are no obvious signs of infection. It requires skin to skin contact and can be spread, person to person, in the following ways:

• Direct skin contact.
• Vaginal, Anal or Oral Sex.
• Mother to baby during birth.

The virus can spread from a mother with Herpes to her baby during birth. This is more likely to happen if the mother has an outbreak of Herpes at the time of birth or has had a recent infection. It is far less likely the baby will get Herpes if you have no symptoms. So if you’re pregnant and you or your partner has Herpes, be sure to let your doctor know to help prevent passing the infection on.

There is, medication that can reduce the severity, regularity and duration of outbreaks.

IMPORTANT NOTE:
Herpes Type 1 can be transmitted to the genitals through direct skin to skin contact, so avoid oral sex if you, or your partner, have a cold sore.

Signs and symptoms

A person can become quite unwell during the first episode of Type 2 Herpes infection, because the virus is brand new to your immune system, meaning it has not had time to develop protective antibodies. The first episode usually lasts about 2 weeks. Infection with Type 2 Herpes produces the following symptoms for both men (on the penis) and women (on and around the vulva or vaginal lips):

• Pain, Tingling, itching or burning sensations.
• Blisters which break open becoming shallow, painful sores. After one to two weeks they dry into scabs and heal up.
• Flu-like symptoms such as tiredness, fever and muscle aches.

As mentioned earlier, some people won’t experience any of these symptoms at all when they are first exposed to the virus, and therefore will be unaware they have the virus until they have a second outbreak.

What are the long term health problems of Herpes?

The most common complication of Herpes is secondary infection of the blisters. This happens when the blisters become infected with bacteria, needing specific treatment from the doctor, like antibiotics, as well as anti- Herpes medication.

Very rarely, the virus spreads from the genital or mouth area to other parts of the body, such as the brain or spinal cord.

How do you prevent getting Herpes?

Condoms and dams reduce the risk of catching Herpes and reduce the risk of giving Herpes to your partner.

They can’t guarantee 100% protection, however, because the virus may be present in areas not covered by a condom or dam, like the base of the penis.

Having sex when blisters are present is the greatest risk of transmission. Like cold sores, blisters are very infectious until they have crusted over into a scab. Although you can still infect your partner when there are no symptoms, this is much less likely. It’s recommended that during episodes of herpes outbreaks, when blisters are present, a person should avoid having sex with their partner(s) to prevent transmission.

Careful sexual foreplay and the use of clean, condom covered sex toys can be good alternatives to sex during Herpes outbreaks. Plus your doctor may recommend antiviral medication, taken daily, to help reduce transmission of herpes to a sexual partner. Many people have taken this daily treatment for years without any negative side effects.

Couples in a stable relationship often decide together how to reduce their risk and you can ask your doctor or nurse to provide the most up to date information. If you don’t get the information you need from one healthcare provider, try another one.

How do you find out if you have Herpes?

Because signs and symptoms are often not present during the first infection of herpes, diagnosis by your doctor or sexual health nurse may take time and will usually involve swab tests of the area infected. The diagnosis is most easily made if the swab is taken directly from a blister or recent ulcer. However a negative swab result does not definitely mean you don’t have Herpes. Sometimes the doctor will decide that it’s likely to be Herpes and give treatment despite a negative result. And sometimes a blood test can be performed to assist with the diagnosis. If it turns out you do have Herpes, it’s important to discuss with your doctor, nurse or health care worker how you can tell your partner(s) about the infection and how to reduce the risk of giving it to others.

This is why it is important that the doctor, nurse or health care worker testing you, also gives you pre and post test counselling. This is because being tested for an STI can be stressful. You need good support and clear information whether your results are positive or negative.

How do you get treated for Herpes?

Currently the Herpes virus has no vaccine for prevention and no cure. There is, however, medication that can reduce the severity, regularity and duration of outbreaks meaning Herpes can be well managed. An oral antiviral medication is available. Antiviral medication is given in both the first infection and any recurrent infections. This is taken just like an antibiotic is for bacterial infections.

The antiviral medication is given to reduce the impact and severity of symptoms, reduce the risk of complications and reduce your chances of passing Herpes on to sexual partners. People who have frequent outbreaks can be given continuous treatment for a period of time to prevent any further outbreaks. Herpes blisters are very infectious.

IMPORTANT NOTE: Antiviral creams or gels used on the skin (topically) for cold sores are not helpful in first infections of the genital area.

Symptomatic treatment, used to lessen the impact or severity of symptoms,includes:

• Taking a salt water bath to relieve the itching of blisters
• Topical anaesthetic (numbing) gel to cool and soothe irritated skin. (These gels shouldn’t be used for more than 2-3 days though, as the skin may become sensitive to them)
• Paracetamol (Panadol) to ease any pain and/or fever.

Getting by with Herpes in your life

Despite it being a very common infection, there is a lot of incorrect information and social stigma surrounding Herpes. Although, over time, most people learn to adjust to having Herpes, getting counseling can be a useful way to deal with any worry, stress or anxiety you might have about it. It is also important to identify what brings on a Herpes attack for you. For many people, outbreaks can be triggered by stress, not eating well or just being a bit rundown and sometimes stressing about Herpes in the first place may be a trigger so it’s important to try and get your head around it.

IMPORTANT NOTE: Be aware that most Herpes websites are sponsored by drug companies promoting their Herpes medication. Compare information and ask your doctor, nurse or health care worker to clarify any questions or conflicting information.

For information and support:

www.thefacts.com.au

www.herpes.com.au