Health Services
Self Care

Herpes Simplex

Description
Herpes infections are caused by the Herpes Simplex virus, Types I and II. Type I infections typically affect the mouth and nose areas. Outbreaks on the mouth are often referred to as cold sores or fever blisters. Type II infections typically affect the mucus membrane (moist) areas of the male and female genitals. Differentiating the types of Herpes can only be done in the lab, and either type can cause infections anywhere on the body.

Infection is caused by direct contact of susceptible skin (mucus membrane or broken skin) with the affected skin of an infected person who is shedding the virus. Viral shedding is associated with outbreaks and symptoms as described below, but there are some people who are asymptomatic (without symptoms) and may not be aware of their infection.

As with other viruses, the immune system responds to the herpes virus by producing antibodies which suppress the virus and resolve symptoms. Due to the nature of the virus and to the relatively small area of the body involved, this immune reaction is often not complete, and outbreaks may reoccur. Trauma to the infected region, or stress, fatigue, and sunburn may trigger outbreaks, but they can be spontaneous. Most people with recurrent herpes infections usually reach a point where their outbreaks are very rare or cease altogether. Some people never have a recurrence.

An active outbreak may cause serious infections in newborns but medical techniques are available to detect herpes risk during delivery. Therefore, it is important for a woman with a history of genital herpes to inform her clinician. Women with a history of Herpes are also urged to be conscientious about getting their annual pap smears.

Symptoms
Typically, herpes appears as thin-walled blisters at the site where the virus entered the body. On dry skin, the lesions may initially appear as a cluster of red bumps. The lesions may itch, tingle or be intensely painful. The blisters will open into shallow, painful ulcers, and primary outbreaks may take two to four weeks to heal. Primary outbreaks are typically accompanied by flu-like symptoms such as fevers, headaches, body aches, and swollen glands, especially in the groin.

After healing, the virus retreats to nearby nerve tissue. Recurrences tend to have similar lesions to the primary outbreak, usually occur at the same site or very near by, and rarely have flu-like symptoms. Most people infected with herpes note a "prodrome" prior to a recurrence, which is a sensation at the site of the pending outbreak of heat, tingling, or itching. Herpes is considered to be infectious from the onset of the prodrome, during the outbreak and for 10 days after healing.

Treatment
At the present time, there is no cure for Herpes. There is an antiviral drug, Zovirax (Acyclovir) which has been shown to help shorten the course of primary herpes, and may help ease recurrences for some people. The immune system's production of antibodies is the body's way of controlling the virus. Taking care of your health, getting adequate rest, eating well and exercising regularly will help your immune system stay healthy and effective. Symptomatic relief, as recommended by a clinician, may be provided by other medications. .

Prevention
Avoid skin contact (oral or genital) with anyone who has oral or genital sores. Herpes may be transmitted via oral-oral contact, genital-genital contact, or oral-genital contact. If you have a history of Herpes, avoid contact during prodromal symptoms, during outbreaks, and for 10 days after healing to reduce the risk of transmitting the infection. Maintaining good health and effective stress management will help keep your immune system healthy.

Due to the risk of asymptomatic shedding (and the difficulty of detecting it), any contact may be risky. Latex condoms, especially when used with the spermicide nonoxynol-9, may reduce the risk of transmission. However, condoms will not protect the external vaginal area or the base of the penis from infections that may be transmitted by skin-to-skin contact. Knowledge of your partner, and frank discussions of sexual risk factors, will help you assess your risk of Herpes.

More Information/Questions
Messiah College students may call Student Health Service at (717) 691-6035 for more information.