Herpes

Read in Hindi

Types
Stages
Symptoms
Causes And Risk Factors
Prevention
Diagnosis
Treatment
Lifestyle/management
Prognosis And Complications
References

[caption id="attachment_551037" align="alignnone" width="655"] Herpes is an infection caused by the human herpes simplex virus (HSV) that can enter the human body through various sites. The virus invades different sites such as the genitals or mouth by attacking the mucosal lining.
The severity of the infection and the symptoms of the infection vary depending upon the site of the entry and immune resistance. The virus can be transmitted by close physical contact and thus, needs to be treated to prevent its spread. Once the virus enters the body, it starts multiplying in the primary contact area of the skin. It subsequently invades the nervous system, multiplies again, and goes dormant. In some cases, the virus lies dormant for years. However, in certain conditions such as trauma, emotional stress, etc., the virus can get activated, cause disease and produce viral particles that allow the infection to spread to other people. The disease symptoms are often severe in people with a weakened immune system, such as those with human immunodeficiency virus (HIV) or those who have undergone organ transplants. There is no cure available currently for the infection, although, some antiviral medicines provide relief from the symptoms of the infection.[/caption]

Types

There are two types of the herpes simplex virus:

Herpes simplex type 1 (HSV 1): It commonly causes cold sores, but in some cases, might also cause genital herpes. This type of virus usually attacks the mouth, eyes and face.

Herpes simplex type 2 (HSV 2): It is the most common cause of genital herpes, which affects the area around the genitals. Although HSV-2 sores are commonly found below the waist, it may affect different parts of the body.

Stages

People infected with the virus may go through the following stages of infection:

Primary stage: This stage usually begins 2-8 days after the virus enters the body. The infected person may develop small, red, painful blisters filled with clear or cloudy fluids. In some people, the blisters may not be visible. The blisters eventually break open and form open sores. Although a majority of the infected people develop symptoms, some people may be asymptomatic, due to which they may not even realise that they are infected.

Latent stage: During this stage, the virus travels from the skin to the spinal cord and becomes dormant. The infected person is usually asymptomatic during this stage.

Shedding stage: This is another stage wherein the infected person does not show any symptoms. However, the person becomes very contagious as the virus multiplies rapidly during this stage and invades body fluids such as saliva, semen or vaginal fluids.

Recurrences: The symptoms may re-emerge in this stage. However, the symptoms that occur in this stage are usually milder than the symptoms seen during the first attack.

Symptoms

In most cases, people suffering from a herpes infection do not show any significant signs and symptoms until several months later. And in some, the symptoms may appear occasionally within a few days of the viral attack. This is because, the virus can remain in a dormant state for a few months and may be activated following an illness.

Many people who encounter the virus for the first time may not develop any symptoms and in some, the infection may go unnoticed. Usually, the following symptoms may develop 2-3 weeks after the infection. The common signs and symptoms of a herpes infection are:

Appearance of blisters on or around the affected areas (mouth, genitals or rectum)

Tender sores due to breaking of the blisters

Pain in the affected areas.

Itching, burning and tingling sensations

Burning sensation in the vagina

Eye discomfort, leading to hazy vision and watery discharge from the eyes

Enlargement of lymph nodes

Flu-like symptoms

Causes And Risk Factors

Causes

Caused by two strains of the herpes simplex virus, this condition affects the genitals, cervix, mouth, eyes, lips and different parts of the skin. The severity of infection and the treatment option are dependent on the factors causing it. As the virus can be transmitted from one person to other through close physical contact, it is recommended that the infected person avoid sex (especially if they suffer from genital herpes) and kissing (mouth sores) that may aid in the spread of the disease. Apart from this, the virus can be transmitted by:

Oral secretions like saliva

Sores on the skin

Sharing toothbrushes, plates or glasses used by infected person

Pregnant women to her child during childbirth

Risk Factors

The risk factors for a herpes simplex infection have been summarised below:

Risk factors	People at an increased risk
Age	Older people
Sex	Females
Body weight	Obese people
Smoking habit	Current or former smokers
Number of sexual partners	People with multiple sexual partners
Medical history	People with a history of sexually transmitted diseases (STDs)

Factors that can increase the risk of reactivation of the virus lying in the dormant state are as follows:

Stress

Menstruation

Fever or illnesses

Medications or illnesses that weaken the immune system

Surgery

Sun exposure

Prevention

By following simple precautions, you can prevent a herpes infection. Some of the common tips to avoid this infection are:

Practise safe sex (use condoms and dental dams). However, condoms do not provide absolute protection, especially if the blisters are present outside the area of the skin protected by the condom.

Avoid sex with sexual partners who have active symptoms.

Avoid sex with infected sexual partners, at least until their scabs fall off.

Avoid sex with multiple partners.

Maintain proper hygiene.

Always wash hands properly, especially when around infected people.

Take medications as prescribed by the doctor.

Diagnosis

Generally, the appearance of symptoms of the herpes simplex virus is typical and thus, there is no need to confirm the condition with diagnostic tests. However, in case your healthcare provider is uncertain, they may recommend a few lab tests such as:

Antibody test

DNA or PCR test

Viral culture

Treatment

There is no cure for the herpes simplex virus. The treatment options are aimed at relieving the pain and minimising the healing time. Antiviral drugs such as Famvir, Zovirax, and Valtrex form the first-line of medications that are prescribed to deal with the condition. Apart from this, following proper hygiene and sanitation; abstaining from sex, alcohol and smoking; and taking warm baths aid in the quick healing of the sores.

Lifestyle/management

People with genital herpes can take the following measures to soothe the pain and deal with the condition:

Avoid touching the sores.

Keep cool or lukewarm clothes on the affected skin.

Keep the affected skin dry and clean.

Wear loose-fitting clothes.

Wear undergarments made of cotton.

Take baths with lukewarm water.

Limit stress.

Exercise and eat healthy food.

Take over-the-counter pain medicines after consulting with the doctor.

On the other hand, people with cold sores can take the following measures to manage the condition:

Apply ice on the affected area.

Keep the affected area clean and dry.

Lip balms can provide relief from dryness or pain and prevent the sores from cracking.

Creams and ointments should be gently dabbed instead of rubbed on the affected area.

Avoid acidic or salty foods as they can irritate the sores. Instead, try to eat soft foods.

Do not poke, lick or pick the sores.

Infected people can prevent the spread of the infection by taking the following measures:

Follow the treatment plan prescribed by the doctor.

Limit the number of sexual partners. It is recommended that infected people have monogamous relationships.

Infected people should inform their sexual partner about their condition so that they can get tested.

Wash hands frequently.

Use dental dams or condoms during sexual activity.

Prognosis And Complications

Prognosis

Most people usually find the first outbreak to be the worst. However, the symptoms do not occur the same way for every affected person. In some people, the symptoms of the first outbreak are so mild that they don’t even realise that they have been infected. While some people usually have only one outbreak in life, others experience multiple outbreaks, especially during the first year of infection. However, the symptoms usually get less severe after each outbreak as the body keeps producing substances to fight off the virus. The outbreaks may eventually stop completely. People with herpes should talk with their doctor and follow their directions.

People with herpes should not feel alone or ashamed. Majority of the individuals contract STD at least once in their lifetime. Herpes, in fact, is an infection that can happen to anybody, as the virus easily spread by kissing or having sex.

Complications

Herpes rarely causes serious complications in healthy people. However, serious complications are often seen in people with long term illnesses or weak immune systems, and in unborn or newborn babies. Herpes can sometimes cause serious diseases such as meningitis (redness and swelling of the tissue covering the spinal cord and the brain) and encephalitis (redness and swelling of the brain).

People with genital herpes and open sores in the genital area are at an increased risk of contracting the human immunodeficiency virus (HIV). Cold sores can cause the following complications:

Bacterial infections that turn the sores crust and produce pus

Cold sores spreading to the eyes may lead to eye damage. One should immediately contact the doctor if they feel that herpes has spread to the eyes.

References

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Chentoufi AA, et al. Clin Dev Immunol. 2012;2012:149135.

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Herpes simplex virus. American Skin Association. Available at: https://www.americanskin.org/resource/herpes.php. Accessed on: March 5, 2021.

Human herpesviruses: biology, therapy and immunoprophylaxis. NCBI. Available at: https://www.ncbi.nlm.nih.gov/books/NBK47449/. Accessed on: March 5, 2021.

Herpes [Updated April 13, 2020]. familydoctor.org. Available at: https://familydoctor.org/condition/herpes/. Accessed on: March 5, 2021.

Herpes simplex: signs and symptoms. American Academy of Dermatology Association. Available at: https://www.aad.org/public/diseases/a-z/herpes-simplex-symptoms. Accessed on: March 5, 2021.

Herpes simplex: who gets and causes. American Academy of Dermatology Association. Available at: https://www.aad.org/public/diseases/a-z/herpes-simplex-causes. Accessed on: March 5, 2021.

Tideman RL, et al. Sexually Transmitted Infections. 2001;77:413-415.

Herpes simplex type 2 [Updated Nov 20, 2020]. NCBI. Available at: https://www.ncbi.nlm.nih.gov/books/NBK554427/. Accessed on: March 5, 2021.

Genital herpes (HSV-2) [Updated Nov 23, 2020]. Cleveland Clinic. Available at: https://my.clevelandclinic.org/health/diseases/4248-genital-herpes-hsv-2. Accessed on: March 5, 2021.

Herpes simplex: diagnosis and treatment. American Academy of Dermatology Association. Available at: https://www.aad.org/public/diseases/a-z/herpes-simplex-treatment. Accessed on: March 5, 2021.

Herpes simplex [Updated Oct, 2015]. DermNet NZ. Available at: https://dermnetnz.org/topics/herpes-simplex/. Accessed on: March 5, 2021.

Herpes simplex virus antibody. University of Rochester Medical Center. Available at: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=herpes_simplex_antibody#:~:text=The%20herpes%20simplex%20virus%20antibodies,recurrence%20of%20a%20previous%20infection. Accessed on: March 5, 2021.

Cold sores [Updated Aug, 2020]. healthdirect. Available at: https://www.healthdirect.gov.au/cold-sores. Accessed on: March 5, 2021.

Living with herpes. Planned Parenthood. Available at: https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/herpes/living-with-herpes. Accessed on: March 5, 2021.

Herpes: HSV-1 and HSV-2. Johns Hopkins Medicine. Available at: https://www.hopkinsmedicine.org/health/conditions-and-diseases/herpes-hsv1-and-hsv2. Accessed on March 5, 2021.