Herpes

Herpes is caused by a virus, either Herpes Simplex 1(HSV1) or Herpes Simplex 2 (HSV2). (These viruses belong to a family of viruses that include Epstein-Barr – which causes mono – and varicella zoster – which causes chicken pox and shingles.) It is currently estimated that 50 – 80% of North American adults have HSV1, and 20% have HSV2.

After contact, some people will have no symptoms for months or even years, but usually, symptoms occur 10 days -2 weeks after exposure. An infected person will probably notice a sensitive, slightly swollen, sore area that feels hot to touch, itchy, and it tingles and throbs. This is called the prodromal stage. Then, an irregular-shaped lesion appears, very sore, red and ugly. The surface of this lesion sloughs off leaving a wet oozy sore. The liquid from this sore is loaded with the HSV. And is very contagious. The lesion will be present for a week to 12 days, and will gradually heal over, leaving no scar.

The virus has retreated down a nerve path and is stored in the spinal cord where it can be reactivated any time. Some people learn what will trigger another outbreak - sunshine, certain foods, (tomatoes, chocolate, pineapple) stress or a fever, (that is why some folks call them "fever blisters".) The first outbreak is usually the most severe. It can cause headaches, nausea and general malaise. After that the outbreaks usually lessen in severity and frequency.

Some people will have a couple of outbreaks a year, but some women have an outbreak with the onset of every menstrual period, lasting up to two weeks, so they spend ½ their lives with cold sores.

Other people are infected, carry the virus and never have an outbreak, but they can spread the virus by shedding (more later).

Herpes 1 is usually cold sores on the mouth, commonly spread by kissing.

Herpes 2 is usually on the genitals of either males or females. This is spread by nude genital contact with an infected partner. But here is the rub…. If you have a cold sore on your mouth and you "go down on" your partner, your lip virus can infect their genitals. And if partner has genital herpes and you "go down on" them, you can get Herpes 2 on your mouth.

You do not get Herpes from toilet seats or door knobs, towels or bath tubs.

Diagnosis is by smear and culture, done by your doctor or Sexual Health Clinic when you have an active lesion. There is also a blood test which is quite accurate.

There is no cure, you have it for life, but there is treatment for oral herpes, an oral medication which you take when you become aware of the prodromal symptoms. This may lessen and shorten the outbreak. For severe cases, the medication is taken every day to prevent an outbreak. This is very expensive and may not be covered by your drug plan.

Herpes will not affect a pregnancy, but your doctor should know about genital herpes ahead of time. If you have infrequent outbreaks, you will probably be allowed to deliver the baby vaginally, but if you have frequent outbreaks on your genitals, they will monitor you carefully, and if you are due to deliver and have an outbreak, in all probability they would prefer to do a Cesarean Section delivery. There is the possibility that a baby exposed to the virus during delivery could be infected. A C Section would avoid any contact with the virus.

SHEDDING

It is possible to contract herpes from an infected person by shedding of the skin around their old, healed lesions, so practicing safer sex, using condoms every time all the time, helps. Since the virus is spread skin-to-skin, a condom will only protect covered areas.

It is small comfort to know that women are more vulnerable to infection by shedding than men. Therefore, it is up to her to insist on condom protection for herself.

Shedding can occur whether or not prodromal symptoms are present. Carriers do not shed all the time, but on-going research continues on this mode of transmission.

INFORMING A NEW PARTNER

You are in a fairly new relationship, things are moving towards sexual intimacy and you know you have Genital Herpes. You know you should inform your partner in advance. But what if they get all upset and regard you as a leper, or somebody who has been indiscrete with a lot of previous partners, in other words, a slut. They may not trust you to warn them if you have prodromal symptoms, the idea of condoms may turn them off.

Every relationship is based on trust, and if they can't trust you to be honest about this, then the relationship is doomed when you have your first outbreak. So not telling is not an option.

And if this is a new relationship, condom use is not an option either… think SAFER SEX…..

When you decide to disclose, do it sometime when you are out for a walk, (not a drive…) playing scrabble, (ask if herpes is a word?). "There is something I need to tell you about and I am really scared because I don't know if you will be really upset, but I have been exposed to the Herpes virus".

There, it is out. You can reassure your partner that you are well aware of the prodromal signs and you would never do anything that would expose them to the virus. I would suggest that you have a copy of the best book on Herpes - THE TRUTH ABOUT HERPES by DR. STEPHEN SACKS published by GORDON SOULES PUBLISHERS. When you have informed your partner, do lend them the book to read; they will be very reassured.

If your partner is honest, sensitive and caring, they may need a few days to get used to the idea, but once they realize you are concerned about your health and their health, they will likely be happy to continue the relationship.

And remember – Herpes is not the end of the world. It is a recurring skin condition, usually mild, that can be managed properly with medication and lifestyle changes. Try to avoid it, but if you become infected, do not let it ruin your life.

For more information, click here: NATIONAL HERPES RESOURCE CENTER