Herpes What is it? Herpes is a common infection caused by the Herpes Simplex Virus (HSV). There are two types of HSV that cause very similar symptoms. HSV can infect the oral area (cold sores or fever blisters) or genital area. Most of the oral infections are caused by HSV 1 while most of the genital infections are from HSV 2. However, either type can cause infection in either the mouth or genital area. About 50-80% of people in the US have oral herpes. One out of five adults have genital herpes. Many people with genital herpes do not know they have the infection because symptoms can be mild. What are the symptoms? The most common symptom is a cluster of blister-like lesions. These develop at the site of contact from an infected person. It can take 2-12 days for symptoms to develop after being exposed. Some people notice itching or burning before the blisters break out. The blisters can be found around the mouth, in the genital area and around the anus/buttocks area. The blisters open and cause open sores which are painful, especially in the female genital area during urination. Swelling can also occur. Females may also have vaginal discharge. Other symptoms that occur with first infection can include swollen lymph glands, fever, muscle aches, headache and fatigue. The sores will eventually crust over and heal. This can take 1-3 weeks for the first infection. Many people with genital HSV can have very mild symptoms or no symptoms at all and not know they are infected. They can also mistake the symptoms for another problem such as jock itch, yeast infections or bug bites. How is it transmitted? HSV is transferred from one person to another by skin to skin contact with an infected person. The virus enters the body through a tiny open area on the skin or through the mucus membranes of the genital or oral area. It can also be transferred to the eye or an open cut on the body through hand contact. Children often get oral HSV from being kissed by an infected relative. The virus is especially contagious when sores are present but can also be contagious when there are no sores. Oral, vaginal and anal intercourse are sexual activities that can transmit the virus. Using condoms and oral barriers can decrease the risk of getting HSV. Hand-washing is important after touching the area that has sores to prevent spreading the virus to another part of the body. HSV does not live long on surfaces so infection from toilet seats and towels is unlikely. How is herpes diagnosed? Your provider will take a history and do an examination. If there are symptoms, testing can be done by taking a viral culture of the fluid from the sores. This test is very accurate if done early in the course of the outbreak. Testing for other sexually transmitted infections may be recommended. What are the complications of herpes? Once a person is infected, recurrences of outbreaks can happen. HSV remains in the body when there are no sores present. Recurrences can be triggered by stress, fatigue, poor nutrition, illness or, in the case of oral HSV, sun exposure. Recurrences are usually milder than the initial outbreak and heal faster. Many people notice a burning or tingling feeling at the site of outbreak before a recurrence happens. More outbreaks happen in the first year after being initially infected. As time goes on, recurrences happen less frequently and become less severe. HSV infection can increase risk for HIV infection. HSV initial infection during pregnancy can cause damage to the fetus. HSV infection in the vagina during vaginal delivery of a baby can cause infection and be fatal to the baby. It is important to tell your provider if you have a history of vaginal HSV and you become pregnant. Medications may help prevent outbreaks or cesarean delivery may be recommended. How can herpes be treated? There is no cure for HSV but it can be treated with anti-viral medications. These medicines can lessen the symptoms and help the sores heal faster. The sooner medication is started, the faster the healing. The medications can be taken daily to suppress frequent outbreaks. They can also lessen the chance of spreading the infection to a sexual partner if taken daily. Talk to your health care provider to see if this is an option. Other things can be done to reduce the discomfort:      Soak in a tub of cool water Keep the infected area clean and dry Use a hair dryer to dry the genital area after a bath or shower Avoid tight fitting clothing Wear cotton underwear How can I decrease the risk of getting herpes?     Being in a monogamous relationship with an uninfected partner Using condoms or oral barriers Talk to your partner before engaging in sexual activities Don’t engage in sexual activities under the influence of alcohol or drugs If you are infected, avoid engaging in sexual activities when you are having an outbreak. Use condoms or oral barriers between outbreaks. Talk to your health care provider about suppressive daily medication. Tell a potential partner about your infection. Many people in long term, monogamous relationships decide together how to manage the risk of transmitting the infection. Where can I find more information about herpes? Being diagnosed with HSV can cause emotional upset. HSV is a recurrent infection that is treatable. Talking to a counselor, a medical provider or a trusted friend may help. Many people find that over time, they are able to manage the symptoms and emotional stress. Pay attention to your body’s signals that might indicate an outbreak. Educate yourself to help you feel in control. Resources: Health and Wellness Education, IU Health Center 855-7338 http://healthcenter.indiana.edu/departments/healthandwellness.html American Social Health Association P. O. Box 13827 Research Triangle Park, NC 27709-3827 1-800-783-9877 www.ashastd.org Center for Disease Control www.cdc.gov/std/Herpes International Herpes Alliance www.herpesalliance.org National Herpes Hotline (919) 361-8488