Herpes - a Common STD

What Is Herpes Disease?

Herpes disease is a sexually transmitted disease caused by the herpes simplex virus. The herpes simplex virus (HSV) is a double-stranded DNA virus that infects humans alone and is almost ubiquitous. There are two closely related HSV species, they are:

• Type 1 (HSV-1) - Oral herpes.

• Type 2 (HSV-2) - Genital herpes.

They cause primary as well as recurrent mucocutaneous infections. HSV-1 and HSV-2 are usually responsible for non-genital and genital infections, respectively, though the reverse can occur in a minority of cases.

True primary infection is usually quite severe in a seronegative individual with no previous exposure to HSV. Following primary infection, the virus induces a latent or dormant state within the posterior root ganglia neurons, and, on reactivation, it travels down the nerve fiber to cause recurrent infection.

What Are the Causes of Herpes Infection?

HSV (herpes simplex virus) type 1 is transmitted via oral secretions or cuts or injuries on the skin. It can be flared through kissing or using things like toothbrushes or utensils. Herpes-type 2 infection can be obtained only through sexual contact with a person who already has genital herpes. In addition, it has been said that herpes simplex type 1 and 2 can be transmitted even if the sores are not present. In case of genital herpes in pregnant women, it should be immediately consulted with the doctor as it can be passed to the infant at the time of delivery. Many people with herpes infection suffer from more dormant outbreaks due to any of the following conditions.

• Menstruation.

• General illness (from mild infection to more serious condition).

• Tiredness or exhaustion.

• Immunosuppression due to AIDS (acquired immunodeficiency syndrome) or medications such as chemotherapy or steroids.

• Physical or emotional anxiety.

• Concussion to the affected area.

What Is the Clinical Presentation of Herpes Infection?

The most common presentation of herpes occurs in two ways. They are orofacial infection and genital infection.

Orofacial Infection:

• Infection at the skin and lip junction is known as herpes labialis. It is usually due to HSV-1 and may develop in 20% to 30% of young adults. It is recurrent in one-third of cases. It is colloquially known as cold sores or fever blisters.

• After an incubation period of 3 to 10 days, primary HSV infection is heralded by itching and burning at the vermilion border of the lip, followed by an erythematous papule that rapidly becomes studded with grouped vesicles that ulcerate, crust, and then heal.

• A primary infection usually lasts for 1 to 3 weeks.

Genital Infection:

• Primary genital herpes, the most common cause of genital ulcerations in the industrialized world, accounts for 20% to 50% of all genital ulcers.

• After the usual incubation period of 3 to 14 days, small grouped vesicles make their appearance over 4 to 6 days and soon ulcerate. Most patients report pain, itching, and dysuria as main symptoms, with painful and tender lymphadenopathy.

• The primary genital herpes may last for 18 to 21 days, and over 80% of the primary genital herpes infections are due to HSV-2, which recur more frequently than those due to HSV-1.

Recurrent Herpes Infection:

The grouped vesicular lesions of recurrent herpes are preceded by itching or burning by one or two days. New lesions cease to appear after one or two days. The course of the eruption is faster; the lesions erode, crust over in four to five days, and completely heal in 8-9 days.

How Is Herpes Infection Diagnosed?

Diagnosis is based on the clinical image and the following investigations. The physician may diagnose the herpes simplex virus in some cases by analyzing the blisters. In addition, the health care provider might also ask for the medical history (previous and present) and can be keen on asking about the flu-like symptoms and earlier clinical manifestations such as tingling or burning.

1. Swab Culture - The health care provider may also ask for a culture that involves the swabbing fluid from the sore, which is sent to the laboratory to confirm the diagnosis.

2. Tzanck Smear - Tzanck smearfrom the vesicles shows giant cells in the blister cavity.

3. Blood Test - When the patient believes that he or she might have HSV but have no symptoms, then a blood test might help determine the presence of HSV antibodies. However, the blood tests will not help to accurately diagnose the herpes simplex virus until 12 weeks of infection.

4. Serological Tests - Appropriate serological tests can type the virus.

5. Home Testing Kit - We could test ourselves for HSV antibodies with this test kit.

6. Laboratory tests such as DNA (deoxyribonucleic acid) and PCR (polymerase chain reaction) tests also help with the diagnosis.

How Is Herpes Infection Treated?

It is said that there is no cure for herpes infection, but treatments can help relieve the symptoms. Antiviral medicines are useful to:

• Decrease the pain during the outbreak.

• Shorten the healing time.

• Diminish the total number of outbreaks.

Famvir, Acyclovir, and Valacyclovir are powerful drugs used to treat herpes symptoms. Tablet Acyclovir 200 mg five times a day for seven days in primary and five days in recurrent herpes simplex virus infections is the standard recommended treatment for herpes.

Is Herpes Simplex a Painful Condition?

Most people do not experience any symptoms or may have mild genital herpes symptoms, as people infected with the herpes virus mostly do not know they have it. On the other hand, it can be extremely painful when symptoms occur, especially when the first outbreak is unbearable, which is often the worst. Outbreaks refer to discomforts or pains in or near the genital area, and there may be burning sensation, discomfort, and difficulty while urinating. In the case of oral herpes lesions, there might be tingling and burning sensations just before the breakout of the blisters, where blisters can also be painful. In addition, some people may also have a discharge from the genital organs.

Conclusion:

It is said that there is no cure for herpes simplex infection, but if a person gets infected, the virus may remain dormant in the body. It may become activated when our body undergoes some triggers such as chronic stress, illness, certain medications, etc. Thus, the virus may lie inactive in the nerve cell ganglion for years and years until something triggers it to be active again.