HERPES

There are three types of herpes:
1. HSV-1: (Simplex) Is commonly seen as the "cold sore herpes". What is NOT known is that exposure to HSV-1 can lead to an outbreak of "genital herpes" but that this is not sexually transmitted and can exist for years in the body without an outbreak. So children can have an outbreak of "genital herpes" without any signs on the face - by kissing, or being in skin contact with someone (including a child) with a 'cold sore'. If someone has had a genital outbreak of HSV-1 it confers an immunity for HSV-2 if only limited.
We often see a genital outbreak of HSV-1 if someone changes partners or their immune system is low.

2. HSV-2: Commonly known as "genital herpes". Is only transmitted sexually and is only seen in adults. This is seen as the "bad herpes".
After the first outbreak, any future outbreaks are usually mild and last only about a week. An infected person may know that an outbreak is about to happen by a tingling feeling or itching in the genital area, or pain in the buttocks or down the leg.
Even with the first outbreak there will be a tingling or itchy feeling in the genital area. When a person becomes infected with HSV-2 for the first time, the obvious symptoms will appear within 2 to 10 days of infection. The sores will appear within days. These first episodes of symptoms usually last 2 to 3 weeks, and are severe:

• Itching or burning feeling in the genital or anal area
• Pain in the legs, buttocks, or genital area
• Discharge of fluid from the vagina
• Feeling of pressure in the abdomen
• Feeling feverish, unwell and exhausted
• Lymph glands in the groin enlarge and become sore.
• Difficulty in the ability to urinate

They can occur inside the vagina and on the cervix in women, or in the urinary passage of women and men. Small red bumps appear first, develop into blisters, and then become painful, open, weeping sores. Over three days after the weeping, the sores become crusty and then heal without leaving a scar.

Other symptoms that may go with the first episode of HSV-2 are fever, headache, muscle aches, painful or difficult urination, vaginal discharge, and swollen glands in the groin area.

The first attack is the worst - thereafter the attacks are mild. Within 1 year the person will be symptom free and if there are no shedding lesions it is unlikely that they can transmit the virus although it may still be dormant in the spinal column. Within 5 years when there has been no mild genital attack for six months the virus is deemed to have "burnt out".


The inescapable fact is that HSV-1 is usually spread through contact with infected lips, while HSV-2 usually spread through contact with infected genitals. From a social point of view, the problem is not the disease; it's how you got it. With EVERY variety of Herpes, including Shingles, it is important to take care of the eyes. Go to the MD when ever herpes is suspected.

3. Herpes Zoster is Shingles. It is caused by the same virus as chickenpox,

Varicella-Zoster Virus.

Early signs of shingles include burning or shooting pain and tingling or itching generally located on one side of the body or face. The rash or blisters are present anywhere from one to 14 days . It is commonly seen in people over the age of 50yrs. It is very contagious to people who have not had chickenpox and can be dangerous. Again, this is a virus that attacks the nerve endings and lies dormant in the spinal column. This is the most unpleasant variety of shingles. It is extremely resistant to antibiotics so often the only medication that helps is prednisone/steroid

Medications/anti-virals: for all types of herpes:

• Acyclovir (Zovirax) has been used for over 10 years and is now available in generic form.
• Valacyclovir (Valtrex) uses acyclovir as its active ingredient, is better absorbed by the body and can be taken less often.
• Famciclovir (Famvir) is similar to acyclovir and is also better absorbed and can be taken less often

Episodic therapy means taking the medication only during an outbreak to speed healing. Your doctor will prescribe treatment to take at the first sign of prodrome and continue treatment for five days. For first episodes, the healing time can be dramatically reduced. For recurrences, the outbreak can be shortened by about two days. If you choose episodic therapy, fill your prescription and have it ready before an outbreak so you can begin taking the medication immediately.

Suppressive therapy means taking an antiviral medication daily as a preventative--to keep HSV in check, reduce flare ups and lessen symptoms. Suppressive therapy can lower the number of outbreaks and, for some, prevent them altogether. This therapy also reduces asymptomatic shedding, and research studies are determining whether on-going antiviral medication can help prevent transmission.