The shingles vaccine reduces the risk of shingles by 50 to 90% depending on the vaccine used. It also decreases rates of postherpetic neuralgia, and if shingles occurs, its severity. If shingles develops, antiviral medications such as aciclovir can reduce the severity and duration of disease if started within 72 hours of the appearance of the rash. Evidence does not show a significant effect of antivirals or steroids on rates of postherpetic neuralgia. Paracetamol, NSAIDs, or opioids may be used to help with the acute pain.
“We don’t know why HSV reactivates at particular times,” says Elna Macintosh, sexologist and director of the DISA clinic. “You may recognise trigger factors that contribute to an outbreak. These may include friction due to sexual intercourse, ill health, stress, fatigue, depression, lack of sleep, direct sunlight and menstruation. The triggers differ from person to person.”
During an outbreak, a dermatologist often can diagnose herpes simplex by looking at the sores. To confirm that a patient has herpes simplex, a dermatologist may take a swab from a sore and send this swab to a laboratory.
You still can have sex if you have genital herpes, but you must tell your partner you have the virus. They need to know so they can get tested. Wear a condom any time you have sex. Never have sex during an outbreak.
Herpes is a sexually transmitted disease (STD) caused by the herpes simplex viruses type 1 (HSV -1) and type 2 (HSV-2). Most individuals have no or only minimal signs or symptoms from HSV-1 or HSV-2 infection. When signs do occur, they typically appear as one or more blisters on or around the genitals or rectum. The blisters break, leaving tender ulcers (sores) that may take two to four weeks to heal the first time they occur. Typically, another outbreak can appear weeks or months after the first, but it almost always is less severe and shorter than the first episode. Although the infection can stay in the body indefinitely, the number of outbreaks tends to go down over a period of years. (Source: excerpt from Genital Herpes: DSTD)
Individual outbreaks of herpes vary among affected people in terms of their frequency and severity. Outbreaks can be related to the function of the immune system and are typically worse in cases in which the immune system is suppressed. For example, at times of physical oremotional stress, during illness, or when taking certain medications, genital herpes outbreaks may be more likely.
Treatment. At the present time there is no cure for genital herpes. (A vaccine to prevent the development of herpes is under active development.) Antivirals such as acyclovir and valacyclovir help shorten episodes during the initial phase of infection, but do not cure it. Palliative treatment consists of measures to keep lesions clean and dry, to control pain with an analgesic, to promote healing with frequent sitz baths, and to prevent secondary bacterial infections.
Jump up ^ Colin J, Prisant O, Cochener B, Lescale O, Rolland B, Hoang-Xuan T (2000). “Comparison of the Efficacy and Safety of Valaciclovir and Acyclovir for the Treatment of Herpes zoster Ophthalmicus”. Ophthalmology. 107 (8): 1507–11. doi:10.1016/S0161-6420(00)00222-0. PMID 10919899.
It is best to discuss a new diagnosis of Genital Herpes with your partner. Genital Herpes is most likely to be passed on just before, during or after an outbreak so you should not have sex during this period. When you do not have symptoms, however, there is still a small risk you can pass on the virus to a partner, although using a condom can lower this risk further. You might not need to tell previous partners but it may be helpful to discuss this with someone at your local sexual health clinic.
The virus that causes genital herpes is usually spread from one person to another during vaginal, oral, or anal sex. The virus can enter your body through a break in your skin. It can also enter through the skin of your mouth, penis, vagina, urinary tract opening, or anus. Herpes is most easily spread when blisters or sores can be seen on the infected person. But it can be spread at any time, even when the person who has herpes isn’t experiencing any symptoms.
The sores and symptoms of oral herpes usually completely disappear in two to three weeks with no scarring. However, the sores may reappear under certain stressful situations. Rarely, some complications develop in a few individuals:
There are 2 distinct types of herpes—HSV1 is an orofacial disease, meaning it infects the mouth and surrounding area; while HSV2 affects individuals below the waist, particularly the moist areas of the genitals and buttocks. Once infected with HSV the patient will have the disease for life. The infection will remain dormant in the body with flare-ups occurring a few times per year. However, medical attention is vital to prevent further health complications.
A baby who has been infected with herpes simplex during delivery may develop skin blisters within days. The blisters are often on the scalp or head, or in the case of a breech baby, on the buttocks. These blisters should be taken as a very serious warning sign; while in some babies the virus may not have spread beyond the skin, in many there is more general infection, with a special risk of brain infection with the Herpes simplex virus. Therefore all babies with skin blisters of herpes must be treated with acyclovir (see treatment). Some babies will not have the skin blisters at all, but have a general infection in the body, which is then very difficult to recognise as herpes.
When a person is first exposed to and infected with the virus, there is an “incubation period” while the virus starts to multiply and before any symptoms occur. The incubation period is usually three to seven days.
A. Cold sores contain the HSV-1 virus, which is the herpes simplex virus . While your boyfriend has cold sores, he should wash his hands often, especially after touching his face. He shouldn’t share cups and eating utensils with others since he is very contagious. You should not kiss him or touch the cold sores either, in order not to be infected.
Herpes simplex virus type 2 (HSV2) is one of two types of the herpes virus and is rarely transmitted orally. However, that doesn’t mean it’s impossible. People with compromised immune systems in particular may be at risk.
If a child is younger than 6 weeks of age, notify a doctor if cold sores appear. Severe infection or disease complications occur more commonly in infants. For instance, besides affecting the mouth, HSV-1 may go to the brain and produce damage.
Jump up ^ Jocelyn A. Lieb; Stacey Brisman; Sara Herman; Jennifer MacGregor; Marc E. Grossman (2008). “Linear erosive Herpes Simplex Virus infection in immunocompromised patients: the “Knife-Cut Sign””. Clin Infect Dis. 47 (11): 1440–41. doi:10.1086/592976. PMID 18937574.
Whatever course is decided on by the doctor and parents, it would be important to observe the baby closely after delivery and intervene with treatment with acyclovir at the slightest sign that infection may have taken place.
Herpes is contracted through direct contact with an active lesion or body fluid of an infected Herpes transmission occurs between discordant partners; a person with a history of infection (HSV seropositive) can pass the virus to an HSV seronegative person. Herpes simplex virus 2 is typically contracted through direct skin-to-skin contact with an infected individual, but can also be contracted by exposure to infected saliva, semen, vaginal fluid, or the fluid from herpetic blisters. To infect a new individual, HSV travels through tiny breaks in the skin or mucous membranes in the mouth or genital areas. Even microscopic abrasions on mucous membranes are sufficient to allow viral entry.
Avoiding direct contact with the virus is the only way to prevent infection. Therefore, avoid having sex with someone who has an active genital or oral sore as there is a high risk of transmission at this time. Herpes can, however, be present on the skin without causing any symptoms and be transmitted by someone who has no sores present. Reducing your number of sexual partners and using condoms will reduce the likelihood of coming into contact with herpes.
Many doctors will begin treatment based only on the appearance of the sores, if the sores seem typical of herpes. Doctors may also take a swab of the sore and send the swab to the laboratory to see if the virus is present. A number of types of tests may be ordered to establish the diagnosis, including:
Jump up ^ Fiala M, Chow A, Guze LB (April 1972). “Susceptibility of Herpesviruses to Cytosine Arabinoside: Standardization of Susceptibility Test Procedure and Relative Resistance of Herpes Simplex Type 2 Strains”. Antimicrob. Agents Chemother. 1 (4): 354–57. doi:10.1128/aac.1.4.354. PMC 444221 . PMID 4364937.
In one study, it was estimated that 26% of those who contract shingles eventually present complications. Postherpetic neuralgia arises in approximately 20% of people with shingles. A study of 1994 California data found hospitalization rates of 2.1 per 100,000 person-years, rising to 9.3 per 100,000 person-years for ages 60 and up. An earlier Connecticut study found a higher hospitalization rate; the difference may be due to the prevalence of HIV in the earlier study, or to the introduction of antivirals in California before 1994.