Herpes simplex is a contagious viral infection which is very common and can be passed from person to person through various direct contacts. Herpes simplex virus is predominantly present on the surface of the skin, saliva, semen and vaginal secretions of an infected person; from where it can easily pass on, incorporate into the cells and live permanently inside the nerve cells of the pelvis of someone else.
People, including children who are infected with herpes simplex house the virus inside their nerve cells for the rest of their lives, sometimes without obvious signs and symptoms. Often, signs and symptoms do manifest and disappear on their own, but can come back at certain situations especially within the first year of infection. Some people infected with herpes simplex may experience regular outbreaks while others will experience only one outbreak, then the virus stays dormant in their nervous system. This viral infection affects women more than men. The spread from men to women occurs more readily especially when an infected person is experiencing an outbreak.
Herpes simplex has been with human for over two thousand years. Globally, the prevalence and incidence of herpes simplex differ amongst the nations, races, sex and ages. Worldwide, among populations of different socioeconomic status the rates of increase of either herpes simplex virus -1 (HSV-1) and/or herpes simplex virus -2 (HSV-2) are between 60 and 95% in adults, particularly as people age. HSV-1 is more common than HSV-2.
According to WHO estimates, herpes simplex virus -1 (HSV-1) infects 67% of all humans under the age of 50. Infection with herpes simplex virus -1 (HSV-1) can occur generally during close personal interactions such as eating from the same utensils, sharing lip stick/balm and kissing. The majority of people infected by the virus are unaware. Annually, it is estimated that15.5% of the population aged 14 to 49 are infected with herpes simplex virus -2 (HSV-2), the virus that is predominantly responsible for genital herpes globally. For many decades, there is a dramatic increase in sexually transmitted diseases including genital herpes. Herpes simplex virus -2 (HSV-2) infections mainly spread through contacts with herpes sores from infected persons.
There are drugs that can reduce the severity and frequency of outbreaks, and treat symptoms. Though herpes simplex infection can be untreatable, annoying, discomforting and painful but it does not pose serious health challenges; and herpes outbreaks usually become less frequent over time. Therefore providing this type of information about herpes simplex, and running message forums and dating websites for sufferers and non-sufferers are of great value in the fight against hazards of herpes simplex infections.
What is herpes simplex?
Herpes simplex is a sexually transmitted infection (STI) which is caused by two different but similar herpes simplex viruses (HSV) mostly transmitted through vaginal, anal and oral sex. The viruses are called herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2).
The herpes simplex infection can appear in various parts of the body causing small blisters that burst into ulcers or red, itchy open painful cold sores around the external genitals, mouth, anus, inner thighs, lips, throat, buttocks and rarely eyes. Reactivation or occurrences of the blisters can repeat intermittently throughout a person’s lifetime. Also herpes simplex infection is a long-term condition which can cause pain during urination. However, in many people who are carriers of herpes simplex virus, there may never be any signs and symptoms. The herpes virus simply travels through the nerves to the tissue where it resides within the body for life.
The average incubation period after exposure to herpes simplex virus is 4 days, but signs and symptoms may develop after 2 to12 days. The first time exposure to herpes simplex is called the primary infection. This may or may not cause obvious signs and symptoms. During the period of primary infection, the virus lives dormant inside the nerve or gets activated occasionally and travels from the nerve to the nearby skin where it causes cold sores around the genitals (penis in men, vulva and vagina in women) or mouth at different frequency and severity. The status of individual outbreaks of herpes can be related to the function of the immune system, physical or emotional stress, illness or in-take of certain drugs.
Types of herpes simplex
There are two types of herpes simplex viruses which can infect the mouth and /or the genitals. They include:
- Genital herpes: This is when the evidence of either herpes simplex virus-1 (HSV-1) or herpes simplex virus-2 (HSV-2) manifests on or around the genitals (vulva, vagina, cervix, anus, penis, scrotum, buttocks or inner thighs). Generally, herpes simplex virus-2 (HSV-2) is responsible for anogenital herpes infection outbreaks. Usually herpes simplex virus-2 (HSV-2) only causes genital herpes, but can cause cold sores sometimes.
- Oral herpes: Occurs when the evidence of either herpes simplex virus-1 (HSV-1) or herpes simplex virus-2 (HSV-2) manifests on or around the lips, face, eyes, mouth or throat. Sometimes oral herpes sores are regarded as cold sores or fever blisters or ulcers. Commonly, herpes simplex virus-1 (HSV-1) is particularly associated with cold sores around the mouth or oral herpes outbreaks. It also causes around half of genital herpes cases.
However, it is possible for both types of herpes simplex viruses to infect either the anogenitals or the mouth. You can be infected with herpes simplex virus-1 (HSV-1) on your genitals if you engage in oral sex with someone with cold sore on the lips. And you can get herpes simplex virus-2 (HSV-2) in your mouth if you have oral sex with someone with genital herpes.
Signs and symptoms of herpes simplex
Many people infected with herpes simplex may manifest mild signs and symptoms within 2-12 days after exposure or no signs and symptoms at all. The obvious signs and symptoms which must be carefully examined, depending on the immune system response and episodes are:
- General feeling of unwell associated with mild fever, aches and pains.
- Clusters of small painful blisters like pimples around the genitals and/or anus which usually erupt into crops of shallow sore ulcers that heal within 1-4 weeks.
- Swollen lymph glands in the groin and feeling of lumps at the top of the legs.
- Painful urination and vaginal discharge especially in women.
- Blisters and ulcers on the neck of the womb (cervix) and top of the vagina, which gradually heal without scarring within 10-28 days.
- A tingling or burning or itchy genital area for 12-24 hours before a recurrence begins.
- Blisters which may form red open sores and oozing fluid in the mouth, lips, face and anywhere else that had contact with the infected areas; forming crust over the sores within a week of the outbreak.
- Ulcers on the face, body and genitals of babies.
- Tiredness and loss of appetite.
- Herpes keratitis which can result to pain, discharge and gritty feeling in the eye.
Herpes simplex virus infection transmission
Herpes simplex is a sneaky infection which can be transmitted through popular and unpopular ways. Herpes simplex can live in your body for years without causing any signs and symptoms, so most times you hardly know for sure when and how you get it into your system or transmit it to others. However, herpes simplex infection is commonly transmitted through direct contact with an active lesion or body fluid of an infected person. Usually, Virus dies very quickly outside the body/skin. Therefore, herpes simplex virus infection can spread through quick skin contacts with infected persons during vaginal, oral or anal sexual interactions; and kissing that involve exchange of salivary secretions. It simply means that the herpes simplex virus can enter the skin or mucous membrane through tiny microscopic abrasions or openings in the tissue when there is close contact with an infected person. Clothes that touch genital skin ulcers from fresh outbreak may transmit herpes simplex virus to any person who wear the clothes without washing and disinfection.
Wet skins with cold sore around the mouth, genitals and back part of the anal passage are most susceptible to herpes infection. However, most people can be infected with herpes simplex from someone who does not have any sores. The saliva and genital secretions of an infected partner can cause oral and genital herpes infection respectively. A sex partner who does not have obvious blisters or who may not know he or she is infected can transmit herpes simplex virus. Herpes simplex virus can also enter into other parts of the body through cut, burn, rash or other sores or breaks in the ordinary skin. Also it can be transmitted through infected fingers or hands or by sharing sex toys with someone who has herpes simplex.
It is reported that herpes simplex transmission from an infected male to a female partner is more likely than transmission from an infected woman to a male partner. Most people are infected with oral herpes simplex when they were kids. Infected mothers can pass herpes simplex to their babies during vaginal childbirth. You can transfer herpes simplex to someone or other parts of your body if you handle herpes simplex blisters before touching someone’s cracked skin or your mouth, genitals or eyes.
It is hard for herpes simplex to be transmitted through toilet seats, bedding, swimming pools or touching uninfected objects like wares, soap, towels, cutlery or cups. Also you cannot be infected with herpes simplex through ways like hugging, holding hands, coughing or sneezing.
Complications of Herpes infection
Herpes simplex virus (HSV) infection causes several distinct medical complications. Some of the complications are:
- HIV/AIDS: The ulcers and sores of genital herpes cause breaks in the skin and expose the body to the transmission and spread of HIV/AIDS during sexual contact.
- Orofacial herpes: The skin or mucosal infection may affect the face and mouth.
- Herpetic whitlow: This is a painful inflammation, typically affecting the fingers, thumbs, toes or nail cuticle.
- Herpes keratitis: The serious disorders occur when the virus infects and damages the eye.
- Herpes encephalitis: Occurs when the herpes simplex virus invades the central nervous system and cause damage to the brain cells.
- Cognitive deficits: Depending on the genetic composition of the infected person, herpes simplex virus promotes bipolar disorder and Alzheimer’s disease.
- Birth defects: Genital herpes can cause miscarriage or premature birth. Blindness, brain damage and death are also possible in infected babies.
- Herpetic sycosis: Occurs as a result of recurrent or initial herpes simplex infection which affects primarily the hair follicles.
Prevention of herpes simplex virus infection
Since herpes simplex infection can be spread through infected people during on and off outbreaks, prevention of the infection can be very difficult. However, observing these preventive measures can help to reduce the impact of herpes simplex virus infection. The preventive measures include:
- Avoiding all sexual contacts with a partner who has visible and active genital sores or blisters.
- Avoiding oral sex or kissing a partner who has a cold sore.
- If you have herpes infection, tell your partner and avoid sex especially during outbreaks to reduce transmission rates.
- If you have recurrent herpes infection, take your antiviral drugs regularly as prescribed to reduce the risk of spreading the virus.
- Be contented with your married sexual partner to decimate your risk of exposure to recurrent herpes simplex infection.
- Try to avoid unprotected direct physical contact or sharing with other people any item that can pass the virus to you such as clothes or lip stick.
- Apply medication to the herpes simplex blisters with cotton swabs and wash your hands thoroughly to reduce contact with sores.
- Pregnant women infected with herpes simplex should take prescribed antiviral drugs regularly and possibly avoid vaginal delivery to prevent the virus from passing to their babies.
Home remedies that reduce the impact of herpes simplex virus infection
The home remedies include:
- Avoiding tight clothing around the affected area and wearing loose-fitting cotton underwear may help to soothe symptoms.
- Washing hands thoroughly after touching herpes simplex blisters or ulcers.
- Refraining from sexual activity until signs and symptoms of outbreak disappear.
- Bathing with lightly salted water to relieve symptoms, and avoiding perfumed soaps or douches near the blisters.
- Soaking the affected part in warm sitz bath and keeping the blisters dry after washing.
- Apply petroleum jelly or shear butter to the affected area and wash your hands before and after applying cream or jelly.
- Apply some cream or lotion to the urethra about five minutes before urinating if passing urine is painful and drink plenty of water.
- Apply ice packs wrapped inside a cloth or towel for about five minutes.
- Avoid sun or heat that could cause more blisters.
Herpes diagnosis and management/treatment
Herpes simplex virus infection is generally diagnosed with careful physical examination which should be confirmed with relevant laboratory tests.
Currently, there is no cure for herpes simplex virus infections. Treatments of different episodes of herpes simplex virus infections are targeted at getting rid of cold sores or blisters, halting outbreaks and spread to other people. An expert and timely treatment plan with appropriate drugs will help in proper management of herpes simplex duration, severity and frequency of the recurrent outbreaks; and reducing the risk of spreading of the virus from infected individuals to others. Expert medical advice and counseling are essential in the use of some helpful natural and home remedies. Sometimes, the blisters do disappear without treatment. Research is still on for the production of vaccines for both prevention and treatment of herpes infections.
Herpes simplex infection and Pregnancy
It is very important for pregnant women who are infected with genital herpes infection to discuss their infection status with expert healthcare professionals for timely advice on what to expect before, during and after delivery. Pregnancy safe treatments plan or caesarean section that ensures safe delivery can be prescribed.
A major concern about genital herpes infection in pregnancy is its transmission to the baby during vaginal delivery. During the last trimester of pregnancy, it is medically advised that women should avoid unprotected oral-genital sexual contact with partners having genital herpes infection. The risk of maternal transmission to the baby is at the peak if the mother gets genital herpes infection with blisters or sores about the time of delivery. Herpes infection from an infected mother can spread through the bloodstream of an infant causing serious adverse health consequences. Therefore Caesarean delivery performed on women who fall into labour while having active outbreak of genital herpes could be the best option to prevent the babies from contacting herpes simplex infection from infected secretions in the birth canal.
Herpes simplex avoidable and unavoidable triggers
The triggers may include:
- Sunburn from ultraviolet light.
- Friction in the genital region from sex (lubricant may help).
- Tight clothing.
- Concurrent bad health conditions or infections or physical illness.
- Genital surgery.
- Weakened immune system due to cancer chemotherapy.
- Stress or tiredness.
- Local injury or trauma to the face, lips, eyes or mouth.
- Genetic factors.
- Excessive alcohol intake.
Untoward effects of herpes simplex infection
There are some unwanted effects associated with herpes simplex infection which usually lessen with time. The negative feelings or effects include:
- Rejection apprehension.
- Fear of being found out especially by new or potential casual sexual partners.
- Suicidal tendency.
Risk factors and people most vulnerable to herpes simplex infections
Anyone can be infected with Herpes Simplex Virus, regardless of age. Your risk is based almost entirely on exposure to the infection. The conditions that highly predispose people to Herpes simplex infection include:
- Having secondary sexually transmitted disease (std).
- Having weak immune system.
- Having multiple sex partners.
- Having sex exposure at a tender (10-15 years) age.
- Being female.
- Baby delivered through the vagina of an infected mother especially during an outbreak.