Herpes Simplex Virus (HSV)
There are many different viruses in the herpesviridae (herpes viral family). On this page we focus on the Herpes Simplex Virus (HSV) 1 & 2, which is the most common version of the virus effecting human beings. It is the cause of the conditions: Genital Herpes (Herpes genitalis) & Cold Sores (Herpes labialis).
What is Herpes?
Herpes is a sexually transmitted infection (STI). There are two types of HSV; Herpes simplex virus 1 (HSV1) and Herpes simplex virus 2 (HSV2).
HSV1 Herpes labialis are commonly found on and around the mouth.
HSV2 Herpes genitalis are commonly found on and around the genitals.
However, BOTH types can be found on AND transmitted to the mouth or genital areas. It is possible to be infected by both HSV 1 and 2. Being infected by one particular strain does not make you immune to another. Genital herpes is the more virulent form of the virus and can have a wider range of possible complications associated with it. It is because of this that genital herpes is considered a more serious condition.
How is Herpes Spread?
Herpes is most commonly and easily spread when a sore is present, but it can spread at other times too. Some people notice itching, tingling or other sensations before they see anything on their skin.
These are called “Prodromal Symptoms” and they warn that the virus is present under the dermis of the skin and possibly shedding on the skin surface at this time. Herpes is most likely to spread from the time these first symptoms are noticed until the area is completely healed and the skin looks normal again. Contact with the infected area (including oral, vaginal, or anal sex) is very risky during this time.
One complication involves spreading the virus from the location of an outbreak to other places on the body by touching the sore(s). The fingers, eyes, and other body areas can accidentally become infected in this way.
Preventing self-infection is simple. Do not touch the area during an outbreak. If you do, wash your hands as soon as possible with soap and warm water. Great caution should be taken in relation to the fluids or secretions that come from the sores. This substance is highly contagious and should be isolated and cleaned immediately if the sores weep excessively or bust. This will help prevent the virus from spreading further on the body.
The spreading of genital herpes through inanimate objects, such as soap, towels, clothing, bed sheets, toilet seats, and spa surfaces is highly unlikely because the genital herpes virus cannot live very long outside of the body. Herpes is not spread through vaginal fluids, blood or semen, or through the air. Herpes is generally spread by direct contact with the viral cells.
Herpes can be spread in the following ways:
- Kissing, touching and caressing infected areas.
- Sexual contact with the infected area (vaginal, oral, or anal sex).
- Skin-to-skin contact with the infected area can transmit HSV-1 and HSV-2.
- Kissing someone when you have a cold sore can transfer the virus and the person you kiss can then contract Herpes on any area on the body which was kissed.
- The virus can be transmitted to your partner if you have active genital herpes and have vaginal or anal intercourse.
- If you have a cold sore and put your mouth on a partner’s genitals (oral sex), the partner can be infected with genital herpes. Consequently, oral sex should be avoided if one partner has a facial Herpes attack.
- People who experience an episode of Herpes, either facial or genital, should consider themselves infectious from the start of the episode up until the healing of the last ulcer.
- Occasionally, one partner in a long-term relationship may develop symptoms of Herpes for the first time. Often this is due to one or both of the partners being carriers of HSV and not knowing it. Or in some cases one of the partners may have contracted the virus long before the relationship and only now has started to show symptoms usually due to a low immune system, stress or a crisis in their life.
- From mother to baby during pregnancy or at birth. However, the baby is protected in the womb by a mother’s antibodies if she already has Herpes before becoming pregnant. Also, the likelihood of having an outbreak at the time of delivery is generally very low – most women with genital herpes are able to have a natural vaginal birth without complications. If your doctor is not supportive of natural birthing simply because of a history of genital herpes (provided there is no sign of an active infection at the time of, or near to, the birth) it may be beneficial to seek further professional opinions from other midwives or doctors if birthing naturally is important to you. It is possible and happens without any problem for most women. Want to know more about herpes transmission
Is having genital Herpes common?
Yes. An estimated 40 million people have genital Herpes (Herpes simplex virus 2) which makes it a chronic viral infection. About 500,000 new people get symptomatic herpes each year and there are even more people without symptoms.
It has been estimated that around 16% to 20% of the population have genital Herpes and between 60 to 80% have cold sores (HSV1). For more detailed information on herpes statistics
How do you know if you are infected with Herpes?
The only way to be sure if a condition is caused by the Herpes virus is to visit a health care provider for a professional diagnosis. To read information on how herpes is diagnosed please read the chapter below.
Many people who are infected with genital Herpes (HSV2) are not aware of being infected. If they do have an active outbreak after contraction then the symptoms of this primary (first) episode can be quite pronounced. The first primary episode usually occurs within two weeks after the virus is transmitted.
Lesions usually heal within two to four weeks of the outbreak. Other symptoms may include a second occurrence of lesions or flu-like symptoms including:
- swollen glands
However, some people infected with HSV-2 do not have lesions or may suffer only very mild, almost unnoticeable symptoms which are sometimes mistaken for a rash or for insect bites. A primary episode of genital herpes can cause several symptomatic recurrences a year (on average 4 or 5); with most recurrences being more prevalent within the first year following the first episode.
If you know that you or your partner are infected with herpes you should begin by learning all you can about the virus, including how herpes can be spread and then take the precautions to prevent this. Always visit your local health care provider for professional information and guidance.
Herpes Diagnosis and Testing
Genital Herpes is considered a serious form of infection and should always be diagnosed by a medical professional. If you suspect that you have Herpes please consult a Doctor or Medical Professional.
There are several tests that are used to diagnose Herpes, some are more accurate than others. Many people need to be tested more than once to gain an accurate result. If active symptoms are present and the sores are not healed, one should request a specific virus culture or assay test for the Herpes virus. A Viral culture test looks for the presence of the virus within the lesion. This method is very specific and does not usually give a positive result if something else is the culprit.
The viral culture test can be somewhat inaccurate and often misses Herpes even when it is present. Because of this, often a patient who has received a negative culture result will be asked to come back again when a new genital lesion appears so the culture can be tried a second or third time.
Blood tests are generally used in cases where no visible symptoms are present. A blood test works by detecting the presence of Herpes antibodies. There is a possibility that the virus will not show up in a blood test, and a positive result is not always indicative that a person has genital Herpes. For these reasons it is important to have more than one test in most cases.
After the first exposure to Herpes, a person may take several weeks to develop the antibodies that the blood test looks for. Usually, it takes two weeks to three months after exposure for Herpes antibodies to appear in the blood. Some blood tests detect antibodies sooner than others. However, once antibodies are found they, as well as the virus remain in the body for life.
A standard blood test will only be able to detect antibodies to the herpes antibodies. It cannot tell the difference between the two types of Herpes, HSV-1 and HSV-2. For this reason, anyone seeking an accurate diagnosis of genital herpes must be sure to get a “type-specific” serologic test, which can accurately distinguish HSV-2 from HSV-1 antibodies. Most commercially available assay kit tests currently cannot make this distinction despite their claims.
Please seek immediate professional help if genital Herpes is suspected. Some of the available diagnostic procedures become less reliable the longer you wait. If you are concerned that a diagnosis for Herpes is incorrect you should consult your healthcare provider for their professional opinion, and request another test to be taken if you feel you require further confirmation. For more detailed information on Herpes Diagnosis and Testing
Treating and Managing Herpes
If you have active outbreaks of any herpes, genital herpes or cold sores, there are treatment options available. Many of these treatments can help speed up the healing time of the lesions and reduce the frequency and severity of their recurrences. There is no “cure” for Herpes at present and the closest attainment of this state will be the total suppression of the virus through various methods and regimes.
Zovirax, Acyclovir, Valtrex and Famvir are prescription drugs that can be helpful for some people. These drugs can either be taken every day as a “suppressant”, or “episodic” used only when an outbreak occurs.
Talk to your Doctor about different treatment options that may be able to help you.
Further Herpes Treatment Options
Diet and life-style changes can also be beneficial in managing Herpes and it is a very important to strengthen the immune system in order to help your body combat the virus efficiently. Good rest, exercise and a diet free from processed and refined foods, with the addition of fresh fruit and vegetable foods and juices will help incredibly to strengthen the immune system.
With any disease or health condition, an approach which improves diet and nutrition should be taken. An appropriate diet for Herpes that is high in quality lysine and low in arginine, with vitamin supplements such as chelated zinc, bioflavonoids and vitamin c, can be highly beneficial for those suffering from viral diseases, in particular the Herpes virus.
There is scientific research to support the concept that arginine, an amino acid, can aggravate Herpes and bring on an outbreak. It is shown that arginine provides the virus with it’s building blocks and supports the herpes virus growth. Foods containing arginine include nuts, protein shakes, chocolate and caffeine (just to name a few). If Herpes outbreaks are a problem for you, see whether cutting back on these foods or eliminating them from your diet helps relieve your symptoms and their occurrences.
It has been found that the amino acid lysine retards virus growth by reducing the virus’ food source arginine. So you should include in your diet foods high in Lysine and decrease the foods high in L-Arginine.
Below are some simple home remedies:
Epsom salts are best if you have them available. You can buy Epsom salts from most local supermarkets or drug stores. Salt water can be used to wash the infected area and help to clean, soothe and dry the sores.
Use 1 teaspoon of salt in 600ml of water or a generous handful in a bath tub. A lengthy swim in the ocean will also have a similar effect.
Ice wrapped in a towel or applied directly to the sores can offer soothing relief.
Bach Flower Remedies may be used to ease the emotional stress of herpes, particularly Rescue Remedy. St John’s Wort (taken internally) may be helpful for stress and anxiety, but does have contra-indications with some medications so please check with your Naturopath or Health Care Provider before taking.
Further Herpes Outbreak Pain Relief Tips
Symptoms of Herpes
Symptoms do vary, with some people having very severe symptoms and others having no noticeable symptoms at all.
Early symptoms before an active genital outbreak may include:
- a burning, itching or tingling sensation in the genitals
- lower back pain
- pain when urinating
- flu-like symptoms
Small red bumps may appear in the genital area following these earlier symptoms, which can further develop into painful blisters, which then crust over, form a scab, and gradually heal.
Genital Herpes – The first outbreak
Symptoms usually develop within 2 to 20 days after contact and could continue to last for up to 2 weeks on average. The first infection may be so mild that it goes unnoticed, whilst in some cases, the first attack causes visible sores and can often be the worst episode one will experience out of all their collective outbreaks. Subsequent recurrences of the virus are usually expressed as outbreaks of blisters.
In the final stages of an outbreak the virus retreats into the nerves and lies dormant within the nervous system. If you are lucky enough to catch the virus in its early stages, act as soon as you can by using an anti-viral treatment. This early intervention suppresses the virus before it is able to take a stronghold within the body and seems to have a greater dominating effect over the virus’ activity.
When Herpes travels along the nerve fibers to the dermis layer of skin cells, the virus replicates itself and starts to multiply, making the skin red and sensitive. In this process blisters or bumps may appear on the genital skin area. The blisters usually open, weep and then heal by the regeneration of new skin cell tissue. The healing of the skin from outbreaks does not normally leave scarring.
During the outbreak the infected area is usually painful and may itch, burn or tingle.
Other symptoms include:
- swollen lymph glands
- painful inflamed blisters around the infected area
- muscle ache
- vaginal or penis discharge
- infection of the urethra causing a burning sensation during urination
Generally the first episode for people is the most severe, with the possibility of the episode lasting 10 – 21 days. A warning sign (prodrome) such as tingling or itching is experienced by many people in recurring outbreaks. These prodromal sensations are a warning that the virus has become active in the system and most probably will be followed by an active outbreak in a short amount of time after feeling them.
Should any of these symptoms occur for the first time, consult your doctor or other health care provider immediately. Genital Herpes should be diagnosed professionally. Want to know more about herpes symptoms
Identifying a Herpes type/strain
Not everyone knows whether they have HSV1 or HSV2 and in certain situations that information could be relevant. In a situation where both partners have genital HSV2, even though reinfection of that area with this HSV2 strain is not possible, precautions should still be made to prevent the spread of the disease to other ‘uninfected’ areas. If one partner has genital HSV1 and the other has HSV2, each can become further infected with a second type.
HSV1 typically prefers to inhabit the the face and mouth regions, just as HSV2 typically prefers to inhabit the genital and sacral areas. When HSV1 is contracted on the genital area it does not thrive here as well and therefore it usually seldom recurs and visa versa for HSV2 on the facial region.
Diagnosing genital HSV1 can be slightly difficult. Since most cases of HSV1 infections are facial, a finding of HSV1 by Western blot serology (blood test) would not necessarily identify genital infection. This result could be concluding that you have HSV1 from a facial infection, while possibly having HSV2 also, which is causing the genital symptoms. The way to clear this confusion is to be serologically tested for both HSV1 and HSV2.
If you are seronegative (negative by blood test) for type 2, but positive for type 1, that gives you a strong clue as to the cause of your genital outbreaks (seropositive for type 1 but not type 2, with infrequent recurring genital Herpes is probably genital HSV1). So in other words, if you are experiencing genital outbreaks or symptoms and there is no sign of antibodies to HSV2 in a blood test, then it is likely that this is a case of genital HSV1.
This same elimination process can be applied to determine the specific type of Herpes causing facial outbreaks. Further Information on Human Herpes Virus Types
Further details on Conditions Confused with Herpes
How can Herpes be prevented?
The following steps can help to reduce the risk of infection and transmission:
Tell Your Partner
It is important to understand what Herpes is and how it can be prevented. You and your partner will need to discuss which precautions are best for you both. Because of the social and emotional impacts that can come from having Herpes, the best approach to living freely and happily with the condition is to understand the virus to the best of your ability. This is done through research, questioning and life experience. With knowledge you hold the power and through this Herpes can become an infrequent and only mildly disruptive phenomena in you and your partners life.
From the first signs of an outbreak, which include the prodromal symptoms, all the way to the complete healing of an active outbreak, avoid sexual activities of all kind. Herpes is most contagious during this time and this approach will ensure that there is no possibility of transmission.
Many couples have had sexual relations for years without transmitting herpes. Some simply avoid having sexual contact when signs or symptoms are present, while others use condoms or other protection between outbreaks to help protect against asymptomatic shedding.
Strengthen your immune system
Building and strengthening the immune system through a healthy lifestyle, diet, supplements and reduction of stress levels will be one of the most powerful ways to prevent any possibility of asymptomatic viral shedding, as well as cutting down the frequency of your outbreaks.
Limit the number of sexual partners
- By having sex with a non-infected partner who has sex only with you (mutual monogamy).
- Use Latex Condoms between outbreaks. Condoms offer useful protection against Herpes by protecting or covering the mucous membranes; which are the most likely sites of infection.
The facts on condoms and foams
Laboratory studies show that:
- The Herpes virus does not pass through latex condoms and, when properly used, latex condoms are likely to reduce your risk of spreading or getting Herpes.
- Condoms are useful in prevention but even the best condoms do not guarantee total safety.
- When Herpes sores occur in places that are not covered by a condom, the condom is of little help in preventing transmission.
- Condoms and foams should not be relied upon when Herpes sores or symptoms are present.
- Spermicidal foams and jellies may offer additional protection. Spermicides used in contraceptive foams, film and gels kill or neutralize HSV in laboratory tests and may provide some protection when used in the vagina (recommended dose is the same as for contraception).
- In test tube trials, it has been shown that some contraceptive foams contain ingredients (such as nonoxynol-9) that kill the Herpes virus and other STDs.
- Foams are best used along with condoms, not in place of condoms.
- Condoms do not provide 100 percent protection because a lesion may be occurring in a place which the condom does not cover. However, when used consistently, condoms are the best available form of prevention aside from abstinence.
Because of the highly contagious nature of this virus, avoid any contact with an active Herpes site, even if the blister is elsewhere on the body and not directly at a sexual organ.
The fingers, eyes and other body areas can be accidentally infected by touching the sores.
Preventing self-infection is simple:
- Do not touch the area during an outbreak
- If you do, wash your hands immediately
- Also, wash any other areas you may have accidentally touched
Women with any sexually transmitted disease (STD) may be at greater risk of developing cervical cancer than other women. All women should have regular Pap tests at least once a year, as early cell changes can be detected by Pap smears. Visit a local sexually transmitted disease (STD) clinic, hospital, doctor or health professional.