How do you get Herpes?
Herpes is spread by direct skin to skin contact. Unlike a flu virus that you can get through the air, herpes spreads by direct contact, that is, directly from the site of infection to the site of contact. For example, if you have a cold sore and kiss someone, you can transfer the virus to their mouth. Similarly, if you have active genital herpes and have vaginal or anal intercourse, you can give your partner genital herpes. Finally, if you have a cold sore and put your mouth on your partners genitals (oral sex), you can give your partner genital herpes.
When Is Herpes Most Likely To Be Spread?
Herpes is most easily spread when a sore is present, but, it is also often 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 virus may be present on the skin. Herpes is most likely to be spread from the time these first symptoms are noticed until the area is completely healed and the skin looks normal again. Sexual contact (oral, vaginal, or anal) is very risky during this time.
Can Herpes Be Transmitted Without Symptoms?
Yes! Sometimes those who know they are infected spread the virus between outbreaks, when no signs or symptoms are present. This is called "Asymptomatic Transmission."
Research also shows that herpes simplex infections are often spread by people who don't know they are infected. These people may have symptoms so mild they don't notice them at all or else don't recognize them as herpes.
Many genital herpes infections are spread from persons who are asymptomatic "Shedders" of the virus.
For those who recognize their symptoms, asymptomatic transmission appears to be far less likely than spreading the virus when lesions are present. Many couples have had sexual relations for years without transmitting herpes. Some simply avoid having sexual contact when signs or symptoms are present. Others use condoms or other protection between outbreaks to help protect against asymptomatic shedding.
Are complications possible?
One kind of 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. The herpes virus is easily killed with soap and water.
What about pregnancy? Can babies get herpes?
Babies can become infected with the herpes virus. If you've been exposed to herpes, you need to talk with your doctor about it before you get pregnant. This is important even if you've never had symptoms or haven't had a recurrence in a long time. The doctor might arrange a test to see if virus is present when you go into labor. In addition, you should be examined to see if you have herpes at labor and should notify the doctor if you think you have active symptoms at that time.
If no virus is found in the birth canal and there are no symptoms or signs of an outbreak, a vaginal delivery is considered safe. If herpes is present in the birth canal near the time of delivery, a cesarean section might be necessary to protect the newborn from coming into direct contact with the virus.
Babies also can get herpes if they are kissed by someone with a cold sore. A young baby cannot fight off infections as easily as an adult can, so serious problems might result. It's important that you do not kiss a baby when you have a cold sore.
What should I do if I think I have herpes?
See a doctor while symptoms are still present. The doctor will look at the area, take a sample from the sore(s) and test to see if the herpes virus is present. The test you should request is a specific virus culture or assay for herpes virus. Remember, the test will not work if the sores have healed.
Known available tests:
Cell Culture Test
Antigen test
Pap Smear
Blood tests are often used when a person has concerns about herpes, but does not have any visible symptoms. In the past, type-specific blood tests were not always accurate because they confused other herpes virus antibodies such as varicella zoster (chicken pox), Epstein Barr, or mononucleosis for herpes simplex (Types 1 and 2) antibodies. The Western Blot has long been the standard test for diagnosis. It was designed to test for antib odies, but is costly and time consuming.
The Food and Drug Administration (FDA) has recently approved very accurate type-specific blood tests to diagnose herpes. The new tests are roughly one-fifth the cost of the Western Blot and are much faster and easier to administer. One of these, the POCkit HSV2 Rapid Test by Diagnology is an accurate test for genital herpes caused by herpes simplex virus type 2 (HSV-2). The "POC" in POCkit stands for "Point Of Care", which means the test can be done in a doctor's office and can provide results in less than 10 minutes. Meridian Diagnostics has developed a test for HSV-1. With Meridian's Premier test, the health care provider takes a blood sample from the arm and the blood is sent to the lab for results. Results could take a few days depending on how fast the lab can do the test. Another test which requires blood to be drawn and sent off for results is HerpeSelect from Focus Technologies. These tests cannot determine whether the HSV infection is oral or genital. However, since most cases of genital her pes are caused by HSV-2, a positive Type 2 result most likely indicates a genital infection.
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Identifying Your Type ...Anna Wald, M.D.
Most readers know they have genital herpes, however, not everyone knows whether they have HSV-1 or 2. Is there any practical reason to find out?
The main reason, according to Anna Wald, M.D., would be in a situation where both partners have genital herpes. Such a couple might reasonably take no precautions to prevent transmission, since both are already infected. If one partner has genital HSV-1, however, and the other has HSV-2, they might infect each other with a second type.
Specifically, the person with the milder genital HSV-I might acquire HSV-2, resulting in more shedding and more recurrences.
Diagnosing genital HSV- 1 after the primary episode is no easy task, however. Because the infection seldom recurs, a culture from an active outbreak can be hard to get. And since many people have HSV-1 orally, a finding of HSV-1 by Western blot serology (blood test) would not positively identify genital infection.
One solution could be a process of elimination, suggests Wald. A Western blot can tell whether or not you have HSV-2. 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 outbreaks.
"If you have infrequently recurring genital herpes, and you are seropositive for type 1 but not type 2, you probably have genital HSV1," reasons Wald.
GENITAL HERPES
Genital herpes is a contagious viral infection affecting primarily the genitals of men and women. It is characterized by recurrent clusters of vesicles and lesions at the genital areas. It is caused by the Herpes Simplex-2 virus (HSV-2), one of several strains of the Herpes Simplex Virus responsible for chickenpox, shingles, mononucleosis, and oral herpes (fever blisters or cold sores, HSV-1). While generally not dangerous, it is a nuisance and can be emotionally traumatic, as there is no cure.
What happens when you first get herpes?
Symptoms of herpes usually develop within 2 to 20 days after contact with the virus, although it could take longer. These symptoms may last up to several weeks, varying from one person to the next. In many people, the first infection is so mild that it goes unnoticed. In others, the first attack causes visible sores. Even so, subsequent recurrences of the disease may cause lesions. When the sores are completely healed, the active phase of infection is over. Healing of the skin usually leaves no scars. In either case, the virus retreats into the nervous system and lies dormant.
Typical symptoms
The virus starts to multiply when it gets into the skin cells. The skin becomes red and sensitive, and soon afterward, one or more blisters or bumps appear. The blisters first open, and then heal as new skin tissue forms. During a first outbreak, the area is usually painful and may itch, burn or tingle. Flu-like symptoms are also common. These include swollen glands, headache, muscle ache or fever. Herpes may also infect the urethra, and urinating may cause a burning sensation.