Herpes is a viral disease caused by the Herpes Simplex Viruses (HSV): both herpes simplex virus 1 (HSV–1) and herpes simplex virus 2 (HSV–2). The disease manifests itself in different disorders depending on the site of infection.
Other disorders such as herpetic whitlow, herpes gladiatorum, ocular herpes (keratitis), cerebral herpes infection encephalitis are less common. For the purposes of this article we will focus on Oral and Genital herpes (those that are most likely the result of infection through sexual activity).
Herpes is contracted through direct contact with an active lesion or body fluid of an infected person. 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. There is no evidence to support the transmission of herpes via inanimate objects such as linen ware of toilet seats.
General symptoms of an infection include an itching or tingling sensations which precedes a localised swelling. The area becomes more and more painful and and sores appear. These ulcers may burst releasing an virus infected fluid until they crust over.
Oral herpes affects the face and mouth and is the most common form of infection and the visual effects of this disease are often referred to as cold sores. These sores or lesions are usually seen on the lips and the area between the lip and skin, although they may show up anywhere on the facial area. Infection occurs when the virus comes into contact with the mucosa or breaks in the skin. Other symptoms include;
- inflammation of the mucosa of the cheek and gums
- painful ulcers
- fever, and sore throat
- difficulty in swallowing
- swollen lymph nodes
Most symptoms will disappear within 3 weeks.
In all cases HSV is never totally removed from the body by the immune system and resides in a latent state.
Genital herpes know as herpes is the next most common form of infection.
Most people that are infected with genital herpes are not aware of their infection,.The most common symptoms include blister like papules and vesicles on the genitals, these appear very similar to cold sores. They usually appear 4 to 7 days after initial infection. Many individuals with HSV infection never have sores, or the signs are very mild and they do not notice or they make a mistake interpreting the signs as insect bites or another skin condition. In the man, lesions occur on the shaft of the penis or other parts of the genital region, on the inner thigh, buttocks, or anus. In women, lesions appear on or near the pubis, labia, clitoris, vulva, buttocks or anus.
Other symptoms includes
- general pain
- muscle pain
- discharge from the penis or vagina,
- swollen and enlarged lymph nodes
- a feeling of discomfort of ‘out of sorts’
- in women – painful urination and cervicitis
After 2–3 weeks, the blister like papules and vesicles turn into ulcers and then crust and heal.
Currently there is no treatment that can cure herpes or eliminate the virus from the body. Some antiviral medications can help to reduce the duration, frequency and severity of outbreaks.
Since the virus is never expelled from the body herpes is recurrent. After the first infection the individual should expect three to five recurrences of the disease in the first year. Recurrences become less frequent over time. Infected people that show no visible symptoms may still shed and transmit virus through their skin, infecting others.
Herpes can cause recurrent painful genital sores in many adults, and herpes infection may be acute in people with a suppressed immune system. Genital herpes frequently causes psychological distress in people who are aware of their infection.
Herpes may play a role in the spread of HIV, the virus that causes AIDS. Herpes can make people more susceptible to HIV infection, and it can make HIV-infected individuals more infectious.
The best way to avoid transmission of sexually transmitted diseases, including genital herpes, is to abstain from sexual contact, or to be in a monogamous relationship with a partner who has been tested and is known to be uninfected.
For genital herpes, condoms are very effective in limiting transmission, however condoms are not completely effective. The virus cannot pass through latex, but the condom may be fitted badly and not completely cover blisters on the penis of an infected man, or the base of the penis or testicles may not be covered by a condom may come into contact with free virus in vaginal fluid of an infected female. The use of condoms and/or dental dams limits the likelihood of transmission from the genitals of one partner to the mouth of the other (or vice versa) during oral sex.
It is paramount that people with herpes should abstain from sexual activity with uninfected partners when lesions or other symptoms of herpes are present.