Herpes Simplex is a medical condition, caused by a virus, that is defined by the area of the body found, where blisters, pain and other symptoms can be found.

Generally speaking, herpes is found orally or genitally though it can be found in other places such as on fingers, eye, and more.

Herpes Simplex is a viral disease that consists of two virus types:

1.) Herpes Simplex Type 1  (HSV-1)

2.) Herpes Simplex Type 2  (HSV-2).

The typical difference between the two types is body location.

Oral Herpes are often referred to as fever blisters or cold sores.

Genital Herpes is referred to as herpes and is a sexually transmitted disease.

Worldwide infection rates are anywhere from 65% – 90%

HSV-1 is more common than HSV-2

It is said that in Rome, over 2,000 years ago, kissing was banned because of the amount of cold sores.

The term Herpes Simplex was first written in Richard Boulton’s – A System of Rational and Practical Chirurgery in 1713.

It was found to be a virus in the 1940’s.

 

Virus Cycle

–  After initial infection the virus travels along nerves to nerve cell bodies where thy become dormant [also called latent].
–  The virus is housed in the nerve bodies from that point on.
–  During Active disease (opposite of latent] is when blisters are seen.
–  Inside blisters – infectious virus particles that last from 2-21 days.
–  This is followed by a remission period until next symptomatic outbreak.
–  New outbreaks are not new transmission of the virus.
–  Over time the frequency of outbreaks and severity can reduce.

 

Transmission of Oral and Genital Herpes

–  This is the passing of the virus.
–  Can easily be transmitted from person to person.
–  Occurs with direct contact with lesions or body fluid with infectious virus.
–  Also can be passed by skin to skin contact.

 

Genital Herpes Transmission

–  Barrier protection methods can help prevent transmission but it does not eliminate the risk.
–  Transmission risk is 8-11% from male to female.
–  Transmission risk is 4-5% from female to male.

 

Signs and Symptoms

–  When affecting face and mouth – Orofacial Herpes
–  When affecting genitalia –  Genital Herpes
–  When affecting hands – Herpetic Shitlow
–  When it damages the eye – Herpes Keratitis
–  When it invades the central nervous system and affects the brain – Herpes Encephalitis
–  Can have serious health problems in those that are immunocompromised
–  Can have serious heath affects in newborns and transplant recipients.
–  Itching in area before blisters arrive  [Prodrone symptoms]
–  Fever or chills
–  Fatigue
–  Blisters or ulcers that are typically round and multiple blisters
–  Redness
–  Drainage is usually clear
–  Risk for secondary bacterial infection
–  Swelling
–  Pain
–  Burning pain

 

Pregnancy

Risk of transmission to baby is highest if mother becomes infected around time of delivery.

Pregnant women should avoid unprotected sexually activity with a partner having active outbreak during the last trimester of pregnancy.

If Vaginal lesions are present – consideration for Cesarean section to reduce exposure in the birth canal.

 

Diagnosis

Typically by visualization by clinical provider.

Can be difficult in some cases

Culture of the wound site or blister fluid

Skin biopsy

Blood work: Immunodot glycoprotein G-specific (IgG) and other blood work.

 

Prevention

Condom use can reduce risk and transmission.

Female condom can provide greater protection than male condoms as it covers the labia.

Vaccines are currently undergoing trials.

 

Treatment

Oral medications

–  These medications are intended to shorten duration of outbreak and are not curative.
  –  Acyclovir
  –  Valacyclovir
  –  Famciclovir
  –  Penciclovir

Topical

–  Acyclovir
 Penciclovir
–  Docosanol – can be purchased over-the-counter

 

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