Genital herpes is among the many diseases caused by herpes virus, a
family of viruses with five different strains afflicting humans with a
variety of diseases that include chicken pox, shingles and
mononucleosis. The most common strain, herpes simplex, has two
variations: Type 1, which is usually associated with cold sores or
fever blisters around the mouth; and Type 2, which generally infects
the genitalia, buttocks and thighs with painful sores and blisters. The
two types are not confined to these areas, however; studies have found
Type 1 herpes virus in genital sores and Type 2 viruses in mouth and
throat infections. Other parts of the body also may be affected,
including the hands, eyes, brain and spinal cord.
Although herpes viruses cause a wide variety of illnesses and have been
studied extensively for the last few decades, they remain a medical
enigma. Once they invade the body, herpes viruses remain for life
although they may be dormant most of the time. some, such as the
varicella-zoster strain, may have different manifestations. This
variety causes chicken pox in children, after which the virus remains
dormant in the nervous system. In most people, the virus never again
becomes active, but for unknown reasons, in others it may erupt into
painful attacks of herpes zoster, more commonly known as shingles.
Similarly, herpes simplex also goes through recurring cycles of
infectious activity and dormancy.
The new “Scourge”
The disease is spread most commonly by direct contact, meaning
that to get herpes, uninfected skin must come in contact with an active
herpes sore. Oral sex is believed to explain the presence of Type 1
herpes sores in the genital areas or Type 2 infections of the throat
and mouth. Recent studies have found that the herpes simplex virus can
survive for short periods on toilet seats, towel and other such items,
but most experts doubt that the disease is very likely to be contracted
from these sources. It is highly contagious through direct contact, but
in order to pass herpes to another person, there usually must be an
active herpes sore or blister, although there may be a shedding of the
virus without suffering symptoms of an attack. Also, since herpes sores
may be hidden in the internal parts of the female genitalia or may not
be painful, one may unwittingly infect others.
Typically, the herpes virus multiplies rapidly once it has penetrated
the skin. The first symptoms are usually an itching or tingling
sensation, followed by the eruption of sores or blisters that are
unusually painful. In fact, the pain usually exceeds the actual medical
seriousness of the disease. In the first attack, the sores customarily
appear two days to two weeks after exposure and last two to three
weeks. Subsequent attacks, which may occur in a few weeks or not for
years, generally last about five days. Fever, general malaise and
headaches may accompany the first attack; these symptoms as well as the
pain of the sores are usually milder in recurring attacks.
Once an attack subsides, the virus becomes dormant, raveling
along the nerve fibers until it reaches a resting place. In rare cases,
the herpes virus may travel to the brain causing a serious, often
fatal, form of encephalitis. More commonly than it infects the brain,
herpes may infect the cornea of the eye; if untreated, a herpetic eye
infection can lead to visual damage and even blindness. About 500,000
such eye infections occur each year in the United States. Type 2 virus
may invade the spinal cord, causing a type of meningitis. None of these
complications, however, is as common as recurrences at the original
site of infection.
Other Complications of Genital Herpes
The most serious complications of genital herpes affect infants born to
women who have active infections at the time of birth. About 50 to 60
percent of newborns who contract disseminated heres infections die and
half of those who survive may suffer brain damage or blindness. Many
doctors recommend that the baby be delivered by cesarean if the mother
has an active infection near the time of delivery. The decision of
whether to have a cesarean should be made early in labor, since
cesarean becomes a less effective preventive measure the longer the
membranes have been ruptured. Women who have had genital herpes also
are advised to have frequent examinations for active infection during
the last three months of pregnancy.
There have been reports of an increased incidence of cervical
cancer among women with genital herpes, but the evidence is not
conclusive.
Treatment of Genital Herpes
As noted earlier, the herpes virus remains in the body, and as yet,
there is no cure for genital herpes. However, a new drug, acyclovir,
has been developed and recently approved for use in the U.S., that will
shorten the length of symptoms with the first attack, which is
generally the most severe. It works by interfering with the
replications of the virus, thus speeding the healing process in the
first episode, but it does not prevent recurrence. Tests are now being
conducted on an oral form of the drug. An intravenous form, recently
approved for use in the U.S., appears to be the most effective in
severe cases.
Other types of treatment include the use of lasers to “vaporize” the herpes sores.
Prevention of Genital Herpes
The surest way of preventing herpes is avoiding all sexual
contact with an infected person. Use of a condom and spermicidal agent
will reduce the risk, but this is not absolutely foolproof,
particularly when the lesions are on the skin of the perineum and not
on the penis or in the vagina.
Psychological Factors
Although genital herpes itself is not usually a medically
serious disease, it can lead to depression and other emotional
problems. Many victims tend to resent the sex partner from whom they
contracted the disease, leading to divorce or the breaking up of a
relationship. Others consider themselves “unclean” or damaged for life,
fearing that they are unfit for marriage or a lasting relationship. A
number of herpes counseling centers and groups have been formed
throughout the country to lend support and help to victims of the
disease.
Summing Up
Genital herpes has become the most widespread sexually
transmitted disease in this country. While not as medically serious as
syphilis or gonorrhea, it is very uncomfortable and can recur at any
time. It also can be life-threatening to infants who are exposed to the
herpes virus at the time of birth. A new drug has proven effective in
easing the symptoms and speeding the healing in patients with the first
episode. Although other treatments are in the experimental stage
, no
cure exists as yet.