Herpes is an infection caused by a virus that sometimes produces painful, recurring skin blisters around the mouth or in the genital area.
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Herpes simplex
Herpesvirus
Herpetic infections
Cold sores or fever blisters—those annoying purplish-reddish-whitish blisters that tend to pop up around people's mouths—are the most familiar sign of herpes, one of the world's commonest viral infections. Its full name is herpes simplex infection, and it occurs around the globe, even among remote Indian tribes in Brazil.
Herpes simplex is best known for causing cold sores or genital blisters that go away on their own, only to break out again weeks or months or even years later. While these can be painful and upsetting, they usually are not serious, and outbreaks get milder as time goes on. When herpes causes genital sores, it is considered a sexually transmitted disease.
In rare cases, herpes simplex can infect the eyes or internal organs, including the brain, where it may cause an infection called viral encephalitis (en-sef-a-LY-tis). If the virus spreads to newborn babies, or to people with weakened immune systems, it can be serious, even fatal. Most often, however, herpes causes no symptoms at all or symptoms so mild that people do not realize they are infected with the virus.
What Is Herpes?
There are two types of herpes simplex virus. Both types can infect the mouth or the genitals. Usually, however, mouth blisters are caused by herpes simplex virus 1 (HSV-1), and genital blisters are caused by herpes simplex virus 2 (HSV-2).
HSV-1
HSV-1 is common in children, and more than 90 percent of Americans become infected with it. It is spread by direct contact with an infected area—kissing a person with a cold sore, for instance—or by saliva. Although it does not usually spread on objects, some experts advise washing an infected person's eating utensils and towels before others use them.
HSV-2
HSV-2 usually is spread by sexual contact with an infected person. About 22 percent of adult Americans, or 1 in 5, have it. That number has risen sharply since 1980, with the fastest increase occurring among teenagers. HSV-2 spreads most easily when blisters are visible, or just before they appear. But it can be contagious * even when there are no symptoms, and infected people often pass it on without knowing they have it. For this reason, genital herpes is sometimes called a silent epidemic.
If a woman becomes newly infected with genital herpes during pregnancy, the infection can spread to the baby, who may be born prematurely, become very sick, or even die.
* contagious means transmittable from one person to another.
People can avoid infection by not engaging in sexual activity. For sexually active people, having few sexual partners and using latex condoms can reduce the chances of infection. Difficult as it may be, people with genital herpes should tell any potential sexual partner that they are infected. They should not have sex during an outbreak or if they feel an outbreak coming on.
What Happens During the First Herpes Outbreak?
In herpes of the mouth or of the genitals, the first signs are usually itching, fever, and aches. Within hours or days, the skin breaks out in clusters of small blisters filled with fluid. In a week or two, the blisters begin to heal, drying into a yellowish crust. After three weeks, they usually are gone. The first time symptoms occur, they usually are more severe, especially in young children, who may have many painful mouth sores, swollen gums, fever, and aching muscles. When the symptoms recur, they usually are milder. Although the first outbreak usually starts within 10 days of infection, sometimes people do not notice blisters until years after they were infected.
Why Does Herpes Keep Coming Back?
When the blisters fade away, the virus hides out in nerve cells in a latent * , or inactive, condition. Weeks, months, or years later, it becomes active again and begins replicating (making copies of itself) in the skin. During these active periods, the virus is contagious, whether or not blisters are visible. What triggers the active periods? Too much sunlight, infection with a cold or flu, stress at home, school, or at work—all these may help set it off.
A doctor who suspects that a person has herpes, based on the symptoms, can use a swab to take cells from a blister and examine them under a microscope. The doctor also can send the sample to a laboratory to make sure of the diagnosis.
Cold sores usually need no treatment, although ice or cold drinks can help relieve the pain. Steroid (cortisone) creams should be avoided, because they can make the blisters last longer.
To shorten outbreaks of genital herpes, a doctor may prescribe an antiviral drug such as acyclovir to be applied as a cream or taken as pills. Although there is no cure for herpes simplex, it usually can be controlled such that it causes a person little trouble.
Did You Know?
More than 90 percent of American adults have been infected with herpes simplex virus 1, which can cause cold sores.
An estimated 22 percent of American adults have been infected with herpes simplex virus 2, which can cause genital blisters.
Among Americans thought to have genital herpes, probably only 10 percent know they have it.
Besides herpes simplex, other kinds of herpes viruses cause different illnesses, such as chickenpox, shingles, and cytomegalovirus.
* latent infections are dormant illnesses that may or may not show the signs and symptoms of active diseases.
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