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Herpes Simplex
Common Names: Cold sores
Image Notes: Infectious fluid-filled blister on lower lip (herpes labialis).
The term "herpes" generally refers to a sexually-transmitted, double-stranded DNA virus called herpes simplex virus (HSV) type 2 (also known as human herpesvirus 2, or HHV2). This virus is closely related to herpes simplex virus type 1 (HSV-1 or HHV1), which is the cause of common nonsexually-transmitted cold sores. These two viruses are among the eight members of the herpes virus family to infect humans, causing a variety of illnesses ranging from cold sores to brain infection (encephalitis) to chickenpox to various cancers.
HSV-1 and HSV-2 are members of the Alphaherpesvirus subfamily. HSV-1 (usually the cause of oral herpes which many people call "cold sores") can also be spread to the genitals via oral sex. HSV-2 (usually the cause of genital herpes) can also be spread to the oral region, although this is somewhat less common. For most people who carry the HSV-1 and/or HSV-2 virus, symptoms are mild, infrequent, or altogether un-noticeable. However, people who carry the virus may still shed the virus from their skin when no symptoms are present, and unknowingly transmit the virus to their partners. This is called "asymptomatic shedding." In one study, approximately 70% of new cases of genital herpes were the result of intimate contact with a partner who had no signs or symptoms at the time.
According to the American Social Health Association (ASHA): - About 50 to 80 percent of American adults have oral herpes, which is commonly called cold sores or fever blisters. - About one in five adults in the United States has genital herpes. However, most people (up to 90%) don’t know they are infected because their symptoms are too mild to notice or mistaken for another condition.
Also, most doctors in the US do not include a herpes blood test in their routine STD screens. You must ask for it specifically or else the test is not done. Therefore, many people assume that after they see their doctor for routine STD testing, that they are "clean" and don't have herpes, when in fact, they were never tested for herpes in the first place, and may carry and spread the virus even if they don't have any symptoms.
For a list of ASHA recommended, very accurate, type-specific herpes blood tests, go to: http://www.ashastd.org/pdfs/blood_test.pdf.
Herpes simplex 1 and 2 viruses are similar in that they are both transmitted by direct contact and can sometimes cause intensely painful fluid-filled blisters, containing millions of infectious virus particles. The primary difference between the two infections is the principle site of infection--mucous membranes of the lips and nearby oro-facial skin for HSV-1 or the genital skin for HSV-2. After initial infection, these viruses both travel to sensory nerves, where they reside as life-long, latent viruses. HSV-1 often infects the trigeminal ganglia that provides sensation to the lips, lower mouth and neck; while HSV-2 often infects the sacral ganglia supplying sensation to the pelvic area including the genitals, perineum and upper legs. When the viruses reactivate to cause symptomatic disease, they travel back to their respective skin areas served by these nerves, leading to the different (oral vs. genital) distributions of cold sores.
Both HSV-1 and HSV-2 are transmitted by contact with a herpetic sore (kissing, touching, and possibly from objects such as shared drinking glasses[citation needed]). Transmission of these two virues can be more complicated in that both HSV-1 and HSV-2 are shed (to a much lesser extent) from persons without active sores.
While both oral and genital herpes are characteristically "nuisance infections" that are not life-threatening, they can cause rare severe or fatal disease if they disseminate to the eyes or brain. This is a particular concern for newborns who might be infected by genital herpes during passage through the birth canal (the risk of this occurring is by far higher when the mother is newly infected with HSV-2 just prior to birth and lacks protective antibodies that would otherwise reduce viable virus shedding). Both oral and genital herpes infections have periods of active cold sore disease lasting 2-10 days and then remission when the cold sores disappear. Over time, periods of remission generally increase in length, and the duration of cold sores decrease, until the person rarely has active disease. This is regulated by specific immunity developed by the patient against the virus. The virus infection is, however, life-long and can be retriggered in some individuals by specific events, such as sunburn, stress or other infections.
The ways in which herpes simplex infections manifest themselves vary tremendously among individuals. The following are general descriptions of the courses outbreaks may take in the oral and genital regions.
Herpes is also formed on the tongue as bumps or white dots.
Text and images are licensed under the GNU Free Documentation License. Material is used from the Wikipedia article "Herpes simplex".
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