The truth about herpes

We all learned about herpes in sex education class. Who can forget the graphic images intended to illustrate what was considered to be a taboo topic? More than 40 million Americans have genital herpes — and more than 80 percent of people who have the virus don’t know it.

Dr. Fadi Haddad, an infectious disease specialist affiliated with Sharp Grossmont Hospital, helps explain the two major types of herpes, as well as the causes and treatment.

“Herpes simplex is a virus, a small infective agent that is only able to multiply within the living cells of other organisms,” he says. “There are two types of the herpes simplex virus, HSV-1 and HSV-2. Typically, HSV-1 causes sores (fever blisters, cold sores) in the oral cavity while HSV-2 affects the genital regions (genital herpes).”

Someone who has either of the herpes simplex viruses may experience the following symptoms:

• Blistering sores (in the mouth or on the genitals)

• Pain during urination

• Tingly on the skin prior to a blister

• Itching

Anyone can contract herpes. However, individuals who practice risky sexual behaviors, have another sexually transmitted infection (STI) or a weakened immune system are at increased risk of contracting the virus.

Close contact
The most common ways that oral herpes (HSV-1) spreads is by close contact, such as kissing or sharing utensils or lip balm with an infected person who has an open sore. Even though it is less likely, it is also possible for someone to get genital herpes from HSV-1 if someone with open sores performs oral sex. Genital herpes (HSV-2) is also transmitted by contact with an infected individual and usually happens during sexual intercourse (vaginal, anal or oral) or close skin-to-skin contact.

Symptoms and treatment
Not all individuals with herpes have ulcers or visible symptoms. When an individual has herpes simplex but presents no symptoms, it is referred to as asymptomatic herpes.

“The virus itself is the ice under the iceberg,” says Dr. Haddad. An individual with asymptomatic herpes may not even know they have the virus, yet they are still able to transmit it to others.

Currently, there is no cure for herpes simplex. Treatments focus on getting rid of the sores and limiting the recurrence of virus flare-ups, or outbreaks. A doctor may prescribe antiviral medication to lower the intensity and frequency of outbreaks, and to help reduce the risk of spreading the virus to others. Treatment is not required for everyone who has herpes simplex because sometimes the sores disappear on their own.

Over time, the outbreaks decrease in frequency and severity, but the virus will continue to live in the infected person’s nerve cells. Certain things such as stress, menstrual periods, fever, illness, sun exposure or sunburn can trigger an outbreak.

To reduce the transmission or contraction of herpes simplex, Dr. Haddad advises individuals to avoid oral or skin-to-skin contact with individuals who have active sores, and to use condoms to help reduce the risk of sexual transmission. “If you are a person who is living with herpes, it is best to try to reduce stress as it can cause the virus to reactivate,” he adds.

If you think you have contracted a herpes simplex virus, contact your doctor. A doctor can perform blood tests to diagnose the disease. Be aware that the test is not a part of a routine STI test, so you must ask for it separately.