¶ … herpes simplex viruses. Herpes simplex virus type 1 (HSV-1) is usually associated with infections of the lips, mouth, and face and is often referred to as labial herpes. It is the most common herpes simplex virus and is usually acquired in childhood. By adulthood, up to ninety percent of individuals will have antibodies to HSV-1. Herpes simplex virus 2 (HSV-2) or genital herpes is sexually transmitted and is usually associated with genital ulcers or sores -- however individuals may harbor HSV-2 and not have developed any symptoms. Genital herpes can also be caused by HSV-1, but this is not as common. Up to twenty-thirty percent of U.S. adults have antibodies against HSV-2.
This paper discusses the effects of both labial and genital herpes in terms of typical consequences and more severe complications that are less likely to arise.
Labial Herpes
The first time a person is infected with HSV-1, he or she may not experience any symptoms. When the virus does cause cold sores, the symptoms are often the most severe the first time the cold sore develops and may include mouth soreness that makes it uncomfortable to eat drink and sleep, fever, sore throat swollen lymph nodes in the neck and drooling in small children. Also, during the first outbreak of cold sores, the blisters may spread to any part of the mouth.
Most people become infected with labial herpes as infants or your children from a parent who has the virus. Cold sores in infants and young children often go unnoticed or confused with other illnesses such as impetigo. Labial herpes usually stays in the body after the first cold sore outbreak and causes cold sores to recur throughout the infected individual's life. Although it's not known exactly what causes cold sores to recur, there are a variety of factors thought to trigger outbreaks such as:
Exposure to sunlight (especially on the lips).
Stress.
Fatigue.
Other infections, such as a cold or flu.
Food allergies.
Dental treatment.
Injury to the lips or gums.
A weakened immune system, either due to medications such as corticosteroids or because of an autoimmune disease.
Cosmetic surgery such as dermabrasion or laser skin resurfacing.
Hormonal changes caused by a woman's menstrual cycle.
Pregnancy.
Sometimes when people are about to develop cold sores, they may feel tingling, burning, itching, numbness, tenderness, or pain in the area where the sores are going to appear. They will normally notice these symptoms six to forty-eight hours before the sores are visible.
The effects of labial herpes are usually more annoying than serious. Skin lesions, rashes and painful blisters that break and ooze cause mostly discomfort and embarrassment. However, labial herpes may spread to other skin areas and cause secondary bacterial skin infections and it can be life threatening in immunosuppressed people such as those with atopic dermatis, cancer and HIV infections. Also, labial herpes that spread to the eye is a leading infectious cause of blindness in the U.S., causing scarring of the cornea.
Genital Herpes
Symptoms of genital herpes vary by person and also by episode. Some people never have any signs while others have mild symptoms that they don't recognize until after many years. Others may have repeated outbreaks that are very uncomfortable. Some people who have latent herpes infection never experience signs or symptoms or have such mild symptoms that they may not recognize the infection for many years. For others, outbreaks can be repeated often and cause extreme discomfort.
When a person is first infected with genital herpes, their immune system is not well developed and the virus can multiply and spread more quickly than it might at later stages of the infection. First symptoms may appear within two weeks after the virus is transmitted and can be uncomfortable. First episode symptoms may include small pimples or blisters that curst over and scab like a cut and may be accompanied by flu-like symptoms, fever, and/or swollen glands in lymph nodes near the groin. First episodes can take as long as six weeks to heal fully and may be the most extreme outbreak a person will ever experience.
How often recurrent outbreaks occur depends upon the HSV type and how long the infection has resided in the body. Triggers for genital herpes are not well understood but it is believed that they include surgical trauma and excessive friction in the genital area. People with genital herpes caused by HSV-2 typically have a strong first episode followed by several recurrences a year with the first year having the most activity. Unrecognized outbreaks account for about a third of all reactivation. In the early stage of a recurring episode, there may be itching, tingling or pain in the area where the lesions will develop a day or two before an outbreak. This may include pain in the buttocks, back of legs or the lower back.
People with an HSV-1 infection may have a significant first episode, but are less likely to have outbreaks in the first year. Recurrence for this group is generally once a year and unrecognized reactivation are lower as well. Recurrent outbreaks are different from first episodes. They don't include flu-like symptoms and swollen glands in lymph nodes near the groin, but they'll still involve small sores or blisters and break or irregularities in the skin. Healing usually takes only half the time as first episodes.
It's common for sufferers of genital herpes to have no symptoms, unrecognized symptoms, or to mistake their symptoms for other issues. A herpes virus that becomes active without producing symptoms is called asymptomatic shedding and subclinical shedding. Some people don't notice their symptoms because lesions can be very small and occur in unseen spots. Some people mistake genital herpes outbreaks for insect bites, jock itch, abrasions or razor burn, yeast infections, hemorrhoids, or ingrown hair follicles.
Genital herpes can present a number of serious complications. If a recurrent outbreak coincides with labor, the virus can be passed to an infant during delivery and a caesarean section must be performed to prevent this from happening. However, a first episode of genital herpes during pregnancy is serious. Infection of the unborn child is more likely and the chance of premature birth rises. Half of all infected infants either die or suffer nerve damage.
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