Herpes: An Insidious Disease of Modern Times Herpes is considered one of the most insidious and pervasive viral diseases to affect the world population today. Conservative studies suggest that as many as 39% of men and nearly 1/2 of all women are expected to contract herpes in the U.S. alone by the year 2025 (Wetstein, 2002). Already nearly 1 in 5 people will have some form of herpes by the time they reach adolescence or early adulthood (Herpes, 2004).

In light of such dire statistics and information, it is important to examine the disease and its implications for the future. Researchers and scientists are working diligently to uncover new avenues for treatment of this incurable disease, and studies are underway for uncovering potential and promising vaccines to halt the spread of this increasingly common problem affecting millions.

There are many different forms of therapy that have been introduced in recent years to treat herpes. Among the more commonly used are episodic and suppressive therapies, meant to help patients with herpes lead as normal a life as possible with as few recurrences as possible. Patients who are diagnosed with herpes once faced huge stigma and esteem issues because of the nature of the illness. Though many people diagnosed with herpes still face anxiety and self-esteem issues, herpes is becoming more widely understood and accepted, in part due to the large numbers of people in the population suffering from the disease.

The report below will begin with a general overview of herpes, followed by a listing of the types of herpes, treatment options and lifestyle coping options available to patients diagnosed with the disease.

General Overview

Herpes is a virus called herpes simplex virus or HSV for short (ASHA, 2001). The virus is a member of a family of viruses that include several different categories, namely: Epstein-Barr, Varicella Zoster, HSV-1 and HSV-2 (ASHA, 2001). The two primary types of herpes simplex are HSV-1 which usually affects the oral area and HSV-2 which typically affects the genitals (ASHA, 2001). Herpes is one of the most easily contracted viral illnesses known to man, perhaps as common as the cold. Most people are exposed to herpes at some point during their life, often when they are children. It is not uncommon for parents to spread the virus to their children through kissing, shared use of utensils or day-to-day contact.

HSV-1 or oral herpes is very common; in fact studies suggests that as many as 80% of adult people have oral herpes (ASHA, 2001). The virus is primarily spread through person to person contact, and most people acquire it when children. 90% of people that carry the virus are unaware that they have it (ASHA, 2001).

Symptoms of all forms of herpes may appear within a few days or weeks, months and even years after exposure to the virus; some people have a severe first initial outbreak whereas others generally have mild symptoms that are easily mistaken for mild skin irritation, thus the disease may go unnoticed (ASHA, 2001). This varies largely from person to person. Some people will be exposed to the herpes virus but never experience any active symptoms. Part of this is relative to a persons overall lifestyle, immune system responses and health and well being.

HSV-1

HSV-1 or oral herpes is one of the most common forms of herpes simplex, affecting up to 80% of the population (Mayo, 2004). HSV-1 is commonly referred to as oral herpes, fever blisters or cold sores. They are highly contagious. It is also one of the most dreaded forms of herpes, because the symptoms affect a persons face, which is highly visible to the public.

Signs and symptoms of HSV-1 include small, fluid filled red and painful blisters on an area of the skin, usually on the lips, mouth, chin and nasal region (Mayo, 2004). Pain or tingling often accompanies formation of the prodrome, which is the stage of viral outbreak that immediately precedes the outburst of blisters (Mayo, 2004). Patients can generally tell when an outbreak is about to happen based on the tingling sensation experienced around the affected region. Outbreaks usually occur in the same location time and time again, though it is possible for the virus to spread to other areas of the body through personal contact.

Generally an outbreak of HSV-1 lasts anywhere from seven to 10 days, though there are anti-viral medications available that may now limit the duration of active symptoms and speed recovery rate (Mayo, 2004). Symptoms may not actually surface for as much as 20 days after exposure to the virus (Mayo,...

The virus is usually spread from person to person via shared utensils, food, towels and other common items (Mayo, 2004).
Prevention involves avoiding skin to skin contact with an individual while they are having an active outbreak of the disease, or when moist secretions are emanating from blisters (Mayo, 2004). Hand washing may also help spread the virus.

There are certain things that may trigger an active outbreak, which include high levels of stress and over exposure to bright sunlight (Mayo, 2004).

HSV-2

Among the more common types of herpes is genital herpes. Genital herpes is caused by HSV type 2, which usually causes sores on the genitals (NIH, 2003). HSV1 can result in sores in or around the vaginal area, on the penis and around the anus and buttocks (NIH, 2003). Transmission usually results from sexual contact. HSV-2 may also affect the oral surfaces of the body, just as HSV-1 may sometimes affect the genital regions, thus it is important that a person with an active outbreak take extreme care not to spread the disease when experiencing active outbreaks.

There is no cure for HSV-2 just as there is no cure for other forms of herpes; it usually resides in the nerve cells of a hosts body for their entire life, and may produce symptoms at any time, though symptoms generally subside over time (NIH, 2003).

The U.S. Center for Disease Control and Prevention have reported that as many as 45 million people in the United States are infected with HSV-2, which translates into 1 in 5 people (NIH, 2003). HSV-2 is rapidly becoming as common as other forms of the herpes virus.

Transmission is most common when an individual is having an active outbreak, meaning the HSV-2 virus is active, and lesions or sores are openly visible (NIH, 2003). When lesions are visible they shed viruses which can infect another person via skin to skin contact (NIH, 2003). The most common symptoms include itching, burning, pain, sores or lesion, discharge and even a feeling or pressure in the abdomen (NIH, 2003).

Generally the first outbreak is the most severe, and subsequent outbreaks are more and more mild (NIH, 2003). Some people do not experience recurrences, though the virus still remains alive in their nerve cells over the years.

Shingles - Varicella Zoster

Shingles is another form of the herpes virus, usually resulting from a previous infection with the chicken pox (NIH, June, 2003). It is estimated that more than 2 of every 10 people will develop shingles in their lifetime, and more than 500,000 people per year come down with the virus (NIH, June, 2003). It is caused by the same virus that results inc chicken pox (NIA, 2004).

The virus is more common in people over the age of 50 and those with weakened immune systems (NIH, June, 2003). Symptoms generally include rash or blisters on the skin that may be painful (NIH, June, 2003). Other common symptoms include burning, tingling, numbness of skin, chills, fever, headache, sensitive skin and fatigue (NIA, 2004). Generally the disease follows a pattern, where first a burning or tingling sensation is experienced, followed by a red rash that covers the body, face or neck, which then turns into fluid filled blisters (NIA, 2004). These blisters eventually dry up and crust over during a period of a few days, though the rash may last for up to 5 weeks (NIA, 2004).

Anyone who has been exposed to the varicella virus at some point in their life is at risk for contracting an active outbreak of shingles later in life, though generally the disease lies dormant until later in life when the immune system is compromised (NIA, 2004).

It is usually treated with anti-viral medications and pain medications (NIA, 2004). Most people with an outbreak of shingles can minimize their chances of recurrence by seeking prompt medical attention. It is recommended that a patient visit a physician within three days of an active outbreak, in order to assess treatment options and minimize the severity of the outbreak.

Epstein Barr

Epstein-Barr virus or EBV is also a member of the herpes family of viruses and is also very common, affecting as many as 95% of adults at one time or another during their lives (CDC, 2002). Children are commonly infected with the virus though they may not demonstrate any symptoms other than a brief illness that includes a fever and sore throat (CDC, 2002).

The primary symptoms of EBV…