Herpes Simplex Virus type 1 & 2

Herpes Simplex Virus type 1 & 2

Herpes Simplex Virus type 1 & 2

By: Taylor Loftus

Whenever someone hears the word herpes they automatically start freaking out and think the world is going to end, but did you know that 3.7 billion people from ages 0-50 or 67% of the population is living with herpes simplex virus 1 (HSV-1), per the World Health Organization (WHO). Then you might ask “What about HSV-2?”. Well, WHO estimates that 417 million people ages 15-49 are infected with herpes simplex virus 2 (HSV-2).

Then the next question is “How do you know if you have this virus?”. The important thing to remember is that everyone is different and although one person may have signs and symptoms another person may be asymptomatic (not have any signs of the virus), and that person can still spread the virus to sexual partners and not know they are. How a person might recognize the signs of herpes simplex is blisters or sores on the mouth or genital area, painful urination, and itching. Painful urination is mainly a symptom for genital herpes.  Also, keep in mind that just because you have these symptoms that doesn’t mean you automatically have herpes. A blood test done by a medical facility or lab, a swab taken of the sores (if you have them) and a physical exam and history done by a physician is the only way to get a proper herpes simplex virus diagnoses.

Testing

1. Blood testing (serology). There are blood tests available which have some usefulness but also have significant limitations. The body responds to infections in part by producing antibodies. The two relevant antibodies for discussion here are the IgG and the IgM types. After exposure to the Herpes Virus, the body produces the Herpes Simplex Virus IgM antibody within 7-10 days after exposure and the levels of this antibody drop after 2-3 weeks. Elevated levels of this antibody indicate a new or recurrent infection but does not localize the source. Also the IgM antibody does not discriminate between Type 1 and type 2 exposures. After 2-3 weeks, elevated levels of the Herpes Simplex IgG antibody can be detected and can stay elevated throughout life. It turns out that 60-70% of individuals are positive for Herpes Simplex Virus Type 1 IgG and many do not know it. Perhaps they shared a drink with someone when they were 3 years old or was kissed by someone on the cheek and inadvertently where exposed. It is important to know that no blood test is perfect and the proper way to diagnose Herpes infection is with a careful history, through examination, and possible laboratory testing. The lab tests have known false positives and false negatives.
2. Polymerase chain reaction or PCR is a way to amplify small quantities of the viral DNA. A small amount of the fluid is sent to the laboratory and very specific and unique sequences of the DNA are amplified. The down side to this test is that it can be expensive, not widely available and it requires live virus to make the diagnosis. The virus is usually most detectable early in the course of a primary (or new infection). Older lesions or recurrent infections can have less viral particles available.
3. Viral culture is a method of taking a sample of fluid from a lesion and growing the virus on a culture dish. It has low sensitivity meaning that it may not be able to make the diagnosis even if the sample really is positive.

Are there treatments available? As of right now there is no cure for this virus, however, there are some great treatments which can greatly suppress the virus. This can diminish the sores and help limit the outbreaks in frequency and severity. These medication may help decrease the risk of spreading the Herpes Virus. These medications are Acyclovir, Famciclovir, and Valacyclovir and are available as oral medications.

The virus resides in the nerve cells and usually can come back in the same location each time. Some people may have outbreaks consistently or rarely. It all depends on the person and how their body responds to the virus. These outbreaks will get triggered by stress, menstrual cycles, fever or illness, sun exposure or sunburns.

It is important to seek treatment right away if you suspect a herpes outbreak because the treatments work better the sooner they are given: preferably, the same day. You can Google: “Urgent Care Near Me” to find the nearest walk-in clinic which you can go in without an appointment. Most urgent cares are open 7 days a week. You can be seen and examined the same day and prescribed a medication that may help (depending on your unique circumstances).

Another important question is “How do you prevent the spread of herpes simplex infections?”. Precautionary measures to avoid becoming infected are strongly encouraged. Oral herpes can be spread by sharing any drinks, utensils, cups, and lip balm with anyone else. Also, it is recommended to not participate in kissing, or any other type or sexual encounter during that outbreak including oral sex. Genital herpes infected individuals should avoid any sexual encounter with another person during an outbreak. When you are not experiencing an outbreak, you should always use a condom and remember that even though you are using a condom as protection it is still possible to spread the virus to someone else from the uncovered skin that is touching during those encounters. The medications discussed above may also help decrease the risk of spread of the herpes virus.

If you have any more questions, feel free to call Surfside Urgent Care of Laguna Beach and speak to a provider.

Come in and get evaluated and tested to put your mind at ease.

_Refrances:

_{Kimberly A. Workowski, MD Gail A. Bolan, MD   “Sexually Transmitted Diseases Treatment Guidelines, 2015”  June 5, 2015 / 64(RR3);1-137}

_{https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6403a1.htm}

_{Hashido M, Kawana T. “Herpes simplex virus-specific IgM, IgA and IgG subclass antibody responses in primary and nonprimary genital herpes patients.” Microbiol Immunol. 1997;41(5):415-20.}



_{Morrow, R. and Friedrich, D. “Performance of a novel test for IgM and IgG antibodies in subjects with culture-documented genital herpes simplex virus-1 or -2 infection” Clin Microbiol Infect 2006; 12: 463–469}



_{Page J, Taylor J, Tideman RL, Seifert C, Marks C, Cunningham A, Mindel A. “Is HSV serology useful for the management of first episode genital herpes?” Sex Transm Infect. 2003 Aug;79(4):276-9.}