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    In this feature, we look at the latest scientific facts about the two types of herpes simplex virus, as well as social attitudes toward oral and genital herpes. When many people first tell someone they have genital herpes, they start by top 10 dating sites with herpes the infection to oral herpes, or cold sores.

    How apt is the comparison? In spite of scientific facts, the social stigma and emotional attitudes surrounding genital herpes can make it hard to compare it objectively with an oral infection that most people casually accept.

    Following the unspoken assumptions of our society, many people still believe there is a "good" herpes virus-HSV- 1, the usual cause of cold sores-and a "bad" herpes virus-HSV-2, the usual cause of genital herpes. In this feature, we take a look at HSV- 1 and 2 to see how alike and different the two viral types really are. We asked leading researchers how the two compare in terms of severity, recurrences, and transmission rates.

    We asked how often each occurs outside its usual site of preference, and how each behaves in the genital area. We questioned how much immunity having one type orally or genitally provides against getting the second type. In addition, we looked at the way our society views oral and genital herpes. What's behind the very different images the two types carry? And what can we do about it? In an interview, counselors at the National Herpes Hotline suggest ways to help replace judgmental social assumptions with a healthy attitude.

    Both types infect the body's mucosal surfaces, usually the mouth or genitals, and then establish latency in the nervous system. For both types, at least two-thirds of infected people have no symptoms, or symptoms too mild to notice. However, both types can recur and spread even when no symptoms are present. The primary difference between the two viral types is in where they typically establish latency in the body- their "site of preference.

    From there, it tends to recur on the lower lip or face. HSV-2 usually sets up residence in the sacral ganglion at the base of the spine.

    From there, it recurs in the genital area. Unfortunately, many people aren't aware of this, which contributes both to the spread of type 1 and to the misperception that the two types are fundamentally different. HSV-1 is usually mild, especially when it infects the lips, face, or genitals. However, in some cases type 1 can recur spontaneously in the eye, causing ocular herpes, a potentially serious infection which can lead to blindness. In very rare cases HSV- 1 can spread spontaneously to the brain, causing herpes encephalitis, a dangerous infection that can lead to death.

    HSV-1 is also the usual cause of herpes whitlow, an infection on the finger, and "wrestler's herpes," herpes gladiatorum a herpes infection on the chest or face. The range and potential severity of HSV-1 infections lead some experts to view the virus as more risky than usually perceived.

    Like HSV-1, type 2 is usually mild-so mild that two- thirds of infected people don't even know they have it. Type 2 rarely causes complications or spreads to other parts of the body. It is the most common cause of neonatal herpes, a rare but dangerous infection in newborns; however, type 1 causes up to one-third of neonatal infections. The two types do behave somewhat differently depending on whether they are residing in their site of preference-the mouth and face for HSV-1, and the genital area for HSV But both types are top 10 dating sites with herpes common, and under most circumstances neither is a major health threat.

    That's one reason medical professionals tend to dismiss HSV -2 despite the emotional trauma a diagnosis can cause for a patient. While HSV can be a frustrating and painful condition for some people, in general the virus is less a medical problem than a social problem. For most of us, genital herpes is no more dangerous than a cold sore. Just how much of a physical problem HSV poses for a person depends largely on three factors.

    Top 10 dating sites with herpes first is how well the person's immune system is able to control the infection. Differences in immune response may be the main reason that some people are bothered by frequent cold sores or genital herpes outbreaks while others are not. It's also the reason that both HSV-1 and 2 can pose serious challenges for infants, who have a limited immune response; and for people with compromised immune systems, including people with cancer, AIDS, severe burns, and people taking immunosuppressant medications.

    The second factor affecting outbreaks is how long a person has had the infection. Over time, recurrences of both HSV- 1 and 2 tend to decrease, for reasons that aren't entirely clear.

    In the case of oral HSV-1, many of the approximately million Americans who are infected acquired the virus when they were children. On the other hand, almost all of the approximately 40 million Americans infected with HSV-2 acquired the virus as teenagers or adults.

    In the first year, those who have recurring outbreaks experience an average of four to six episodes. Over time, as with oral infections, the number of outbreaks usually drops off.

    A third factor influencing the frequency of HSV -1 and 2 outbreaks is whether the virus is established in its site of preference. While HSV can infect both genital and oral areas, both types cause milder infections when they are away from "home" territory.

    Outside their site of preference, both type 1 and 2 lose most of their punch. For example, most people infected with HSV-1 in the genital area have few, if any, outbreaks after the initial episode, far fewer than is typical with either oral HSV-1 or genital HSV According to a study by Wald et al.

    New England Journal of Medicine,among women with genital herpes, the average number of recurrences per year for those with genital HSV-1 was zero. Other studies have shown an average of about one outbreak per year Benedetti, Annals of Internal Medicine, Similarly, HSV-2 infection in theoral area-outside its site of preference-very rarely causes problems. First of all, oral, HSV-2 infections are rare, for reasons discussed below. But even when an infection occurs, recurrent outbreaks are uncommon.

    In one study Lafferty et al. A possible fourth factor affecting recurrence rate is viral type. As a number of readers have attested over the years, many people with genital herpes are at least as concerned about transmission-the likelihood of spreading the virus to a partner-as about their own health.

    On the other hand, few people with oral herpes, share this concern. Is this because one type is more contagious than the other? The short answer is no. Both viral types are easily transmitted to their site of preference, and can also be spread to other sites. Both are most contagious during active outbreaks, but are often spread through viral shedding when there are no recognizable symptoms. Both of these figures reflect shedding as detected by viral culture. From here, however, the question of transmissibility gets more complicated.

    Acquisition of one type is more difficult-though certainly possible-if you already have the other type. This is because either type, contracted orally or genitally, causes the body to produce antibodies, some of which are active against both HSV-1 and 2. This acquired immune response gives some limited protection if the body encounters a second type. When a person with a prior HSV infection does contract the second type, the first episode tends to be less severe than when no prior antibodies are present.

    On a practical level, this means oral HSV-1 is often the most easily acquired herpes infection. Usually the first herpes simplex virus that people encounter, oral HSV-1, is typically spread simply by the kind of social kiss that a relative gives a child.

    Because children have no prior infection with any HSV type, they have no immune defense against the virus. By comparison, almost all HSV-2 is encountered after childhood, when people become sexually active. Those who have a prior infection with HSV-1 have an acquired immune response that lowers - though certainly doesn't eliminate-the risk of acquiring HSV In the absence of prior oral infection, however, HSV-1 spreads easily to the genital area, usually through oral sex.

    Finally, the question of immunity and HSV types is complicated by an additional issue. Some studies suggest that the ganglia themselves may acquire some immunity to HSV after they are exposed to one viral type.

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    In the laboratory, infection of ganglia with more than one virus is difficult, suggesting that it may be more difficult to acquire a second HSV type in a location where you already have HSV. What does all this mean on a practical level?

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    Let's look at some examples to find out. If you have unprotected sex, there is a small but real risk that you will get HSV-2, resulting in more outbreaks and more shedding. Will you get HSV- 2 in the mouth? Given the widespread practice of oral sex some three-quarters of all adults practice it, according to The Social Organization of Sexuality, and the prevalence of genital HSV-2 infection, you might expect oral HSV-2 to be relatively common.

    One reason is that most adults are already infected with HSV-1 orally, which provides some immunity against infection with HSV 2. Another reason is that oral HSV-2 rarely reactivates, so even if an infection does exist, no one knows. So far we've been talking about transmission of HSV-1 or 2 from its site of preference. What about transmission from another site?

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    Say you acquire genital HSV-1 through oral sex. Can you spread the virus to a partner through genital sex? The answer is yes, but probably not as easily as it was spread through oral sex. The main reason is that the virus reactivates and sheds less often outside its site of preference. While HSV- 1 can be spread from genitals to genitals, "we think it is spread more easily through oral sex because HSV-1 reactivates more frequently in the oral area," says Wald.

    However, she warns, "transmission of genital HSV-1 during asymptomatic shedding has been documented. Why don't we kiss through dental dams? But the unspoken attitudes of our society send a different message. That's just the problem, social attitudes whisper. Below the waist is bad. But it's also that good and bad is how our culture views sex and our bodies.

    From a social point of view, the problem is not the disease; it's how you got it. Whether we like it or not, the social prejudice against genital herpes, no matter which virus causes it, is a reality.
    Although herpes is a common condition it is not always the culprit. There are many other conditions that can appear similar at a glance and even ordinary nuisances, such as pimples, jock itch and ingrown hairs can be mistaken for herpes.

    If any irritation looks suspicious it is recommended that you visit a Doctor, if possible, make the visit while you still have active symptoms. A herpes specific test is often required to find out the real cause of the infection.

    OK, so you have what you think could be herpes but are top 10 dating sites with herpes To help figure out if your symptoms may be caused by the herpes virus there are some simple questions that you can begin with. Just remember, these points are merely a guide! The herpes virus is only active on the skin for a short period of time before it retreats back inside the body, at which point the skin typically heals and returns to normal.

    Depending on the individual, the symptoms of a genital herpes infection can last as long as six weeks, but The typical duration of a genital outbreak is 3 to 14 days The typical duration of a cold sore outbreak is 8 to 12 days.

    If the infection persists for longer periods of time without relief it is possible that the cause is something other than herpes.

    Does a blister or sore appear? A herpes breakout will sometimes but not always develop into a cut, sore, blister or lesion. Herpes symptoms are not always easy to identify because they can vary so much from person to person and do not always appear as expected.

    In fact, some people show little to no symptoms at all. Real herpes symptoms can be overlooked or passed off as being something less significant, such as a pimple, bump, skin rash or ingrown hair. If you have ANY doubt please contact your Doctor for appropriate testing. Commonly Confused Conditions It is very easy to confuse other conditions with herpes.

    Here are a few ailments commonly mistaken as being herpes. To view pictures of cold sores and genital herpes Canker sores Aphthous ulcers Canker sores are not a form of herpes, however, they are often confused and mistaken as herpes. Canker sores are not considered to be contagious. Cold sores and mouth herpes on the other hand are caused by the herpes simplex virus and can be very contagious. Canker sores usually occur inside the mouth, are gray in color and have a distinct edge.

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    The sores will usually heal within 10 to 14 days, without treatment. In comparison, oral herpes sores such as cold sores or fever blisters are caused by the Herpes simplex virus and are usually relatively easy to identify. Canker sores are ulcerations, especially of the lip or oral mucosa and can be caused by acute stress, trauma to the area in your mouth, allergies, or by a reaction to a particular bacteria.

    Bacterial or yeast infections Bacterial infections are sometimes confused with genital herpes, but do not usually produce blistering. If a yeast infection is present in a male, most often there are no symptoms.

    Some men have, however, reported a transient rash and burning of the penis after intercourse when condoms were not used. These possible symptoms are usually short lived. More information about Yeast Infections:
    Herpes simplex virus 2 is typically contracted through direct skin-to-skin contact with an infected individual, but can also be contracted by exposure to infected saliva, semen, vaginal fluid, or the fluid from herpetic blisters.

    Even microscopic abrasions on mucous membranes are sufficient to allow viral entry.

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    HSV asymptomatic shedding occurs at some time in most individuals infected with herpes. Concurrent infection with HIV increases the frequency and duration of asymptomatic shedding.

    Herpes simplex is a double-stranded DNA virus. The appearance and distribution of sores in these individuals typically presents as multiple, round, superficial oral ulcers, accompanied by acute gingivitis. Prodromal symptoms that occur before the appearance of herpetic lesions help differentiate HSV symptoms from the similar symptoms of other disorders, such as allergic stomatitis. When lesions do not appear inside the mouth, primary orofacial herpes is sometimes mistaken for impetigoa bacterial infection.

    Common mouth ulcers aphthous ulcer also resemble intraoral herpes, but do not present a vesicular stage. Laboratory tests include culture of the virus, direct fluorescent antibody DFA studies to detect virus, skin biopsyand polymerase chain reaction to test for presence of viral DNA.

    Although these procedures produce highly sensitive and specific diagnoses, their high costs and time constraints discourage their regular use in clinical practice. The differential diagnosis includes hand, foot and mouth disease due to similar lesions on the skin. Prevention Barrier protection, such as a condomcan reduce the risk of herpes transmission. As with almost all sexually transmitted infections, women are more susceptible to acquiring genital HSV-2 than men.

    Condom use also reduces the transmission risk significantly. In many infections, the first symptom people will have of their own infections is the horizontal transmission to a sexual partner or the vertical transmission of neonatal herpes to a newborn at term.

    Since most asymptomatic individuals are unaware of their infection, they are considered at high risk for spreading HSV. Neither type of condom prevents contact with the scrotum, anus, buttocks, or upper top 10 dating sites with herpes, areas that may come in contact with ulcers or genital secretions during sexual activity.

    Protection against herpes simplex depends on the site of the ulcer; therefore, if ulcers appear on areas not covered by condoms, abstaining from sexual activity until the ulcers are fully healed is one way to limit risk of transmission. When one partner has a herpes simplex infection and the other does not, the use of antiviral medication, such as valaciclovirin conjunction with a condom, further decreases the chances of transmission to the uninfected partner.

    To prevent neonatal infections, seronegative women are recommended to avoid unprotected oral-genital contact with an HSVseropositive partner and conventional sex with a partner having a genital infection during the last trimester of pregnancy.

    Mothers infected with HSV are advised to avoid procedures that would cause trauma to the infant during birth e. The use of valaciclovir and famciclovir, while potentially improving compliance, have less-well-determined safety in pregnancy. Management No method eradicates herpes virus from the body, but antiviral medications can reduce the frequency, duration, and severity of outbreaks.

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    Analgesics such as ibuprofen and paracetamol acetaminophen can reduce pain and fever. Topical anesthetic treatments such as prilocainelidocainebenzocaineor tetracaine can also relieve itching and pain. Acyclovir was the first discovered and is now available in generic. The double-stranded DNA of the virus is incorporated into the cell physiology by infection of the nucleus of a nerve's cell body.

    HSV latency is static; no virus is produced; and is controlled by a number of viral genes, including latency-associated transcript. Prodromal symptoms include tingling paresthesiaitching, and pain where lumbosacral nerves innervate the skin.

    Prodrome may occur as long as several days or as short as a few hours before top 10 dating sites with herpes develop. Beginning antiviral treatment when prodrome is experienced can reduce the appearance and duration of lesions in some individuals.

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    During recurrence, fewer lesions are likely to develop and are less painful and heal faster within 5—10 days without antiviral treatment than those occurring during the primary infection. The causes of reactivation are uncertain, but several potential triggers have been documented.

    A study showed the protein VP16 plays a key role in reactivation of the dormant virus. Reactivation due to other infections is the likely source of the historic terms 'cold sore' and 'fever blister'. Other identified triggers include local injury to the face, lips, eyes, or mouth; trauma; surgery; radiotherapy ; and exposure to wind, ultraviolet lightor sunlight. Some individuals' outbreaks can be quite debilitating, with large, painful lesions persisting for several weeks, while others experience only minor itching or burning for a few days.

    Some evidence indicates genetics play a role in the frequency of cold sore outbreaks. An area of human chromosome 21 that includes six genes has been linked to frequent oral herpes outbreaks.

    An immunity to the virus is built over time. Most infected individuals experience fewer outbreaks and outbreak symptoms often become less severe. After several years, some people become perpetually asymptomatic and no longer experience outbreaks, though they may still be contagious to others. Immunocompromised individuals may experience longer, more frequent, and more severe episodes.

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    Antiviral medication has been proven to shorten the frequency and duration of outbreaks. In the case of a genital infection, sores can appear at the original site of infection or near the base of the spine, the buttocks, or the back of the thighs.

    HSVinfected individuals are at higher risk for acquiring HIV when practicing unprotected sex with HIV-positive persons, in particular during an outbreak with active lesions. As many as one in seven Canadians aged 14 to 59 may be infected with herpes simplex type 2 virus [80] and more than 90 per cent of them may be unaware of their status, a new study suggests. Emperor Tiberius is said to have banned kissing in Rome for a time due to so many people having cold sores.

    In the 16th-century Romeo and Julietblisters "o'er ladies' lips" are mentioned. In the 18th century, it was so common among prostitutes that it was called "a vocational disease of women". Herpes was not found to be a virus until the s. The original use was against normally fatal or debilitating illnesses such as adult encephalitis, [87] keratitis, [88] in immunocompromised transplant patients, [89] or disseminated herpes zoster.

    The usage expanded to include topical treatment of herpes simplex, [92] zoster, and varicella. Vidarabine was the first systemically administered antiviral medication with activity against HSV for which therapeutic efficacy outweighed toxicity for the management of life-threatening HSV disease. Intravenous vidarabine was licensed for use by the U. Food and Drug Administration in Other experimental antivirals of that period included: It was merely a cold sore in an unusual place until the s.

    As late asa study of "Psychological morbidity in a clinic for sexually transmitted disease" does not mention herpes simplex because at that time, no significant morbidity problem i. Most had hardly heard of genital herpes Feelings can include depressionfear of rejection, feelings of isolationfear of being found out, and self-destructive feelings.

    Much of the hysteria and stigma surrounding herpes stems from a media campaign beginning in the late s and peaking in the early s. Multiple articles were worded in fear-mongering and anxiety-provoking terminology, such as the now-ubiquitous "attacks", "outbreaks", "victims", and "sufferers".

    At one point, the term "herpetic" even entered the popular lexicon. The articles were published by Reader's Digest, U.

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    News, and Time magazine, among others. A made-for-TV movie was named Intimate Agony. The peak was when Time magazine had 'Herpes: The New Scarlet Letter' on the cover in Augustforever stigmatizing the word in the public mind. People with the herpes virus are often hesitant to divulge to other people, including friends and family, that they are infected.

    This is especially true of new or potential sexual partners whom they consider casual. One of the diseases that increased dramatically was genital herpes.

    The HRC was designed to meet top 10 dating sites with herpes growing need for education and awareness about the virus. The goal of these HELP groups was to provide a safe, confidential environment where participants can get accurate information and share experiences, fears, and feelings with others who are concerned about herpes. The charity started as a string of local group meetings before acquiring an office and a national spread.

    Herpes simplex research Research has gone into vaccines for both prevention and treatment of herpes infections. Unsuccessful clinical trials have been conducted for some glycoprotein subunit vaccines. As ofthe future pipeline includes several promising replication-incompetent vaccine proposals while two replication-competent live-attenuated HSV vaccine are undergoing human testing. A genomic study of the herpes simplex type 1 virus confirmed the human migration pattern theory known as the out-of-Africa hypothesis.

    Archived from the original on 31 December Retrieved 31 December Dental clinics of North America.

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