Herpes is an infectious disease of the skin and mucous membrane. It is part of the most common infections worldwide, affecting people of all age groups regardless of race or gender. There are a number of herpes viruses which when activated cause unsightly blisters, usually accompanied by severe pain. Though the group of herpes viruses is relatively large, it includes eight viruses that cause completely different diseases; the description of some of which will soon follow. The cause is herpes simplex which exists in two forms: HSV I and HSV II. HSV I, or herpes simplex type 1, is mostly responsible for cold sores. The second type of virus causes infection in the genital and anal area, known as genital herpes or genital warts. Included in the group of human herpetic viruses is the Varicella zoster virus responsible for shingles.
- Herpes simplex virus type 1 (HSV I) is the cause of cold sores but can occasionally affect other areas.
- Herpes simplex virus type 2 (HSV II) is the cause of genital herpes and as with HSV I, can affect other parts of the body. The virus that causes cold sores is very similar to the cause of genital herpes.
- Varicella zoster virus (VZV) is characterized by its 2 stage infection. The first infection causes chickenpox and the second causes shingles.
- Epstein-Barr virus (EBV) is omnipresent and a large part of the infection occurs symptomless during childhood. Diseases associated with EBV mainly include mononucleosis (mono) and cancers such as Burkitt's lymphoma, nasopharyngeal carcinoma (cancer of the nasopharynx) or Hodgkin's lymphoma (cancer of the lymphatic system). The infection usually affects individuals with impaired immune systems and those experiencing chronic fatigue. According to some theories, EBV causes, or rather accompanies, chronic fatigue syndrome.
- Cytomegalovirus (CMV) causes mononucleosis or mono. Endangered are patients with supressed immune systems (lowered immune response due to immunosuppressive medication) including AIDS and transplant patients. This may lead to retinitis, colitis, encephalitis, pneumonia, esophagitis or cholecystis.
- Roseolovirus is the cause of roseola, or sixth disease, which affects infants and toddlers. It is manifested by a characteristic rash and a fever.
- KSH virus typically affects patients with a severely compromised immune system (AIDS). It causes skin cancer called Kaposi's sarcoma.
Transmission of Herpes
The herpes virus enters the human body through broken skin or mucous membrane. Direct contact with an infected area is the main form of transmission, as well as transmission through bodily fluids such as saliva, vaginal secretion, ejaculate, tears or infected objects. For example with infectious mono, also called the kissing disease, transmission does not occur through direct contact with the herpes virus, rather it is transferred through saliva. Danger arises when the virus is transmitted through the placenta from a mother to the fetus as children infected by herpes can experience very serious complication. The herpes virus in the human population is very widespread, it is estimated that about 90% of the population is affected. This is why infection from HSV I, which causes cold sores, is typically transmitted from a parent or family member to a child within the first years of life. Genital herpes is linked to sexual activity which is why its transmission typically occurs in adolescence.
The Course of Herpes Infections
The development of herpes or other diseases is dependent on the current state of the patient, mainly on the state of his or her immune system, level of stress or whether he or she is affected by another illness. The first contact with the virus usually occurs without symptoms. After contact with the virus, even in the case where there were no manifestations, antibodies begin to form. The main task of antibodies is to identify and defuse foreign objects (bacteria and viruses) in the body. Unfortunately they are not able to completely remove the virus from the infected organism. This is why an individual already affected by the herpes virus once, becomes a carrier for the rest of his or her life. At the site of primary infection, the virus travels along the nerve fibers to the nerve nodules on the spine or in the brain where the virus lives for the rest of the individual's life. Given the right conditions, such as weakening of the immune system (due to stress, injury, excess sun exposure, the flu or other inflammation in the body) the virus travels along the nerves to the adjacent area of skin or mucous membrane and painful blisters develop.
Symptoms of Herpes
Common cold sores or genital herpes is a blistering disease which appears on the skin or mucous membrane. It takes the form of tiny fluid-filled sores which burst and form scabs. After the incubation period (2-6 days) and after exposure to above mentioned factors, the affected areas become tight, itch or burn and are sometimes painful. Subsequently, the affected area reddens and swells. Small tight blisters about the size of a pinhead develop on the affected skin or mucous membrane. Once they burst, tiny erosions appear or scabs form which fall off in a few days. The symptoms usually last 10-14 days. Herpes infections can also be dramatic, especially as the first infection can have more massive and extensive manifestations. The whole lip or oral cavity can be affected and this with more severe swelling and blistering accompanied by swollen lymph nodes. Sometimes even the whole body can be affected.