Herpes is a chronic long-life sexually transmitted infection caused by a virus (herpes simplex), that affects 15-20% of people aged 14 to 49. After the outbreak, the infection becomes dormant and alternates between symptomatic (recurrences) and silent phases.
Symptoms, like sores, can occur in the anogenital area or the lips and the oral cavity, depending on sexual intercourse.
The skin swab test is useful for diagnosis. We test the serum antibodies to know if the non-symptomatic patient has already been infected.
It does not exist a definitive cure. It means that there is no treatment to eradicate the virus. Even if herpes goes away on its own without medication, outbreak and recurrences can be treated with local creams or tablets (acyclovir) to minimize the symptoms and to speed up the recovery. In highly recurrent disease we prescribe long term treatments.
There are two species of herpes virus: genitalis (HSV-2) and labialis (HSV-1). Both can spread during vaginal, anal, or oral sex with someone who has even mild symptomatic disease. The transmission occurs through contact with a herpes sore, saliva, genital secretions, skin, or oral mucosa of the affected partner.
Where the virus enters the body, it produces the typical skin abnormality (sores) in 1-4 weeks (incubation period). After complete healing, the infection becomes silent, and the virus hides inside the nerves supplying the skin. Periodically the virus unhides migrating through the nerves to the skin and producing the recurrence. Many people might have mild or unrecognized infections but shed virus intermittently in the anogenital area. As a result, people unaware that they have herpes can spread the disease.
The belief that people can get infected from public toilet seats, bedding, or swimming pools, or from touching objects such as silverware, soap, or towels, is unlikely.
Mostly, the herpes infection is silent or infected people may have very mild symptoms. Patients may not notice mild symptoms, or they may mistake them for another minor skin condition. As a consequence, most people who have herpes do not know it.
General symptoms like fever, body aches, or swollen glands, and the typical skin signs in the affected area (where the virus enters the body), are specific to the first outbreak after the infection.
Recurrences are usually multiple blisters on or around the genitals, anal area, or mouth. The blisters break leaving painful sores that may take 1 to 4 weeks to heal.
People experiencing an initial outbreak of herpes can have recurrences. Repeat outbreaks are usually less severe than the first outbreak.
We can do the swab test to demonstrate an HSV infection when there are typical skin signs and symptoms. In atypical cases, it helps us to differentiate this infection from other skin infections with similar symptoms. The swab test does not detect the virus while the disease is silent. To know if the patient has already infected, we can test the antibodies in the blood.
It does not exist a definitive cure. It means that there is no treatment to eradicate the virus. Outbreak and recurrences can be treated with local creams or tablets (acyclovir) to minimize the symptoms and to speed up the recovery. One of these anti-herpes medications can be taken daily and makes it less likely the spreading infection during sexual intercourse. Similar chronic medications may help people with frequent recurrences.