Friday, February 3, 2023

What Are Early Signs Of Herpes

Is It Safe To Breastfeed If I Have Genital Herpes

Herpes (oral & genital) – causes, symptoms, diagnosis, treatment, pathology

Yes as long as there isnt an open lesion on your chest or breast. If you have an active outbreak while breastfeeding, its possible to spread the infection to your nipples through touch. Careful hand-washing can prevent this spread. You shouldnt nurse from a breast that has herpes sores. You can pump breast milk until the sores heal. Dont give your baby expressed breast milk if the pump comes into contact with an open sore.

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Genital Herpes By Race/ethnicity

As with most infectious diseases, genital herpes is more prevalent among some racial/ethnic groups than others. This is especially true of Black people in the United States who are nearly 4 times as likely to have HSV-2 as White people.

The causes for this disparity are many, including poverty and limited access to health care and diagnosis. Institutional racism and healthcare discrimination can often discourage people from seeking the care they need, as well. Moreover, living in a community where STI rates are already high increases the likelihood of infection.

Even more concerning is the fact that genital herpes increases the risk of HIV, in part because open sores provide HIV easier access into the body and the inflammatory response attracts the very immune cells that HIV targets for infection.

As a result of these intersecting risk factors, a 2013 study in the journal PLoS suggested that genital herpes in Black people increases their vulnerability to HIV three times more than in White people.

The herpes virus is spread by skin-to-skin contact with a person who has the herpes virus:

  • Most often, from herpes sores or blisters
  • Less often, from normal looking skin where the virusfirst entered the body
  • The herpes virus enters the body through the:
    • Lining of the mouth
    • Regular skin that has small cracks or cuts

People who dont know they have herpes can still spread the virus to others.

How Is Herpes Diagnosed

Your HCP can diagnose herpes by looking at the sores during a physical exam and by testing fluid taken from the sores to see if you have HSV-1 or HSV-2. There are also specific blood tests, which can be helpful in some patients to figure out which virus type caused the symptoms or to figure out if you have been infected by herpes. Testing for herpes may or may not be included when your health care provider tests for other sexually transmitted infections because the Centers for Disease Control and Prevention does not recommend routine screening.

If you think you have symptoms of herpes or have a partner with genital herpes, see your HCP right away and ask if you need testing and treatment. Its important to call your HCP right away, as you would want to start treatment within 72 hours of the symptoms starting.

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Risk For Genital Herpes

According to the US Centers for Disease Control and Prevention , about 1 in 6 Americans ages 14 to 49 years have genital herpes. While HSV-2 remains the main cause of genital herpes, HSV-1 has significantly increased as a cause, most likely because of oral-genital sex. Except for people in monogamous relationships with uninfected partners, everyone who is sexually active is at risk for genital herpes.

Risk factors for genital herpes include:

  • History of an STD
  • First sexual intercourse at an early age
  • High number of sexual partners
  • Low socioeconomic status

Women are more susceptible to HSV-2 infection because herpes is more easily transmitted from men to women than from women to men. About 1 in 5 women, compared to 1 in 9 men, have genital herpes. African-American women are at particularly high risk.

People with compromised immune systems, such as those who have HIV, are at very high risk for genital herpes. These people are also at risk for more severe complications from herpes. Drugs that suppress the immune system, and organ transplantation, can also weaken the immune system and increase the risk for contracting genital herpes.

What Is The Difference Between Genital Herpes And Genital Warts

Stages of Oral Herpes

Both genital herpes and genital warts are STIs, are spread through skin-to-skin contact, and are caused by a virus. But the viruses that cause genital herpes and genital warts are different:

  • Herpes simplex virus is the virus that causes genital herpes.
  • Human papillomavirus is the virus that causes genital warts.

There is no cure for either genital herpes or genital warts. But, different medicines can help manage the symptoms of herpes and treat the complications of HPV infections that can cause genital warts.

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Symptoms Of Recurrent Herpes Outbreaks

Herpes can remain inactive in the body between outbreaks. In fact, many people infected with genital herpes never experience any outbreaks even though they have the virus, causing them to be unaware that theyre infected.

After an initial outbreak, genital herpes can remain dormant in your body for several months at a time. This means you might not notice any negative effects from herpes for months after your initial outbreak.

Most of the time, people with genital HSV-1 experience one to two outbreaks per year, with HSV-2 causing more frequent outbreaks .

The good news is that recurrent herpes outbreaks usually arent as bad as the first herpes outbreak. Recurrent outbreaks are usually shorter and less severe than the first outbreak. Its also easier to treat recurrent outbreaks, since youre more likely to be prepared.

Recurrent outbreaks tend to produce the same genital herpes symptoms as initial outbreaks tingling skin on and around the genitals, followed by the development or herpes lesions. Just like in an initial outbreak, these lesions heal naturally over the course of days or weeks.

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Do Symptoms Differ Depending On Location

Youll most likely notice similar blisters and prodromal symptoms, no matter what type of the virus you have or where it shows up. The two different types of HSV .

The only major difference, of course, is where you experience symptoms:

  • If HSV affects your genitals, you might notice pain or burning during urination.
  • If HSV affects your mouth, you might have difficulty eating spicy or acidic foods while you have open sores.

Theres also a slight difference in where oral blisters appear, depending on whether theyre primary or recurrent. During the first episode, blisters may appear on your mouth and lips, but during later episodes, theyre more likely to

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Pain In The Genital Region And While Urinating

It is not uncommon to hear of pain as well as swelling in the genital region. For some people, this pain can be quite bad and hard to ignore. You could also find that passing urine becomes difficult and causes you additional pain.11 As the urine flows over the sores and touches them, it causes a burning sensation for some people.12

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Antiviral Creams And Tablets

Shingles (Herpes Zoster): Pathophysiology, Risk Factors, Phases of Infection, Symptoms, Treatment

Antiviral creams such as aciclovir or penciclovir may speed up the healing time of a recurrent cold sore infection if used correctly.

Cold sore creams are widely available over the counter from pharmacies without a prescription.

Theyre only effective if you apply them as soon as the first signs of a cold sore appear, when the herpes simplex virus is spreading and replicating. Using an antiviral cream after this initial period is unlikely to have much effect.

If you have frequently recurring bouts of cold sores, use antiviral medication as soon as you feel the tingling sensation that indicates a cold sore is about to develop. Youll need to apply the cream up to five times a day for four to five days.

Antiviral creams can only help to heal a current outbreak of cold sores. They dont get rid of the herpes simplex virus or prevent future outbreaks of cold sores occurring.

Antiviral tablets are generally more effective than creams at treating cold sores, but are usually only prescribed for more severe cases.

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Can Genital Herpes Come Back

Yes. Genital herpes symptoms can come and go, but the virus stays inside your body even after all signs of the infection have gone away. The virus becomes active from time to time, leading to an outbreak. Some people have outbreaks only once or twice. Other people may have four or five outbreaks within a year. Over time, the outbreaks usually happen less often and are less severe.

Experts do not know what causes the virus to become active. Some women say the virus comes back when they are sick, under stress, out in the sun, or during their period.

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How Is Genital Herpes Diagnosed

HSV nucleic acid amplification tests are the most sensitive and highly specific tests available for diagnosing herpes. However, in some settings viral culture is the only test available. The sensitivity of viral culture can be low, especially among people who have recurrent or healing lesions. Because viral shedding is intermittent, it is possible for someone to have a genital herpes infection even though it was not detected by NAAT or culture. 11

Type-specific virologic tests can be used for diagnosing genital herpes when a person has recurrent symptoms or lesion without a confirmatory NAAT, culture result, or has a partner with genital herpes. Both virologic tests and type-specific serologic tests should be available in clinical settings serving patients with, or at risk for, sexually transmitted infections. 11

Given performance limitations with commercially available type-specific serologic tests , a confirmatory test with a second method should be performed before test interpretation. If confirmatory tests are unavailable, patients should be counseled about the limitations of available testing before serologic testing. Healthcare providers should also be aware that false-positive results occur. In instances of suspected recent acquisition, serologic testing within 12 weeks after acquisition may be associated with false negative test results. 11

Providers are strongly encouraged to look at CDCs STI Treatment Guidelines for further diagnostic considerations.

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Maternal And Neonatal Herpes

If a woman is infected with the HSV during pregnancy, it is possible for the virus to be passed on to the newborn baby, normally during delivery. Although this is rare, the resulting neonatal herpes can pose serious risks to newborns.

Signs that a pregnant woman is infected with the herpes simplex virus are the same as those in non-pregnant people. The risk of neonatal herpes is highest in cases where the pregnant woman develops herpes for the first time in the late stages of pregnancy, as the body is unlikely to have the necessary antibodies for combatting the virus. Women with HSV in a latent form, i.e. who have had the virus previously without recurrence, have a very low risk of passing the virus onto the newborn baby.

Good to know: When acute/florid HSV infection is present around the time of the expected date of delivery, a Cesarean birth will usually be recommended before the waters break to avoid the transmission of infection from mother to child.

Signs that a newborn baby has neonatal herpes include:

  • Blue skin and tongue

If there is a suspicion of neonatal herpes, a doctor or midwife should be contacted as a matter of urgency. Treatment will typically involve the use of antiviral drugs administered intravenously over several weeks.

How Is Herpes Simplex Treated

Herpes

Some people have few to no herpes outbreaks and choose not to have treatment. But many people prefer to use medications that shorten outbreaks and reduce symptoms.

During an outbreak, you may use an antiviral ointment or cream to help lessen your symptoms and help them go away faster, but it only works if you start it soon after you start an outbreak. Many people with HSV-2 take daily oral medications to keep outbreaks at bay.

Your provider may prescribe a topical medication or oral medication such as:

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When To See A Healthcare Provider

The early recognition of genital herpes, ideally during the prodromal stage, allows you to access treatments that can shorten the duration and severity of an outbreak.

Clearly, this can be difficult during your first outbreak, given that you probably wont be expecting it. But, over time, you will be better able to recognize the tell-tale signs and know when its time to act.

What Are The Symptoms Of Oral Herpes

The first oral contact with herpes often causes no symptoms, but it may cause sores in the mouth around the teeth and gums . Typically the infection shows up later as small blisters on the lips , a flare-up of an earlier infection. The flare-ups are more common during colds, fevers, and sun exposure.

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Treatment For Genital Herpes

Three drugs are approved to treat genital herpes:

These medications are antiviral drugs called nucleoside analogues. The drugs are used initially to treat a first attack of herpes, and then afterward to either treat recurrent outbreaks or reduce frequency of recurrences .

No drug can cure herpes simplex virus. The infection may recur after treatment has been stopped. Even during therapy, an infected person can still transmit the virus to another person. Drugs can, however, reduce the severity of symptoms, improve healing times, and prevent recurrences.

Antiviral drugs for genital herpes are generally given as pills that are taken by mouth. If people experience very severe disease or complications, they need to be hospitalized and receive an antiviral drug intravenously. Acyclovir is also available as an ointment, which can be used as an adjunct for treatment of initial genital herpes.

Can Herpes Be Prevented Or Avoided

Herpes Simplex Virus

The best way to prevent getting herpes is to not have sex with anyone who has the virus. It can be spread even when the person who has it isnt showing any symptoms. If your partner has herpes, there is no way of knowing for sure that you wont get it.

There is no time that is completely safe to have sex and not spread herpes. If you have herpes, you must tell your sex partner. You should avoid having sex if you have any sores. Herpes can spread from one person to another very easily when sores are present.

You should use condoms every time you have sex. They can help reduce the risk of spreading herpes. But its still possible to spread or get herpes if youre using a condom.

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What Does A Herpes Outbreak Feel Like

Symptoms usually appear within 2 weeks of exposure.

The first outbreak is usually the worst. At first, you might develop some flu-like symptoms. Then you might feel itchy or have an uncomfortable feeling around your genitals or mouth before the lesions appear.

Future outbreaks are likely to be milder and resolve faster.

You may have heard that herpes is only contagious during an outbreak. However, it can be transmitted even though there are no visible signs. You can have herpes and not know it.

For those reasons, its important to try to talk with your sexual partners before assuming or blaming.

It can be a challenging situation to cope with. Learning you have herpes can stir a variety of emotions. Its normal to have mixed feelings and wonder what to expect.

Its important to make an appointment with your healthcare provider as quickly as possible. If you have herpes, your healthcare provider can provide important information about managing your condition.

Make a list of questions before you go, which can help you get the most out of your visit. Let your healthcare provider know if youre having trouble understanding the information.

The more you know and understand about herpes, the better prepared youll be to manage your symptoms and condition. Your healthcare provider will help you create a treatment plan that works best for your medical needs.

Are There Treatments And Medications For Oral Herpes

Treatment includes medication for fever and taking plenty of fluids.

  • A topical anesthetic such as viscous lidocaine may be prescribed to relieve pain associated with oral blisters and lesions.
  • Oral or IV medication does exist for HSV but is not recommended for people with a normal immune system. It is used only for people with weakened immune systems, infants younger than 6 weeks of age, or people with severe disease.
  • Some people may require hospital admission.
  • Those with severe local infection
  • People whose infection has spread to other organ systems
  • People with weakened immune systems
  • Dehydrated individuals who need IV hydration
  • Infants younger than 6 weeks of age

Mild uncomplicated eruptions of herpes simplex require no treatment. Severe infection may require treatment with an antiviral agent. Oral antiviral drugs include

To reduce the chance of acquiring HSV-1, avoid touching saliva, skin, or mucous membranes of people who have HSV-1 lesions. Prevention of genital HSV may be accomplished by latex condoms, but protection is never 100%. Spermicides do not protect against HSV. Some clinicians recommend using dental dams during oral sex, but like condoms, they are not 100% protective.

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What Happens In An Hsv Infection

Genital herpes virus is passed from one person to another through sexual contact. This happens even if the person with the virus doesn’t have symptoms or signs of infection.

Once the virus enters through the skin, it travels along nerve paths. It may become dormant in the nerves and remain there indefinitely.

From time to time, the virus may become active. When that happens, the virus travels back along the nerve path to the surface of the skin, where additional virus is shed.

At this point the virus may cause an outbreak of symptoms. Or it may remain undetected.

In either case, the active virus is easily passed from one partner to another through sexual contact. Even wearing a condom may not protect the uninfected partner. The virus can be present on skin that remains uncovered.

The number of recurrences or outbreaks a person can have may vary.

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