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Genital
Herpes
Genital herpes is a sexually transmitted
disease (STD) that produces blisters and skin ulcers in the
genital area. It can be caused by either one of two types of
herpes simplex virus, HSV-1 or HSV-2. HSV-2 is the more common
culprit. HSV spreads from person to person through kissing and
skin-to-skin contact, as well as through vaginal, oral or anal
intercourse. An infected person can transmit the virus during
times when skin blisters or ulcers are visible, but he or she
also can spread the virus when there are no symptoms at all.
The virus also can be transmitted by people who are unaware
that they are infected.
In a pregnant
woman with HSV infection (usually HSV-2), the virus can pass
to the baby during delivery, causing infections of the newborn's
skin, mouth, lungs or eyes. If the herpes virus spreads through
the baby's bloodstream, serious infections of the brain and
other vital organs also can occur.
According
to government health experts, approximately 45 million people
in the United States older than age 12 are infected with HSV-2.
Genital herpes, with or without symptoms, currently affects
approximately one in every four females and one in every five
males in the total population of U.S. adults and adolescents
between ages 15 and 45. Within the past two decades, the number
of genital herpes infections has increased significantly among
Americans, with the most dramatic increases seen in adolescents
and young adults.
Symptoms
Most people with an HSV-2 infection have no symptoms.
When symptoms appear, they are usually mild and can include
itching, burning, soreness and small blisters in the genital
area; small ulcers (skin sores) when the blisters break; local
pain if urine contacts the genital ulcers; enlarged and/or
painful lymph nodes (swollen glands) in the groin; headache,
fever and a generally sick feeling. In some people with genital
herpes, cold sores or fever blisters also can erupt around
the mouth. In general, symptoms of genital herpes appear approximately
one week after being exposed to someone with herpes infection.
The first episode of herpes symptoms is usually the worst.
About 40 percent of infected people never have a second attack.
Others, however, have four to five recurrences per year. In
people who have recurrent herpes episodes, symptoms generally
are most common after sexual intercourse, after sunbathing,
and during times of physical or emotional stress.
In newborns who are infected with herpes during delivery,
symptoms usually appear nine to 11 days after birth and can
include skin blisters, red eyes and an abnormal eye discharge.
If the virus spreads through the baby's bloodstream to the
brain, there can be lethargy, irritability and seizures. If
the virus spreads to the baby's lungs, the baby may have difficulty
breathing and may need to be placed on a ventilator for breathing
assistance.
Diagnosis
Your
doctor can diagnose genital herpes based on your sexual
history, your symptoms and the results of your physical
examination. Your doctor may want to confirm the diagnosis
by scraping the affected skin area for laboratory testing.
Because people who have one type of STD are at risk for
others, your doctor may wish to perform tests for other
STDs, such as syphilis, gonorrhea, chlamydia, chancroid
and human immunodeficiency virus (HIV).
Expected Duration
The
HSV infection that causes genital herpes is a lifelong
illness whose symptoms tend to recur. The pattern of recurrence
is different for every person.
Prevention
To
help prevent the spread of genital herpes, people who
have the illness should abstain from sexual activity when
they have symptoms of a herpes recurrence. They also should
tell all sex partners about their herpes infection and
use condoms during sexual activity. Even without symptoms,
the virus still can be shed and transmitted.
Pregnant
women who have visible ulcers from genital herpes at the
time of delivery usually are encouraged to undergo Caesarean
section to prevent HSV from spreading to her newborn.
Because the decision for Caesarean section is based on
many factors, a pregnant woman with HSV infection should
discuss the subject with her physician as early as possible
in her pregnancy. If a pregnant woman in her third trimester
feels a recurrence of herpes coming on, she should call
her doctor right away.
People
with genital herpes are more likely to contract HIV infection
if they are exposed through sexual intercourse. If you
already have HIV, a simultaneous HSV-2 infection may make
you more likely to spread HIV to others in high-risk situations.
Treatment
Episodes
of genital herpes can be treated with oral anti-viral
medications, including acyclovir (Zovirax), famciclovir
(Famvir) and valacyclovir (Valtrex). These medications
do not cure the herpes infection. They can shorten the
duration of skin symptoms but most often are used to prevent
symptoms from recurring or make recurrences less severe.
When herpes infection spreads through the bloodstream
and causes widespread infection, it can be treated with
antiviral medication given intravenously (directly into
the veins).
When
To Call A Professional
Call
your doctor if you have blisters or sores in your genital
area, especially if you are pregnant or have frequent bouts
of symptoms.
Prognosis
Although
there currently is no cure for genital herpes, the frequency
of recurrences often decreases with time. Daily oral antiviral
medication also can decrease the number of recurrences by
at least 75 percent in people with frequent herpes episodes
(six or more recurrences per year).
Additional Information
American Social Health Association
P.O. Box 13827
100 Capitol Dr.
Research Triangle Park, NC 27709-3827
Phone: (919) 361-8400
Fax: (919) 361-8425
http://www.ashastd.org/
Last
updated November 05, 2002
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What
is Shingles?
Shingles is an infection caused by the varicella-zoster virus,
which is the virus that causes chickenpox. Shingles occurs in
people who have had chickenpox and represents a reactivation
of the dormant varicella-zoster virus. The disease generally
affects the elderly, although it occasionally occurs in younger
and/or immunodeficient individuals. The first sign is usually
a tingling feeling, itchiness, or stabbing pain on the skin.
After a few days, a rash appears as a band or patch of raised
dots on the side of the trunk or face. The rash develops into
small, fluid-filled blisters which begin to dry out and crust
over within several days. When the rash is at its peak, symptoms
can range from mild itching to extreme and intense pain. Contact
with a person with shingles may cause chickenpox (but not shingles)
in someone who has never had chickenpox before.
Is there any treatment?
Treatment for shingles includes antiviral drugs, steroids, antidepressants,
anticonvulsants, and topical agents. The severity and duration
of an attack of shingles can be significantly reduced by immediate
treatment with the antiviral drugs acyclovir, valacyclovir or
famcyclovir. These drugs may also help stave off the painful
aftereffects of shingles known as postherpetic neuralgia.
What
is the prognosis?
Although shingles can be very painful and itchy, it is not generally
dangerous to healthy individuals and it usually resolves without
complications. The rash and pain usually go away within 3 to
5 weeks. Sometimes serious effects including partial facial
paralysis (usually temporary), ear damage, or encephalitis (inflammation
of the brain) may occur. Persons with shingles on the upper
half of the face should seek medical attention immediately as
the virus may cause serious damage to the eyes. Most people
who have shingles have only one bout with the disease in their
lifetime. However, individuals with impaired immune systems,
i.e., people with AIDS or cancer, may suffer repeated episodes.
What
research is being done?
The NINDS conducts and supports a program of research aimed
at developing new treatments for and preventing the painful
conditions of shingles.
Select this link to view a list of studies currently seeking
patients.
Organizations
Related
NINDS Publications and Information
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Shingles:
Hope Through Research
An informational booklet on shingles compiled by the National
Institute of Neurological Disorders and Stroke (NINDS). |
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Ramsay
Hunt Syndrome Type I
Ramsay Hunt Syndrome Type I (Herpes Zoster Oticus) information
page compiled by the National Institute of Neurological
Disorders and Stroke (NINDS). |
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Pain:
Hope Through Research
Information booklet on pain compiled by the National Institute
of Neurological Disorders and Stroke (NINDS). |
NINDS health-related material is provided for information purposes
only and does not necessarily represent endorsement by or an official
position of the National Institute of Neurological Disorders and
Stroke or any other Federal agency. Advice on the treatment or
care of an individual patient should be obtained through consultation
with a physician who has examined that patient or is familiar
with that patient's medical history.
All
NINDS-prepared information is in the public domain and may be
freely copied. Credit to the NINDS or the NIH is appreciated.
Provided
by:
The National Institute of Neurological Disorders and Stroke
National Institutes of Health
Bethesda, MD 20892
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This
health article is made available by
Dr. Eliot Y Ghatan MD a Dermatologist. AESTHETIC SURGERY &
DERMATOLOGY office at 1226 Ocean Parkway, Brooklyn, NY 11230.
Dr. Ghatan is easy reachable from Breezy Point, Bronx, Brooklyn,
Connecticut, Far Rockaway, Howard Beach, Long Island, Manhattan,
New Jersey, Queens, Ridgewood, Rockaway Park, and Staten Island.
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