Relay-Version: version B 2.10 5/3/83; site utzoo.UUCP Posting-Version: version B 2.10.2 9/18/84; site gatech.UUCP Path: utzoo!watmath!clyde!burl!ulysses!mhuxr!ihnp4!crsp!pesnta!amd!gatech!spaf From: spaf@gatech.UUCP (Gene Spafford) Newsgroups: net.singles Subject: Herpes Q & A Message-ID: <11733@gatech.UUCP> Date: Wed, 23-Jan-85 00:57:18 EST Article-I.D.: gatech.11733 Posted: Wed Jan 23 00:57:18 1985 Date-Received: Thu, 24-Jan-85 07:13:05 EST Reply-To: spaf@gatech.UUCP (Gene Spafford) Organization: The Clouds Project, School of ICS, Georgia Tech Lines: 198 Well, the herpes issue arises here and no one has yet dived in and presented any (correct) information. So, let me delve into my file of counseling materials, and pull out some info. Those of you who wish to get more information may write to the following addresses for printed materials (from which I quote, below): Nat. Inst. of Allergy and Infectious Diseases (NIAID) National Institute of Health Bethesda, MD 20205 Center for Disease Control VD Control Division Atlanta, GA 30333 HELP American Social Health Association P.O. Box 100 Palo Alto, CA 94302 (send a self-addressed, stamped envelope to this one) If you have more immediate questions on herpes or other sexually transmitted diseases, or if you want information without having something mailed to you (i.e., anonymously), you can call the VD Hotline toll-free at (800) 227-8922. In California, the number is (800) 982-5883. This service is run by the American Social Health Association and the United Way. Now, on to some questions and answers: What is herpes? Herpes is the name given to a family of viruses. One such virus is cytomegalovirus, also known as CMV (I have no literature on this particular strain). Another form of herpes is varicella-zoster which is responsible for chicken pox and shingles (from which former President Richard Nixon is now suffering). Epstein-Barr is the herpes virus which causes mononucleosis. Of primary interest to readers of this group, I suppose, are the strains herpes simplex type I, and herpes simplex type II -- hereafter referred to as HSV-I and HSV-II. Both strains are responsible for genital and labial (lip) sores (cold sores). HSV-I HSV-II are so simlar, that it basically requires a DNA analysis to differentiate between them. Canker sores are not caused by herpes (in fact, no infectious agent has ever been cultured from canker sores -- also known as aphtlous ulcers). The majority (90%) of all oral herpes is caused by HSV-I, and the majority (85%) of genital herpes infections are caused by HSV-II, with the remaining percentages being caused by the reverse. Herpes simplex can also (rarely) cause encephalitis, and it can infect the eyes. How common is genital herpes? Although herpes is not a reportable disease in the US (primarily because there is no current treatment), the CDC estimates that at least 300,000 NEW cases occur each year, and that currently between 4 and 20 million Americans have the disease. Some tests indicate that as many as 80% of the population have been exposed to herpes-simplex and have antibodies for either HSV-I or HSV-II. It is further estimated that up to 35% of the population may have been explicitly exposed to genital herpes. What are the symptoms of herpes? I'll skip the description of cold sores -- most people have had them or know what they are. A person undergoing the initial outbreak of herpes may notice and itching, burning sensation during urination, or pain in the genital region. Women may notice an unusual vaginal discharge. Usually within a week, small painful blisters appear on the vagina, cervix, urethra or anal area (in women, obviously), or the penis or anal area on men. The sores eventually become crusty and heal, usually within 3 weeks on the initial outbreak, and often more quickly on subsequent outbreaks. Other symptoms, such as swelling, sore throat, and headache may also occur. Incubation time is usual 4 to 10 days, although it is possible to be exposed to herpes and not suffer an outbreak for an extended period of time (months or years). It is also possible to have herpes and not show any symptoms, or symptoms so mild as to go unnoticed. Later outbreaks are often much milder and last for shorter periods of time. These outbreaks are often signalled by itching or burning. Many individuals suffer only a few recurrences, while some significant percentage (I can't find the figure) appear to never suffer a further outbreak. Although exposure to herpes results in the production of antibodies, this does not prevent further infection or reinfection. In fact, people with active infection of herpes often have a very antibody level. How is herpes spread? Basically, you come in contact with live herpes virus. Intact skin is usually resistant to herpes, but cuts and burns weaken this. The mucous membranes are also quite sensitive to herpes infections. Infants and newborn are very susceptible to herpes infections, and mothers with an active infection may need to deliver by Caesarian to prevent infecting their child (with possible severe results). Herpes viruses might be spread by immediate contact with items, such as towels (or damp sheets!) which contain the virus, but such exposure is very unlikely to cause infection. Almost any sexual contact, including oral-genital sex can result in exposure. (Sexual contact is not required to spread the disease, however.) Use of condoms can help prevent contact with the virus (and other germs, etc) but cannot guarantee that no infection may occur through contamination of other areas. Furthermore, by having sex with someone with an active herpes eruption, it is possible to contaminate other areas by spreading the virus, or to infect them with another strain -- thus, someone with an active eruption of sores should probably refrain from sexual contact until the sores are completely healed. People with herpes who get live virus on their hands may accidentally transfer the virus to others, or to other parts of their bodies (such as the eyes) and should exercise extreme care during outbreaks. Active sores generally have a high concentration of the virus. Also, the areas where sores will occur are also highly contagious just prior to an occurance of herpes (this is known as viral shedding). Some individuals even have the virus present in their saliva when there are no active sores. Herpes virus resides in sensory nerve ganglia and travels down the nerves to the skin when reactivated. No known pattern has been found for triggering recurrences, although stress appears to be one cause. What treatments are available for herpes? There is currently no completely effective treatment for HSV, nor is there a vaccine. A cream containing the drug acyclovir appears to ease initial outbreaks, and may be of some use during secondary outbreaks. Acyclovir is also being tested for oral use. Other drugs with possible dangerous side-effects are available in cases of life-threatening encephilitis. AT THE PRESENT TIME, other than analgesics and possibly tranquilizers, there is no other effective treatment for herpes outbreaks other than waiting them out. How should I treat someone with herpes? Like anyone else. They are people too. Sexual contact need not be avoided or feared as long as care is taken, especially during outbreaks. Hugs and kisses need not be feared, unless you're afraid of them normally. Often, the emotional trauma is more devastating than the physical difficulties. Herpes should not be dreaded. In most cases, the symptoms are annoying and painful for a few weeks, but disappear and do not surface again. Many long-time herpes sufferers complain of colds more often than they do herpes. Also, don't be quick to accuse a SO of infidelity should they suddenly develop herpes for the first time. Herpes can lie dormant for years before appearing the first time. It is also possible that you have a symptomless case, and you just recently had an (unnoticed) outbreak which infected them. Outbreaks are traumatic and should not result in further stress from loved ones. What should I do if I suspect I have herpes? Someone who suspects they have herpes should consult a doctor. Other conditions may have symptoms similar to herpes. Obtaining acyclovir can also ease some of the physical pain. Pregnant women should definitely check with their doctor to protect their baby against possible contamination. Also, women with HSV infections, and/or having ever had Epstein-Barr, should have regular PAP smears done (a good idea anyhow) -- there appears to be a small but significant statistical correlation between herpes exposure and cervical malignancies, although this may just be a statistical artifact. If you or a loved one (or loved-one-to-be) have herpes, obtaining factual information and counseling may be helpful; contact the people at one of the addresses given at the beginning of the article. In case anyone wants the gruesome details -- no, I don't have herpes (that I know of). I had chicken pox, once. However, to my memory, I've never had anything indicating a case of HSV-I or HSV-II. I have been exposed to both, however, at various points in my travels. I've also served to counsel some of my friends who have contracted this disease. I think there has been far too much misinformation spread about herpes, with the current hysterical reaction to some defenseless children being an excellent example of same. I hope this information helps anyone needing some info. Anyone wishing to may send me mail for more information or just conversation, if they wish. -- Gene "7 months and counting" Spafford The Clouds Project, School of ICS, Georgia Tech, Atlanta GA 30332 CSNet: Spaf @ GATech ARPA: Spaf%GATech.CSNet @ CSNet-Relay.ARPA uucp: ...!{akgua,allegra,hplabs,ihnp4,linus,seismo,ulysses}!gatech!spaf