Oral herpes

Herpes is the medical name for a group of similar viruses. This group includes the varicella-zoster virus, which causes chicken pox; the Epstein-Barr virus, which causes infectious mononucleosis (mono); cytomegalovirus (CMV), which is responsible for infections that usually afflict newborns and people with defective immune systems; and the herpes simplex virus, which causes genital and oral infections. To most people, however, herpes is the common term for infections caused by the herpes simplex virus (HSV).

Description

There are two types of herpes simplex virus. In most cases, Type 1 (HSV-1) causes cold sores or fever blisters, and Type 2 (HSV-2) causes genital herpes. However, some genital herpes may be caused by HSV-1 virus, and some oral herpes may be caused by HSV-2. This cross infection can happen when sexual partners have oral-genital relations. Fever Blisters – Cold Sores Fever blisters or cold sores infections typically take the form of tiny, clear, fluid-filled blisters on the face.

They occur on mucous membranes and may also develop in wounds on the skin. Symptoms include blisters on the lip, under the nose, sometimes fever. A cold sore usually clears by itself in seven to twelve days, and rarely leads to medical complications. The cold sore is highly contagious and is easily transmitted in saliva or close sexual or social contact. There are two kinds of infections, primary and recurrent. Though most individuals contract the virus, only 10 percent or so will actually develop symptoms indicative of a primary, or first, infection. Some people may get a cold sore once in their life, others may get them once a year, while others may have them once every three weeks. The number of blisters varies, from one to a whole cluster.

Before the blisters erupt, the soon-to-be-infected skin may itch or become very sensitive. The natural course of the blisters is to break spontaneously or as a result of minor trauma, allowing the fluid contents to ooze. Eventually, scabs form and slough, leaving slightly red skin. Though the primary infection heals completely, rarely causing a scar, the virus that caused it remains in the body, migrating to nerve cells where it remains in a dormant phase. Many people will not experience another infection or recurrence. Others will be plagued with recurrences, either in the same location as the first infection or in a nearby location. Recurrent infections, which tend to be milder than primary infections, may be triggered by a variety of stresses including fever, exposure to the sun, and menstruation. However, for many individuals, the recurrences are unpredictable and have no recognizable precipitating cause. There are some serious complications of herpes simplex: Eye infections. The herpes virus may infect the eye and lead to a condition called herpes keratitis.

The inflammation results in the feeling that there is something in the eye, pain, sensitivity to light, and discharge. Drugs are available that prevent severe scarring of the cornea and in eliminating infection. Infections in babies. A pregnant woman who has genital herpes at the time of delivery may transmit the virus to her baby as it passes through the birth canal, touching the affected area. The baby can die or suffer severe damage, particularly mental retardation. Women who know that they have had genital herpes or think they might have it during their pregnancies should tell their physicians so preventive measures can be taken. A cesarean section is indicated for some patients. It is estimated that only half of the infants delivered through an infected vagina acquire the disease, but the ones that do are at risk for having a severe infection. The newborn can also be infected by exposure to the virus from non-genital lesions. If the mother or a person working in the nursery has active blisters on the lips or hands, the baby can become infected.

Family members and friends with active herpes simplex virus should not handle the newborn. Pregnant women should avoid sexual contact, especially in later pregnancy, with a partner with active genital herpes. The use of condoms can be suggested for those who will not abstain. There is no evidence to suggest that infection of an infant with herpes simplex virus (HSV Type 1) carries a different risk than infection with genital herpes. (HSV Type 2).

Symptoms

HSV infections take the form of blisters or lesions that generally occur periodically, often causing itching and pain.

Treatment

If fever blisters erupt, they should be kept clean and dry to prevent bacterial infections. A soft, bland diet is recommended to avoid irritating the sores and surrounding sensitive areas. Care should be taken to refrain from touching the sores and spreading the virus to new sites, such as the eyes and genitals. To prevent infecting others, kissing should be avoided, as well as touching the sores and then touching others. Research on fever blisters is extensive. Several laboratories are developing and testing new antiviral drugs tailored to hamper or prevent blister outbreaks.

Investigators are also trying to develop ointments that enable antiviral drugs to penetrate the skin more effectively. Ice applied directly to the cold sore site prior to the eruption of a blister can reduce the potential swelling. Wrap an ice cube in a damp cloth and keep it on the area for five minutes. Reapply every hour. Any drying or astringent OTC cold sore preparation that contains camphor and/or phenol such as Campho-Phenique or Orabase may provide relief if applied in the early stages. When used in the scab stage, these ointments can help prevent painful cracking and bleeding. Acyclovir and Famcyclovir are recently developed antiviral drugs that in clinical studies lessen the symptoms and frequency of fever blister recurrences for some patients. These drugs prevent the herpes virus from multiplying and are effective when taken in pill form prior to an outbreak of the virus.