Dr. Catherine Lynch: Herpes is a viral infection or virus that can infect both men and women. There are two different types of herpes; there is the type 1, which we generally think of as Cold Sores and the type 2 which is genital herpes, where they are more classically associated as being a sexually transmitted disease.
It's been estimated that between 45,000,000-60,000,000 Americans are infected with genital herpes, which is roughly one in five adult Americans. The CDC thinks that about 1,000,000 American get infected every year with general herpes.
Dr. Jay Reese: At least 60% of the population in United States will test positive for antibodies to herpes type 1, and 30-50% will show positive for herpes type 2.
Dr. Catherine Lynch: A significant number of people, it's estimated have no idea that they actually -- they have been infected with the virus. They may have had a very minimal initial outbreak and then just think every now and then, when they get a little itching or burning and not even realize that they have the virus at all.
Dr. Jay Reese: It's generally accepted by most people that that's the only time you have to worry is when you are having an outbreak, but that's not true. Medical science has proven this far back as 1985 that people could get the disease from a person who didn't know they had it, have the disease themselves without knowing they had it and pass it on to someone else who got the disease from them without anyone knowing anybody had anything. One of the problems we've had until last three or four years has been that the testing for antibodies was not as accurate as it is now with thanks to newer tests which have been available for the last three or four years. As a result, a lot of people had herpes without knowing it.
Dr. Catherine Lynch: When someone first gets it, what we refer to as the primary outbreak or their first outbreak of genital herpes, they quite frequently will have the feeling after coming down with the flu. They may run a fever, and then get this pain, stinging blisters, and then the ulcers in the in the genital area.
Dr. Jay Reese: Symptoms are an irritation in the area where the herpes is going to break out, a feeling of tingling or maybe some redness which turns into a little blister type thing or cluster of blisters, and the blisters break forming open sores which heal over time. The incubation period has traditionally been set at 3-20 days, which is a little different from other viral diseases in the same category where a disease breaks out 14 days after you are exposed.
Dr. Catherine Lynch: For some people, it may be a very mild to non-noticeable infection. As I said, other people may actually have serious flu or symptoms and on occasions we sometimes have to admit women into the hospital because of the extensive nature of the outbreak.
Dr. Jay Reese: Because some people who have the virus in an asymptomatic state don't know it and they may give it to somebody who instead of being asymptomatic goes ahead and breaks out. That's where the problems come, and you get all the recriminations of someone who basically tells their partner I've never had herpes, all of a sudden, the partner comes up with herpes and now they think there has been some infidelity there when maybe there hasn't been.
Dr. Catherine Lynch: Basically, the virus goes into a bloom just like certainly sometimes people with allergies not notice that their allergies are acquiring because the pollen is higher in the air. You don't notice anymore flowers on the trees so much, it's just they are shedding their pollen. And similarly, the virus goes into a bloom and sheds itself from areas like the cervix or other tissues that have been infected and so that the bloom is there, the pollen is there, so to speak and available to then attack somebody else.
Dr. Jay Reese: It's not possible to be sure that it's a safe time because the virus can be present. The only way to know whether it's present or not would be to do a culture of the area where a person has outbreaks, hence find out if the herpes virus was there, but by the time you get the culture report back, it doesn't really matter.
Dr. Catherine Lynch: Basically, the treatment is breakdown to either pills or creams of antiviral agents. The most classically are the Aciklovir, the Zovirax, the Famvir or Famciclovir or the Valacyclovir or Valtrex.
Well there are two different ways that you can take the medications. First, for the primary outbreak or for recurring outbreaks, you would begin the medication and it has been shown to shorten the duration and decrease the severity of the outbreak itself. It's not going to immediately clean it up, but it will kind of lessen the severity. The other approach is to do what is a suppressive therapy, where you actually take the medication on a daily basis to decrease the chance of an outbreak happening.
Dr. Jay Reese: There are studies available that show that the Zovirax, Valtrex, and Famvir do shorten the time during which a virus is being shed in an outbreak, and it cuts down the time for healing completely, and if a person takes the drug on a suppressive basis to suppress outbreaks, they can actually cut down the chances of having a symptomatic viral shedding by as much as 75%.
Dr. Catherine Lynch: A significant percentage of patients actually do improve with the antiviral therapy, especially in terms of the suppressive therapy, which has been shown to decrease the frequency of recurrences, which probably is one of the better ways to use the medications for someone who has more than a couple of outbreaks a year because the medication itself as I mentioned doesn't suddenly shut the outbreak off, it just decreases the duration and shortens the -- shortens the duration and decrease the intensity.
So instead of having a seven-day-outbreak they might have a five-day-outbreak. So the better approach is to suppress the outbreaks totally for someone who has recurring outbreaks. Someone who has a primary infection and never has another outbreak again, then symptomatic therapy is probably a better approach.
Transcription by:
Scribe4you Transcription Services