Herpes: Symptoms and Treatment
Herpes is a viral disease, manifested in the form of characteristic rashes (vesicles), grouped together and localized in the mucous membranes and on the skin. Herpes, the symptoms of which occur against the background of herpesviruses, are most often found in the form of a labial (more precisely — labial) infection, its manifestations in traditional usage are defined as «colds on the lips.» There are other forms of the disease, for example, genital herpes (with the predominant lesion of the genital organs), as well as the forms in which the most diverse areas are affected.
Herpes manifests itself only in the case when the immune system of the body is in a weakened state. This can be facilitated by factors such as hypothermia or overheating, the transfer of certain diseases, abortion, an unstable mental or physical condition, etc. As already noted, the herpes is formed on the skin or on the mucous membranes in the form of small red vesicles, with friend. In some cases of the course of the disease, the formed vesicles merge together. As a concomitant manifestation of this may be burning and itching.
Herpes on the body occurs due to the impact of the virus, which is constantly in the human body, it is herpes simplex. Herpesviruses that provoke the disease can be of two types, HSV-1 and HSV-2. Most often there is a labial infection, which, as we have already identified, is defined as a «cold», the next (according to the frequency of occurrence) is genital herpes, in which, according to its name, the genital area is affected. As a rule, HSV-1 (or type I) leads to infection in the face, mouth, eyes, neck and central nervous system. HSV-2 (type II), in turn, is characterized by genital lesions. Meanwhile, both HSV-1 and HSV-2 can provoke a defeat in the area of localization, to each other the opposite. For example, such an option is possible in the case of orogenital forms of sexual contacts.
What is noteworthy, the herpes simplex virus, as evidenced by some statistics, occurs in 90% of the world’s inhabitants, while herpes of type II accounts for 15%. Other varieties of herpes (varicella virus, cytomegalovirus, Epstein-Barr virus, VI, VII and VIII viruses) are characterized by their own characteristics that characterize them.
Herpes on the lips — Symptoms, as is clear, manifest on the lips, the virus causes type I virus. Meanwhile, this type of virus affects not only the lips, as we noted earlier, and «herpes on the lips» is just one of the variants of manifesting this type of disease. So, for example, here you can consider herpes in the nose, the symptoms of which are similar to the general specificity of the disease, herpes on the cheeks or on the eye mucosa, or even herpes at all on the face, which will be an even more precise definition of its localization (in the vast majority of cases). Often, incidentally, in addition to the defeat of the lips, patients face a lesion of the eye mucosa, the disease in this form is defined as keratitis or viral conjunctivitis (which is determined on the basis of the features of its manifestation).
It is often enough to diagnose herpes in the mouth, this time more often it is noted in children. Given the fact that they have not yet fully formed the immune system, this form of herpes can develop into stomatitis. In this case, the mouth cavity is covered with characteristic bubbles, which, in turn, complicates the processes of eating and drinking. There is a similar lesion in adults, and it is much more difficult for them to transfer: the pain sensations are quite intense in manifestation, the duration of the disease can be as long as two weeks or more than a month.
Sexual herpes — Symptoms of it, as we have already noted, are noted in the genital area, the disease itself is provoked by type II virus. Herpes during pregnancy in this case within the terminating pregnancy in most cases is transmitted to the child. The disease is typical, in the form of the same accumulations of vesicles. In addition, herpes on the genitals may indicate that there is a tumor in the body. For example, herpes, the symptoms in women with which appear on the labia, may indicate that the patient developed cervical cancer. When considering this disease in men, herpes can act, for example, as a symptom of prostate cancer.
The following type, varicella-zoster virus ( type III) , is the immediate cause of diseases such as chicken pox In children, as well as shingles (a disease that is also defined as herpes zoster, its symptoms are found in both children and adults). Chickenpox in particular is accompanied by the appearance of a rash and a temperature within 38-40 degrees, there is a fever (lasting about a week, until the appearance of the entire rash on the skin). The rash is accompanied by itching, combing should be avoided to avoid infection. The rash, after 3-4 weeks, completely disappears.
Varicella in adults can be accompanied by complications, as well as provoke shingles. The rash with shingles is transformed into typical for herpes vesicles, the spread of which occurs throughout the body. Herpes on the body, the symptoms of which we examined, disappears within a period of about a month. It should be noted that shingles can be affected even by people who had previously suffered from chickenpox, but if shingles did not appear within 10 years of the patient’s chickenpox transfer, the chances of his occurrence decrease at times.
It provokes the herpes simplex Epstein-Barr virus ( IV type) , manifested as infectious mononucleosis — acute infectious Disease, in which there is a pronounced fever, angina, there is an increase in lymph nodes and, in fact, changes in the composition of the blood. By the way, this type often causes the development of cancer of the nasopharyngeal region or the cause of the development of malignant form of Burkitt’s lymphoma. As the main sign of this type of virus is herpes in the throat, the symptoms of which are detected during the examination of the nasopharynx.
Cytomegalovirus ( V type) — is a disease provoked by another, V type of herpesvirus group, characterized by a mild symptomatology And predominantly amazes men. Symptoms of cytomegalovirus are minor, reminiscent of the mild form of cold in its manifestations. If the disease occurs in patients with weakened immune system (malignant diseases, AIDS, etc.), the symptomatology is characterized by more serious manifestations. So, cytomegalovirus can cause the development of hepatitis, pneumonitis, subacute encephalitis, rhinitis, colitis and transverse myelitis. In case of occurrence of any of the listed diseases in a complex with a herpetic rash, it is necessary, first of all, to start treatment with the elimination of cytomegalovirus. It is important to note that cytomegalovirus in pregnancy becomes the cause of the formation of birth defects in newborn babies in those mothers who get the virus into the body of which occurred while carrying the child.
The herpes virus 6 ( VI) type is diagnosed in both children and adults. Due to its effect, children develop roseola — a disease in which a characteristic rash appears on the body, which is also accompanied by a rise in temperature. The rash may appear anywhere — on the hands, on the back, on the lip, on the genitals. Herpes of type 6 in adults causes the development of the syndrome of chronic fatigue. Chronic fatigue is characterized by the following symptoms:
- fast fatigue;
- severe muscle weakness, inability to perform physical exercises
- the patient can not get enough sleep even with a full sleep mode (about 10 hours)
- lethargy, apathy.
The following type, herpes virus 7 ( VII) type, is currently not deep enough, however One can say for certain: its presence in the body is a factor provoking chronic fatigue syndrome (which, as you noted, is also relevant for the previous type of virus). Symptoms that characterize this type of herpes are: depression, enlarged lymph nodes, increased tearfulness, fever (within 36.9-37.7, restrained in the period of half a year), severe weakness, sleep disturbances (it is not possible to fall asleep quickly in the patient, Extremely hard). The listed symptoms can accompany other conditions, because an accurate diagnosis is established solely on the basis of a number of clinical studies.
And finally, herpes virus 8 ( VIII) type. This type of herpesvirus is directly associated with a pathology such as Kaposi’s sarcoma. This pathology is accompanied by the formation on the skin of small-sized flat tumor malignant tumors. The main category of people affected by this type of herpes are patients with HIV infection — they occur in about 60% of cases.
In addition to the listed variants of diseases to which a herpesvirus of one type or another relates, it is also assumed that it plays an important role in the development of such a disease as schizophrenia.
Causes of herpes
To transmit herpes simplex it is sufficient to make direct contact with biological fluids or with damaged areas of the skin / mucous diseased person. Also sufficient for this is skin contact during the asymptomatic course of the disease.
The lack of hygiene, low socioeconomic status, as well as habitation in an environment of overpopulated or underdeveloped countries, are identified as factors of rice infection of children of HSV-1.
In an environment in conditions of a normal level of humidity and room temperature, the survival of the viral herpes simplex virus is a period per day. In conditions of a temperature of about +52 degrees, in half an hour, its inactivation occurs (complete or partial loss of the virus-specific activity), under conditions of minus temperatures (about -70), the virus remains viable for five days. Survival of the virus on metal surfaces in the form of water taps, coins, door handles, etc. is approximately 2 hours, and on wet gauze or medical cotton wool — until they dry (about 6 hours).
Virus transmission also occurs as follows:
- when overheating / supercooling
- when kissing a partner infected with herpes
- when having sex with unfamiliar partners, with frequent partner changes, and also with oral sex with a partner infected with the herpes virus
- if there is a violation of hygiene
- when using public toilets (with the exception of toilet disinfection)
Herpes simplex: symptoms
Herpes in its own current overcomes four main stages, we will consider them below, respectively, and each stage determines its own symptoms of herpes, they will also be taken into account.
- I stage
This stage is characterized by tingling, patients in most cases feel that they begin to fall ill. Until the time when the characteristic «cold» appears in the corresponding area of the lesion, the skin starts to itch, which occurs in the area from the inside of the lips, on the skin of the corners of the mouth, in the tongue or in the area of another part of the face. In the place where the recurrence of herpes will soon develop, there are precursors of this disease. They consist in the appearance of pain, in pruritus, tingling and tingling. There is also a reddening of the skin in the area of the future development of relapse.
At this stage, it is possible to prevent the development of the disease, which can be achieved using appropriate drugs, the basis of active ingredients of which is acyclovir. When there is intense and unbearable itching, you can use paracetamol or aspirin to reduce the severity of its manifestation.
- Stage II
This stage manifests itself in the form of inflammation. A small vesicle appears, gradually increasing in size. Its tension is noted, the base of the vial is filled with a liquid that is initially transparent, but becomes muddy when the disease progresses.
- Stage III
This stage is characterized by the appearance of ulceration. Here there is a rupture of the bladder, followed by the outflow of the liquid contained in it, in which there are many viral elements. On the place on which up to this point there was a bubble, there is a sore. It should be noted that during the period of this stage, in particular after the bubble breakthrough, the sick person is especially contagious, because it is at this stage of the disease that he allocates a huge number of viral elements directly to the environment. In addition, this stage is accompanied by a special discomfort because of the soreness of the formations and their special activity on the face.
- IV stage
This stage is accompanied by a stucco formation. The sores are covered with a crust, pain is accompanied by painful sensations, often bleeding.
Note an important point in the course of the disease, which is as follows. So, if the «cold» lasts more than 10 days, you should definitely consult a doctor. The fact is that the herpes virus, the symptoms of which appear on the lips, without causing special concerns, in addition to the characteristic discomfort, can indicate in such a flow the presence of other diseases of a more serious scale. Accordingly, this option will require specialized treatment.
With prolonged colds on the lips (beyond the 30-day limit), there are reasons to consider the relevance of such conditions as lymphoproliferative diseases, HIV infection, tumoral diseases (benign or malignant). With reduced immunity (HIV, immunosuppression), the possibility of necrotic form of the course of the herpes virus can not be ruled out when scarring on the affected skin is formed on its background.
Genital Herpes: Symptoms
Genital herpes, depending on the characteristics of infection of the patient, can manifest itself in the primary form or in the form of a recurrent. Depending on this, accordingly, there will be some difference in the course of the disease.
Primary genital herpes predominantly proceeds without manifestation of symptoms, in connection with which a hidden virus carrier occurs or a recurrent form of herpes develops.
The asymptomatic form is the most dangerous, when viewed in general terms, focusing on the spread of the disease. Because of the absence of symptoms, the sick person does not know that it is so, and therefore freely continues to lead an active sexual life, exposing the corresponding danger to partners. What is noteworthy is that the primary development of infection determines the greatest risks in terms of infectiousness.
The incubation period is the precursor to the development of the symptomatology (under this period the time separating the moment of infection by the virus from the explicit type of reaction from the infected person is indicated), its duration can be different (1-26 days). Meanwhile, most often for the primary herpes this period is 2-12 days. There are differences in its duration and depending on sex. Thus, in women, the duration of the incubation period of primary herpes is about 10 days, while for men it is within 7 days.
The manifestation of symptoms of primary genital herpes usually occurs 1-10 days after the end of the incubation period, it differs from future exacerbations in that it manifests itself in a more severe form, with a longer duration of flow.
As the main symptoms of the disease, similarly with the symptoms of the vast majority of viral infections in which mucous membranes and skin are affected, the following can be distinguished:
- the appearance of rashes within the genital area
- formation of small bubbles of grouped type on the mucous membranes of the genitals, as well as on the skin adjacent to them, with a transparent liquid inside, and also with reddening of the skin surrounding them
- turbidity of the liquid in the vesicle after 2-4 days from the moment of their appearance and subsequent bursting of the vesicles with the formation of erectile erosive formations (somewhat less frequently — ulcers), these formations become crusty when dried;
- If there is an uncomplicated form of the disease, after 5-7 days, the crust falls off, and an appreciable stain remains at the site where erosion (or sore) was previously located
- In addition to the characteristic herpes rash, patients are also concerned about the itching and burning sensation in the lesion;
- Sometimes itching and burning act as previous manifestations of herpes, that is, they appear before formation on the skin (mucous) rashes
- associated with the disease and a number of common types of symptoms: temperature (within 38 degrees), increased urination, joint and muscle pain, headache, enlarged lymph nodes in the groin area.
The duration of the acute period of the primary form of herpes can be about 3-5 weeks. A typical area of lesions of genital herpes is the genitals, a lesion with this kind of oral cavity is somewhat less frequent (contact oral-genital).
What is noteworthy, the rashes that occur with genital herpes can focus not only on the outside of the genitals, but also on the inner side, thus appearing inside the vagina or urethra. Do not exclude the defeat of his legs and thighs. Genital herpes in women often focuses within the buttock area, there may be a connection with the approach of menstruation. In conclusion, considering the areas of concentration of the rash, we note that a bubble rash can also cover the rectum area, affecting it and inside — all this also determines the symptoms of genital herpes.
Complications in the primary form of the disease in question are noted in about 30% of cases. Some cases of the disease course are accompanied by the appearance of edema and cracks, which for a long time do not heal and are also concentrated in the genital area.
Completion of manifestations of genital herpes in the primary form (this occurs in the period 1-3 weeks, and even without the use of certain measures of therapy), the infection either becomes latent or recursive.
The occurrence of recurrences of genital herpes is determined by a different frequency. So, the disease can manifest itself as 3-4 times within a month, and once during a period of several years. A contributing factor for the occurrence of relapses is such periods in which the resistance of the organism is significantly reduced, which is actual in the states after the transfer of any diseases, under stresses, emotional and physical overloads, hypothermia, etc.
Recurrences of genital herpes in women often occur during pregnancy, and sometimes — during the period of menstruation. As a rule, lesions focus in the same place where they appeared and with the primary infection, however, relapse, as we have already noted, in contrast to the primary form of the disease, proceeds much more easily. Misery, headache and fever are absent, rashes are not so much, healing is faster (up to 10 days).
The recurrent form of genital herpes is observed in the order of 50-75% of cases. It should be noted that infection can become an obstacle to a normal sexual life, so that patients in this background develop neuropsychic disorders.
In addition to the typical course of recurrent herpes, it can also occur in atypical form. The diagnosis of an atypical course of recurrent herpes in a patient is made with chronic inflammation from the internal genitalia with a justification in the form of laboratory confirmation indicating the herpes nature of the condition, in which, in turn, typical for herpes vesicles and erosion. Atypical form of the disease is accompanied by a slight reddening, marked in the genital area, as well as the appearance of painful cracks on the skin. Also, the patient can only face a symptom in the form of itching, again, without the appearance of vesicles.
Herpes and Pregnancy
Infection with herpes during pregnancy of the fetus or directly at birth determines for him the likelihood of developing congenital herpes. Infection determines approximately 50% mortality for children, as well as a sufficiently high degree of disability. In 60% of cases, infection with the congenital form of herpes occurs with genital herpes, although this does not exclude the possibility of infection with herpes simplex in its active phase in the body (that is, the herpes we examined earlier on the lips, skin and mucous membranes).
The risk of contracting fetal herpes in particular increases by the end of pregnancy, which is associated with the greatest permeability during this period of the placental barrier. So, at the onset of pregnancy, the risk of infection is estimated at about 10%, to the onset of childbirth — in 40-60%.
Transmission of infection occurs at the time of passage through the birth canal, by ascending or transplacental. Most often in practice, there is an infection when passing through the birth canal (up to 70% of cases), often this option is relevant in the presence of the mother’s genital herpes.
Also, the possibility of infection by the upward path is not excluded, especially if the mother is infected with herpes simplex type II (herpes genital).
The transplacental transmission path is the least common — about 8% of all cases of morbidity. This option is relevant in the case of primary infection of the woman in childbirth with type I or type II herpes, including in the case of the presence of viremia in the blood (which implies the presence of active forms of herpes in it, not destroyed by immunity).
Getting to the fetus of infection leads to the development of degenerative and inflammatory changes in the surrounding membranes and in the umbilical cord, resulting in their fibrosis, the walls are thickened and thickened. Infection, getting into the fetus, can cause the formation of an immune block in it, due to which immunoglobulins and antibodies from the mother stop falling into his body, thereby depriving him of the necessary protection from the effects of another type of infection. The above factors cause the disruption of a number of body functions.
If a herpetic infection gets into the fetus during the first trimester, degenerative changes develop that are incompatible with life, which leads to miscarriage and, consequently, abortion.
Infection on later terms still does not exclude the possibility of miscarriage or the onset of premature birth, but there is also the possibility of compensation, due to which the fetus starts to develop those or other changes:
- changes in the central nervous system: epilepsy, microcephaly, hydrocephalus
- changes in liver function: hepatitis, cirrhosis
- changes affecting the eyes: retinal dysplasia, cataract, etc.
- lung injury: pneumonia (intrauterine form)
- skin lesions: gingivitis, stomatitis, etc.
In the generalized form of infection, polyorganism develops (multiple nature of internal organ damage), reminiscent of the form of manifestation inherent in neonatal sepsis. The effect of herpetic infection on this scheme causes the development of severe CNS lesions, as well as the possibility of coma and death. All this determines the most unfavorable variant of development of the congenital form of herpes.
As the primary method of diagnosing herpes, examining the patient and his questioning are used, thereby revealing the symptoms characteristic of the disease. It is more difficult to diagnose genital herpes, because he, in most cases of occurrence, does not have the typical symptomatology of herpes. For this reason, virological methods are used. Actually, this includes virological research, PCR (polymerase chain reaction method) and RIF (or immunofluorescence reaction).
The listed methods have sufficient accuracy and specificity, but their high cost determines some restrictions in the application. In addition to these methods, methods such as the serological method, the immunocurrent G-specific test are also used. Meanwhile, both simple and genital herpes in most cases are diagnosed without special difficulties due to the presence of visible signs characteristic of herpes and the general nature of the course of the disease.
To date, there is no drug that completely eliminates the herpes virus. Those drugs that are offered to treat herpes today only provide an opportunity to suppress the reproduction of the virus, but do not contribute to the removal of the fragments of viral DNA from the neurocytes. Given this feature, the probability of recurrence of the disease is relevant, especially in immunodeficient conditions (tumors, HIV). The use of antiviral drugs makes it possible to reduce activity on the part of the virus, and to alleviate the symptoms. Currently developed vaccines do not determine the proper effectiveness in the conduct of clinical trials. Among the most common to the use of drugs: Acyclovir, Valaciclovir, Famciclovir, Dokosanol, Tromantadine and others.
As for the question of a specialist who needs to be treated with herpes accompanied by symptomatology, everything is determined here depending on the area of the lesion. So, cutaneous herpes and shingles, as well as any other kind of rash on the skin, require treatment to a dermatologist. If the oral cavity is damaged and gingivitis or stomatitis provoked on the background of herpes, accordingly, it is irreversible to apply to the dentist. If the herpes eye is affected (ophthalmoherpes), it should be referred to an ophthalmologist. The appearance of neuritis or radiculitis of herpetic nature requires treatment to a neurologist. Genital herpes is treated by gynecologists, urologists and andrologists. In the case of any type of herpes, it will not be superfluous to visit the immunologist because of the direct relationship of the disease to the immune system and in particular to its weakened state against the background of this or that concomitant condition. When you visit a dermatovenereologist, you can determine the nature of the disease, the prognosis for it and the specific features of the treatment required in a particular case.