If you have been exposed to herpes, see your physician as soon as you notice symptoms! External symptoms are a definite warning. But also pay attention to other signs, such as a vaginal discharge, or pain or burning in the genital area or when urinating. Do not wait until symptoms disappear——because they will! The herpes virus will not.
Initial diagnosis is made on the basis of visual examination. Unless something is visible, there is not much for a physician to go on. A deﬁnitive veriﬁcation of the presence of herpes is done by means of a viral culture test. If you and your physician are unsure about symptoms, do suggest a culture test.
A blood test like those for syphilis and gonorrhea will not help because until specific antibodies develop, nothing will show up to indicate herpes. And, if antibodies do show up in a blood test, this only indicates that you have been exposed to herpes at some time in the past, and not that you have an active infection now.
The reason to seek attention early when you notice symptoms is that current treatments, if applied early enough, can be quite effective in preventing viral replication and spread. If the activity of the virus is minimized as much as possible at this point, you can protect yourself from any kind of complication. When attacked by body defenses, the virus can escape into nerve cells, where it is safe, and can go into what is called a “latent” or “dormant” phase. Early treatment strives to eliminate as much virus as possible before that happens. Learn about herpes symptoms and treatments.
Points to Remember:
Primary herpes infection can result in a number of effects ranging from subclinical states to severe and pro- longed symptoms, depending on such factors as amount of virus transmitted, your constitution, and your general physical health. Most cases, the first outbreak will be the worst experience you have with herpes and will pass with appropriate precautions and care.
Don’t self-diagnose, or self-medicate. Get early attention.
Latency and Recurrences
Herpes is such a difficult disease to cure outright because although symptoms may be gone and the area of the rash healed, the virus still remains in the body in such a state that it may be reactivated to cause another rash on the surface of the body. After healing has occurred, the virus enters nerve endings near the initial rash, migrating away from the surface of the skin, and escaping the body defenses that can only operate in other tissue. The virus moves along the nerve cells to what is called the sacral ganglion (ganglion being a collection of nerve cell bodies) just outside the spinal cord, where it can coexist with the cells without any overt difficulties occurring. It settles down, quite content to avoid being annihilated. The best way to characterize the virus at this time is as dormant. In facial herpes, the same process occurs in the nerve cells that make up the trigeminal nerve of the face, leading the virus to its ganglion outside the base of the brain.
The dormant herpes virus can remain in this state indeﬁnitely without causing damage and without causing infectious lesions on the surface of the body. In effect, you are cured of the impact of herpes in your life in general, including the problem of transmission, while you and the virus coexist more or less harmoniously. The herpes virus is like the virus causing warts, which also remains in your body after the warts have disappeared. There is, therefore, no cause for alarm at this point.
For many people, the latent state is essentially permanent, and no further symptoms will develop unless the balance between virus and body is dramatically disturbed. For others, however, the relationship does not remain so stable, and periodically the virus retraces its original escape route toward the body surface. If sufficient virus safely leaves the nerve cells to invade other tissue, a new rash will develop pretty much where the ﬁrst one occurred. This is the beginning of a recurrent outbreak.
Recurrences are very different from primary infections in that the body now has a reservoir of antibodies to mobilize against the virus when it leaves its natural retreat. Generally speaking, recurrences are much less severe than ﬁrst-time infections and should get increasingly less severe with each new episode.
Patterns of recurrence depend on many factors and vary with each person. Some ﬁgures suggest an average recurrence rate of three to ﬁve outbreaks a year, each of which lasts between four and ten days. But again, this can vary with each individual. Some people will rarely break out while others will break out quite regularly. The pattern may vary considerably even within individuals, with perhaps a series of breakouts in quick succession, followed by a period of months or years without any outbreak at all.
In general, if nothing hinders the body’s adjustment to the virus, outbreak frequency and duration will continue to decrease, and few symptoms will show after a few years.
The ideal situation can be difficult to bring about, since there are many factors that contribute to recurrent outbreaks and their healing. Your job is to play as big a role as possible in keeping the virus as dormant as possible. You can facilitate the body’s adaptation process to a large degree, although it does take some time. The chapters on recurrences and personal problems will address specifically how you can do this. And the first thing to remember is that correct information—supplied herein—will reduce the uncertainties, fears, and anxieties that may hinder this adaptation process. Then you will be on the road to a fast adjustment and control over the problem.
Points to Remember:
After an initial infection, the herpes virus retreats from body defenses into nerve cells and away from the body surface to remain in a latent state. Various disturbances can reactivate the virus so that it migrates back to the original site of infection and causes a recurrent outbreak. The recurrences will gradually be- come less severe, especially once you identify the factors that hinder and that facilitate your body’s adaptation.