Herpes Simplex

Herpes is a contagious infection that's caused by the herpes simplex virus. One type of the virus - herpes simplex virus type 1 (HSV1) - can lead to cold sores around the mouth. An infection of herpes simplex virus type 2 (HSV2) can lead to genital herpes, a sexually transmitted disease that causes blisters and pain in the genital area.

Both types of the virus can be transmitted through direct contact. A person can get the cold sores of HSV1 by kissing or sharing eating utensils with an infected person. A person can get genital herpes or HSV2 by having intimate contact with an infected person. A mother who has genital herpes can pass the infection on to her newborn if she delivers the baby vaginally.

In many cases, herpes doesn't cause any symptoms, so it's possible for a person to carry it and unknowingly pass it on to someone else. In other cases, herpes infections can lead to infections in other parts of the body.

Sometimes people who have oral or genital herpes only have one outbreak. But other people have many outbreaks, which are less painful and shorter than the initial episode.

There's no cure for herpes. In fact, once a person has been infected with the herpes virus, it's in the body forever. There are medications that can alleviate some of the discomfort that outbreaks cause. And there are things you can do to help protect yourself - and your family -from getting infected by the virus.

Types of Herpes Infections
Cold sores around the mouth are usually caused by HSV1. This form of the virus is usually transmitted from person to person by saliva or direct contact, like kissing or sharing eating utensils.

In this form of herpes, blisters form on the lips and on the inside of the mouth, and soon develop into painful ulcers. The gums become red and swollen, and the tongue may develop a white coating. Other symptoms may include fever, muscle aches, eating difficulties, a generally ill feeling, irritability, and swollen neck glands. These symptoms can last from 3 to 2 weeks.

After the first herpes infection, the virus can lie dormant without causing any symptoms for some time. But the virus can reactivate at a later time, leading to a tingling and numbness around the mouth, then a blister that breaks and forms a crust. The virus tends to reactivate following some type of stress on the body, like a cold, an infection, hormone changes, menstrual periods, or even a tooth extraction.

Genital herpes is usually caused by HSV2. This form of the virus occurs mainly in sexually active teens and adults and is transmitted through intimate contact.

Symptoms typically begin with pain, tenderness, or itching in the genital area and also include fever and headache.

In males, blisters appear on the penis. In females, blisters appear on the area around the vagina and in the cervix. In both genders, the blisters may appear on the thighs and buttocks. Blisters soon erupt to form painful sores that last 1 to 3 weeks.

Other symptoms may include: pain or a burning sensation during urination; a clear mucus-like discharge from the vagina or urethra (opening for urine) in females; a clear mucus-like discharge from the tip of the penis in males; and tender, swollen glands in the groin area.

As with HSV1, after an initial outbreak of genital herpes blisters, HSV2 also remains dormant in nearby nerves and can be reactivated later in life. The symptoms of reactivated genital herpes are similar to those of first outbreak, but they're generally less severe.

Transmission
Both types of herpes virus are contagious and can be passed from person to person through contact with the herpes sores or blisters.

Herpes simplex virus type 1 is very common. Most kids who have the virus get infected during their preschool years, most likely from eating or drinking after someone who has it or getting kissed by an adult with the virus.

Herpes simplex virus type 2 can be passed in the urine or genital discharge of an infected person.

In both cases, people who are infected can have no symptoms of an active infection, and can unknowingly spread the infection to another person.

Pregnant women with genital herpes can pass a herpes infection to their newborns during vaginal delivery. If you are pregnant and have a herpes infection, it's important to talk with your doctor about labor and delivery options.

Prevention
Herpes infections can be prevented by avoiding direct contact with sores or ulcers of someone who has an active herpes infection - either on the mouth or on the genitals.

Teens who are sexually active should properly use a latex condom during sexual activity, but even condoms will not completely eliminate the risk of spreading genital herpes while there are active lesions. The only surefire way to prevent genital herpes is abstinence.

Pregnant women who have had genital herpes or any type of genital sores or blisters in the past should always tell their obstetricians before delivery. In some cases, other delivery options - like a cesarean section - can prevent HSV2 from being passed to the newborn.

Treatment
Cold sores from HSV1 usually go away on their own within 7 to 10 days. Although no medications can make the infection go away, prescription drugs and creams are available that can shorten the length of the outbreak and make the cold sores less painful.

To treat genital herpes, the doctor may prescribe an antiviral medicine like acyclovir in the form of an ointment or pills. These medications can't cure HSV2, but they can help make a person feel better and shorten the duration of the outbreak.

If your child has a cold sore, it's important to call your child's doctor if:

• your child has another health condition that has weakened the immune system
• the sores don't heal by themselves within 7 to 10 days
• your child gets cold sores frequently

Home Treatment
To help relieve the discomfort of cold sores from a herpes infection, give your child cool liquids or frozen juice bars. Remember that apple and grape juices may be gentler on irritated mouth areas than more acidic juices such as orange juice or lemonade. Applying an ice cube directly to the cold sore for short periods can also relieve any pain your child has.

Keep your child's drinking glass and eating utensils separate from those of other family members, and wash these items thoroughly after your child uses them. Quiet activities - like board games, puzzles, and model building - may also help to keep busy hands away from the mouth and eyes. Children with cold sores should not kiss others until the sores heal.

Another way to relieve the pain of cold sores or blisters is by giving your child acetaminophen. Aspirin should not be given to children with viral infections since the use of aspirin in such cases has been associated with the development of Reye syndrome.

To treat genital herpes at home, try frequent warm baths to help soothe skin irritation.

When to Call Your Child's Doctor
Call your child's doctor if your child has any of the following symptoms: a painful open sore or blister around the mouth, fever, swollen neck glands, or difficulty eating due to mouth sores.

A genital herpes infection in a child or infant suggests that the infection may have been transmitted by inappropriate or abusive touching (sexual abuse). This possibility should be considered and discussed with your child's doctor.