Herpes Simplex Virus 1 and 2

by Cindy Enghusen

Do these phrases sound familiar?

  • "Does this mean I am going to die?"
  • "I thought only prostitutes got it."
  • "I was absolutely devastated. I felt dirty, I felt diseased, and I felt that I would never have another partner again. It was a huge burden."
  • "The whole thing terrifies me."
  • "I was humiliated when I found out."

I am 33, married with a child. I do not consider myself promiscuous. I was infected with Herpes in a monogamous relationship (we anticipated our vows, and I am now married to him). This is my story. I am writing this article so that others in my situation hopefully find the answers to their questions.

There are many forms of Herpes, but my article will focus on Herpes Simplex Virus 1 and 2. These are the most common forms of Herpes.

These viruses look identical under the microscope, and either type can infect the mouth or genitals. Most commonly, however, HSV-1 occurs above the waist, and HSV-2 below.

Let me be blunt, Herpes can be an emotionally devastating disease.

What is Herpes?

I was raised in an extremely strict, traditional 50's-type devout Christian home. Growing up I was taught that only prostitutes and sluts got Herpes.

I was one of those kids whose Mom had our sex education taken care of herself. She also pulled us out of some of the more secular classes when she didn't agree with its content. She was thorough about it too, and not shy about anything, even educating my friends if they asked questions and not at all shy to say how monogamous married sex was the ONLY way to go. We learnt all about the main STD's too, one of which was Herpes.

I was a rebellious child and did not listen. At 15 I did something really stupid, I had my first sexual relationship. I didn't get pregnant, and considering with whom, I was lucky enough not to catch anything.

For the next 12 or so years I had my fair share of relationships and partners. Nothing wild, not many, but still a game of roulette. When I was 27 I met this crazy OLD guy online. He was 15 years my senior, a divorced engineer with a 15-year-old son -- three strikes against him. I told him he was too old to be more than friends, so friends we became. Funny how some things change though. Two and a half years later, I married him.

We did have premarital sex. I did know he got a VERY occasional cold sore, but I never thought about it. I had cousins and an aunt that got them so I sympathized. He had a habit of poking and playing with them and that worried me. I told him he shouldn't do that. Did he know he could give himself genital herpes? In hindsight, I should have heeded my own warning and paid more attention but, I was still thinking I was invincible.

Two weeks before our wedding, we had dry sex. I try not to be too graphic, but it helps with a later explanation. I was a little sore the following day, but I figured that made sense. We had planned a trip to Mt. Rainier to let off some steam and spend some time alone without worrying about the wedding. I felt off, almost sick, and conditions weren't too good on the trip either. At one point we had to stop so I could, um, "view" the flora and fauna up close!

To make a long story short, I ended up with an outbreak, a yeast infection and a bacterial infection. I spent three days sick on the couch. I was achy, it was excruciating to walk or urinate and I had a fever. I finally made it to the doctor's office to get things checked out. She told me it looked like Herpes. I sobbed for several minutes. Remember, only sluts got this, so what did that make me?

My OB was very sympathetic and gave me a few statistics. For instance, Herpes is one of the most common STDs. Other statistics I found:

  • About one in five adults in the United States has genital Herpes, however as many as 90% are unaware that they have the virus.
  • About 50 - 80 % of the adult population in the United States has oral Herpes.

She sent me home with a prescription for Diflucan, and Valtrex. A few days later I went back in, went on a round of antibiotics, and a few days after that on another round of Diflucan. (On a personal note, whoever developed Diflucan should be knighted on so many levels!)

Once the shock of the price of the medications wore off, I got angry. I wanted to call off the wedding, 2-3 weeks away. I wanted to inflict bodily harm on him as well. I felt dirty, I felt betrayed, I felt alone. I didn't want to be touched.

We did get married though. I was afraid of sex for quite some time, but we got through it, one day at a time. I was and am deeply in love with Mark. I found a way to get past my anger, which was no easy task. We discussed having children, and 2 years later I became pregnant with my son, Brian. Before I even considered getting pregnant I did extensive research. The result, in part, is this article.

The research I found was invaluable. It reassured me that I could not only have healthy children, I could also do it naturally if I could find my trigger and / or go on a preventative course of medication. I found answers both in online research and talking to medical professionals.

I found more than one person with the same problems as mine, pregnant with a STD and afraid. I did more research, I shared what I could find and we started a STD board.

Types of Herpes

There are two types of HSV that are commonly associated with cold sores and genital Herpes.

  • HSV type 1 most commonly infects the lips, causing sores known as fever blisters or cold sores. However, it can infect the genital area and cause sores.
  • HSV type 2 is the usual cause of genital Herpes, but can infect the mouth during oral sex.

Any person who has a genital Herpes outbreak can easily pass or transmit the virus to another person during sex. Both HSV 1 and 2 can produce sores (also called lesions) in and around the vaginal area, on the penis, around the anal opening, on the buttocks or thighs, or the face, usually around the mouth. Occasionally, sores also appear on other parts of the body where the virus has entered through broken skin.

From what I have read and from my own experience, the lesions appear wherever there is broken skin. This might explain why as much as 90% of infected people don't know they have the virus and don't have outbreaks. If there were no open wounds (acrobatic sex, dry sex, rough sex) at the time of infection, you can have the virus, but no symptoms. Sometimes a person (who knows they are infected) can have an outbreak and have no visible sores at all. This is called asymptomatic shedding.

People often get genital Herpes by having sexual contact with others who don't know they are infected or who have outbreaks of Herpes without any sores. HSV remains in certain nerve cells of the body for life, and can produce symptoms off and on in some infected people. This is why Herpes is so easily transmittable.

The Outbreak

The initial symptoms of Herpes can vary from person to person in intensity.

  • It can produce an itching or burning feeling in the infected area
  • There might be a discharge of fluid from the vagina (a yeast infection)
  • A feeling of pressure in the abdomen
  • It can be accompanied by fever, headache, muscle aches, painful or difficult urination, and swollen glands in the groin area

Once a person is infected, the virus travels through the nerves and settles at the base of the spine where it lies dormant. Subsequent outbreaks are usually in the same location as the initial outbreak. Some people have only one or two recurrences (if any), while others have them frequently.

For most people, later outbreaks are less severe than the initial one. In fact, after the first year, most people have fewer and milder recurrences, lasting a shorter period. Some may have asymptomatic shedding with no visible lesions. Some people have warning signs, some don't. There may be a tingling or itching in the genital area, or pain in the buttocks, down the legs, or in the lower back. Some have flu like symptoms.

There is some research that indicates why some have more severe outbreaks than others. How severe can depend on three factors:

  • A person's immune system
  • How long ago you became infected
  • Where the virus is

Any person with a compromised immune system will most likely have more problems. A person who has had the infection for a long period of time is less likely to have severe outbreaks. HSV-1 is generally oral Herpes and "prefers" to be oral Herpes. HSV-2 is generally genital Herpes and "prefers" to be genital Herpes. That means if you are infected genitally with HSV-1, generally the outbreaks aren't as severe and don't reoccur as often. The same applies to HSV-2.

Some people report that recurrences are triggered by stress, illness, poor nutrition, menstruation, and friction in the genital area such as that caused by vigorous (or dry) sex. Research also shows that people who don't know they are infected often spread Herpes Simplex infections. These people may have symptoms so mild they don't notice them at all or else don't recognize them as Herpes.

Pregnancy and Herpes

In my search for knowledge I found that being pregnant with HSV will not usually cause problems, while delivering a child vaginally during an outbreak can cause problems.

There is good news however, even for those who DO deliver during an outbreak. The greatest risk to the baby comes when the mother has her FIRST outbreak during the last trimester (delivery), when the risk of transmission is at its highest. This is partially due to the antibodies the mother's body has developed to combat the virus. (The presence of antibodies is one of the reasons that subsequent outbreaks are USUALLY not as bad as the original.)

However, having said that, there is a less than or equal to 3% neonatal transmission rate among women having recurrent (not initial) outbreaks. At the time of delivery, a visual exam is done, many of questions are asked and if there are no signs of an outbreak, a vaginal delivery (if possible) is allowed.

There are also differing medical opinions on how to prevent an outbreak since there are many different triggers, and not everyone has the same one. Some can be triggered by food or stress. If the trigger is known, it can be avoided during the last trimester. Some providers give a prescription for Acyclovir as a preventative.

"The safety of systemic Acyclovir therapy among pregnant women has not been established. Burroughs Wellcome Co., in cooperation with CDC, maintains a registry to assess the effects of the use of Acyclovir during pregnancy. Women who receive Acyclovir during pregnancy should be reported to this registry (1-800-722-9292, ext. 58465). Current registry findings do not indicate an increase in the number of birth defects identified among the prospective reports".

I took Acyclovir for a short time during the end of my pregnancy, but the side effects for me were too great. I knew my trigger and avoided it. Studies so far indicate no additional risk of defects and there are providers out there that prescribe them as a preventative.

There are a few infants that are infected at delivery. The numbers are small, but not zero. Women that do have genital Herpes DO need to keep an eye out for signs of infant infection. They are extremely rare, but not unheard of.

The GOOD news - "Less than 0.1 percent of infants born in the United States each year get infected with genital Herpes during birth, according to the American Social Health Association. A mother who was infected with Herpes prior to getting pregnant passes Herpes antibodies on to her fetus, protecting it from becoming infected with the virus. The FDA has approved the drug Acyclovir in injectable form or Vidarabine to treat infants with Herpes."

If a woman delivers during an outbreak, the infant is watched closely for a period of 24-48 hours for signs of infection. If there are signs of infection, a course of Acyclovir can be given and it usually is effective (very). However, if left untreated, it can be devastating if not fatal. It is imperative that you seek medical advice before, during, and after delivery if you have HSV, both for you AND your child.

Treatment Options

Just about everyone has seen the commercial, you know, the Valtrex one.

"Learning that you have genital Herpes can be devastating. Coping with unpredictable outbreaks and the possibility of spreading the disease to a partner can be even worse. But you don't have to suffer in silence. You can arm yourself with information." The ad quickly follows up with "There is no cure for Herpes. Even with treatment, it may be possible to spread Herpes."

HSV is a virus, for which there is NO cure. Treatment yes, cure no. There are several medications available including (but not limited too) Herpe-Care, Virostat, Inter-Fear-On Magic, Simplex Solutions & Immune Enhance Herbal System, Famvir, Attack Pack Gold, Herpes-V BALM, Herpes Treatment by Waldon Research, Herpes Herbs, Herpes No More, Valtrex, Buddy's Oil, Herpes Prevention Formula, Vir-L-Lysine, Red Marine Algae, Herpasil by SkinChoice, Zovirax, Herpeskil, Viraway, Simply Essential's Herpe Alternative, Let There Be Light, Phyto-Clear, Pure Lip Solution Pack, Progenn, Neuragen RL.

Some folks swear that L-Lysine helps, and I have seen a post that says applying cardboard to the site can help (one of the chemicals helps). If you know what your trigger is, you can avoid it (I have been told chocolate and caffeine can be a trigger to some). If you have questions, no matter how silly, ask a medical professional. In all probability it isn't that silly, and someone else has already asked that question!

Living with Herpes

Living with Herpes can vary from person to person. Some people have one outbreak and it goes away. Others have an outbreak once or twice a month. Some are brought on by menstruation, stress, foods, etc. Not everyone knows WHAT his or her trigger is. Not everyone can eliminate stress (or a period), so avoiding the trigger is not always the answer.

Most people can find a medication (homeopathic or prescription) that can help manage more severe outbreaks. With management, it can be easy to limit exposure to partners. Herpes is transmittable, but not on inanimate objects. If one person has HSV, it is not a given that the partner will get it as well. HSV is NOT transmittable via toilet, towels, hot tubs etc.

Avoiding Infection

Sadly Herpes is very common. "Herpes is estimated to affect some 80 million people in America. At least one in six adults in the United States has genital Herpes."

The common perception is that Herpes is spread by direct skin-to-skin contact. Does this mean you have to have sex to get it? No, what it means is that if you have a cold sore, touch it, and then touch your genitals before washing your hands, you can transmit the virus from oral to genital Herpes.

My husband has both oral and genital Herpes. He autoinnoculated himself because he played with his cold sore and went to the bathroom without washing his hands. You can also transmit the disease through oral sex, anal sex and intercourse. A person could touch a cold sore, engage in foreplay and transmit it that way as well.

The best way to prevent transmission is to prevent contact. This means WASH YOUR HANDS: after a meal, after going to the bathroom, before you touch others. This is ESPECIALLY important for infants and young children! It means NO kissing babies if you have a cold sore. It means washing your hands BEFORE AND AFTER a diaper change.

Sexually, this also means WEAR A CONDOM. I am not condoning promiscuous sex here. What I am saying is be aware of what your body is doing. Even in a monogamous relationship, if one partner has it, it can be transmitted if you don't take proper precautions. However, WITH proper precautions, transmission CAN be avoided.

Herpes might be a life sentence to some. It IS an incurable virus, but it isn't untreatable. Herpes is something you deal with for life, but it doesn't have to bring your life to a halt.

Sources:
Herpes: Get the Facts
Genital Herpes
"Good" Virus, "Bad" Virus
Transmission
Genital Herpes: A Hidden Epidemic
Herpes Simplex

Cindy Enghusen Cindy Enghusen is the mother of 1 child. She is trying to conceive her second (with help from her ever patient and very loving husband). Cindy has worked in many fields (literally), is quite a handy person around the house and yard. Her first love is animal husbandry and farming, but it doesn't hold a candle to being a Mom. She has 3 AAS degrees in Agriculture (technical degrees) and when her child(ren) go to school, she hopes to return to work in agriculture, and maybe, some day, try her hand at writing.

Copyright © Cindy Enghusen. Permission to republish granted to Pregnancy.org, LLC.