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The Devil Is In The Details
As we await the outcome of Pridgens antiviral herpes simplex trial in fibromyalgia, Albert Chang takes a deeper look at herpes simplex viruses.
Herpes simplex viruses have not generally been associated with ME/CFS or fibromyaglia,but that may change with the Pridgen study
Two herpesviruses, Epstein-Barr virus and HHV-6, have been of interest in chronic fatigue syndrome for decades. However, it was not until the Pridgen antiviral Fibromyalgia study put the spotlight on the Herpes Simplex Virus that it has shown up in a big way. Like other herpes viruses, HSV tends to reactivate during times of physical, hormonal and/or emotional stress.
- Learn more about the Pridgen Fibromyalgia trial here
Herpes Simplex is a dsDNA virus that belongs to the Herpesviridae family of human-infecting viruses. This virus subset comes in two forms: HSV-1, commonly referred to as cold sores, and HSV-2, commonly referred to as genital herpes. One of the distinguishing attributes of this virus is that it stays with the host for life by residing in the nerve ganglia, which are nerve clusters within the body that act as conduits between the central nervous system and the various functional components of our body: organs, glands, skin, blood vessels, and muscles.
How Common Are Recurrences
- 80% of persons having a first episode caused by HSV-2 will have at least one recurrence
- 50% of persons with HSV-1 will experience a recurrence
- The most common scenario is occasional recurrences
- Usually, the first year has the most viral activity
A recurrence takes place when the virus replicates in the nerve ganglia and particles of virus travel along the nerve to the site of primary infection in the skin or mucous membranes .
There are very subtle forms of recurring herpes found on the penis, vulva, anus, thigh and buttocks or anywhere in or around the genital area that heal very quickly .
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Symptoms Of Genital Herpes In Women
Genital herpes outbreaks in women can range from asymptomatic to severe. Some women don’t even know they have the virus, but it can still be passed.
It’s essential to bring up any unusual skin changes or symptoms with your healthcare provider. Once a person has become infected with herpes simplex virus, it lives in the nerve cells for life regardless of the presence of symptoms.
You Can Only Get Genital Herpes If Your Partner Has An Active Infection With Sores Right Wrong
A person can be exposed to the virus and pass it to someone else without ever having symptoms. It happens more often than youd think. Thats because the virus can exist in genital fluids even without any ulcers. This is called “asymptomatic shedding of virus.” Although there is a lot more active virus when there are sores, asymptomatic shedding is probably how most people get herpes. Whats more, only one out of four people who tests positive for genital herpes actually knows that they have the virus. Thats a lot of people. Combine the two and you have many people unknowingly infecting others.
Many people who learn they have genital herpes are shocked. They often didnt see any sores on their partner or that their partner had never had any ulcers, ever. This is common and true, because people can have genital herpes and not know it.
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Can Herpes Be Prevented Or Avoided
The best way to prevent getting herpes is to not have sex with anyone who has the virus. It can be spread even when the person who has it isnt showing any symptoms. If your partner has herpes, there is no way of knowing for sure that you wont get it.
If you are infected, there is no time that is completely safe to have sex and not spread herpes. If you have herpes, you must tell your sex partner. You should avoid having sex if you have any sores. Herpes can spread from one person to another very easily when sores are present.
You should use condoms every time you have sex. They can help reduce the risk of spreading herpes. But its still possible to spread or get herpes if youre using a condom.
Questions To Ask Your Doctor
- What is the best treatment for me?
- Are there any side effects to my treatment?
- Is it safe to have unprotected sex if I dont have any sores?
- Can I give myself genital herpes if I also have oral herpes?
- Can I give someone else herpes even if Im not having an outbreak?
- What is the best way to prevent herpes outbreaks?
- Can I live a normal life with herpes?
- Am I at risk of developing any other diseases?
- Are there any support groups in my area?
- If I give my baby herpes, what is the treatment?
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What Causes Symptoms To Come Back
When symptoms recur, they usually come on during times of emotional stress or illness. That’s because, during these times, your body’s immune system may be less able to suppress the virus and keep it from becoming active.
Symptom triggers can include:
- Interfere with a person’s sense of security and intimacy
In some cases, though, complications from genital herpes can be serious, even life-threatening.
Although it’s rare, pregnant women can pass on the herpes infection to their child. This can result in a serious and sometimes deadly infection in the baby. That’s why taking steps to prevent an outbreak at time of delivery is recommended starting at 34 weeks into the pregnancy. If you have signs of an active viral infection when it’s time to deliver, your doctor will likely recommend a cesarean section for delivery.
If you have any reason to believe you may have an HSV infection as the result of a sexual encounter — either genital or oral — contact your health care provider.
When To See A Healthcare Provider
If you have a cold sore, you do not necessarily need to make an appointment with your healthcare provider because the sore will likely go away on its own within a few days. However, make an appointment for an evaluation if you have signs and symptoms of cold sores that are persistent and/or extremely painful, especially if they are associated with fevers, swelling, bleeding, or oozing. Though cold sores are generally not serious and rarely cause complications, you’ll want to get outbreaks under control.
If you have any signs of genital herpes, however, you should see a healthcare provider within a few days, before the lesions go away.
Sores on or near the genital area can herald a sexually transmitted infection , or they may be the result of some other type of irritation. Most STIs are treatable, but it is difficult to know which one you may haveor if you have one at allunless you are trained in diagnosing them.
Many people do not freely communicate with sexual partners when it comes to STI status, so it’s best to get a definitive answer on what’s causing your symptoms.
If you have pain or bleeding with urination, pain with sexual activity, or if you notice that lesions in the genital area seem to be inflamed, you should call your healthcare provider, even if you have already been diagnosed with and treated for herpes.
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My Immune System Has Me Covered Doesnt It
We should know more about a possible connection between herpes simplex and fibromyalgia soon
Despite the small set of categorizations for the immune system , and the overwhelming claims from doctors that infection elsewhere in the body was unlikely unless a host was immunocompromised, I present the following cases:
1) Immunocompetent patients developing vocal cord-related paralysis following HSV infection:2) Lower respiratory tract HSV infections even in immunologically sound patients 3) HSV Bronchopneumonitis infections in immunocompetent patients 4 A hypothesis suggesting HSV infects the smooth muscles of arterial walls:
The point is that theres a lot we dont know about the Herpes Simplex Virus. Whether or not it plays a role in fibromyalgia and/or chronic fatigue ayndrome is simply speculation at this point. Well find out more about HSV and Fibromyalgia in March, though, when Dr. Pridgen begins releasing information on the Fibromyalgia antiviral trial targeting Herpes Simplex. This study includes examining gut tissues for evidence of the virus.
Update in 2022 the gut study was published and HSV-1 was found in FM patients guts.
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How Is Genital Herpes Diagnosed
Your doctor may diagnose genital herpes by examining you. He or she may ask you questions about your symptoms and your risk factors, which are things that make you more likely to get an infection.
If this is your first outbreak, your doctor may take a sample of tissue from the sore for testing. Testing can help the doctor be sure that you have herpes. You may also have a blood test.
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How Soon Will I Get My First Outbreak
If youve come into contact with the virus but havent had an outbreak, theres no absolutely certain answer.
A newly infected person will typically have their first outbreak two weeks after contact. However, it can begin within hours of contact or even take a couple of years.
In as many as half of people having primary outbreaks, there are no clinically evident symptoms. In the rest, the symptoms may appear anytime between a few hours to weeks after contact. However, in most, the symptoms start during the first 24 hours of contact.
What Can I Do To Help Relieve Symptoms Of Cold Sores
While cold sores are uncomfortable, you can find relief at home. Suggestions to help manage cold sores:
- Use over-the-counter creams and ointments: These remedies can help shorten the healing time and ease your symptoms. They are most effective when you use them as soon as you feel a cold sore coming on.
- Take pain relievers: If you are in a lot of pain, your doctor may recommend an over-the-counter topical pain reliever such as lidocaine that you can apply directly to the cold sore. You can also take acetaminophen or ibuprofen by mouth to ease your discomfort.
- Wear sunscreen and SPF lip balm: It is important to make sure a cold sore doesnt get sunburned while it is healing. Also, wearing a lip balm with SPF 30 every day could prevent future cold sores.
- Avoid acidic foods: Orange juice, tomatoes and other acidic foods can aggravate a cold sore.
- Apply a cool compress: You can use a cool, damp washcloth to soothe a cold sore. Apply it for a few minutes off and on throughout the day. Be sure to wash the towel after youve used it to avoid spreading the cold sore to others.
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Conditions That Look Like Herpes
Not every rash that looks like herpes is herpes. There are other infections that cause painful blistering rash. These include:
- Aphthous stomatitis: Also known as canker sores
- Dermatitis herpetiformis: An intensely itchy, blistering skin rash that affects people with celiac disease
- Herpangina: A viral illness caused by the Coxsackie virus that leads to mouth sores
- Herpes gladiatorum: A type of herpes virus common among athletes that is passed through skin-to-skin contact
- Herpes zoster: Also known as shingles
- Syphilis: A sexually transmitted disease that typically causes a single painless ulcer on the genitals or anus
How Herpes Is Treated
There is no cure for herpes, but there are antiviral drugs that may lessen the duration or severity of an outbreak. Antiviral drugs are those used to treat viral infections. As a rule, antiviral treatment is most effective when it is started at the first signs of an outbreak.
The treatment can vary by the location of the sores and other factors:
- Oral herpes can be treated with Zovirax , Famvir , or Valtrex . The antiviral medications are taken by mouth. The course of treatment can range from one to seven days.
- Genital herpes can be also be treated with Zovirax, Famvir, or Valtrex. In addition to tablets, acyclovir can be delivered by injection or applied to the sore as an ointment. Famvir and Valtrex are taken by mouth. The course of treatment varies by whether it is a first or subsequent outbreak.
You can help soothe a genital herpes outbreak by sitting in a warm bath. A cold compress placed against the rash for 10 to 15 minutes several times daily may also help.
Avoid eating spicy or acidic foods when you have a cold sore. You can also use over-the-counter topical anesthetics like lidocaine to numb the sore just be sure to wash your hands immediately after.
OTC pain killers like Tylenol or Advil can also help relieve pain for both oral and genital herpes.
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When To Seek Help For Herpes Symptoms
If your herpes symptoms are bothersome or youre worried about giving someone else the virus, see your doctor or another healthcare provider.
Antiviral medications can help make genital herpes sores go away faster, reduce the number of outbreaks, and lower the risk of transmission.
Consistent use of condoms and dental dams during sex also lowers but doesnt eliminate the risk of transmitting the virus.
Signs Of Genital Herpes
Genital herpes can be passed even if an outbreak isn’t occuring when infected cells cross from a carrier to a newly infected individual. The virus enters the blood stream and can remain dormant until it flares up, causing a group of open sores to appear on the skin. The open sores will eventually blister and heal over within a few weeks. Other symptoms include:
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Where Can I Get Tested For Herpes
To get a private herpes test, you can use a service that doesnt accept insurance so that no one else is notified that you were tested. This is up to you, since you can also have your doctor test you with a blood test or a swab. Be warned, though, that for swabs to be accurate they need to be done within 24-48 hours at most of a blister forming.
You can use this website for a 100% confidential STD test that you order online and then have done in a lab of your choice near you. The site says it will only take a few minutes to do so you can get peace of mind fast and privately.
Cold Sore Stages Symptoms And Treatment
If you suspect you have a cold sore developing, its best to be proactive to decrease the duration of your discomfort. While cold sores can be a little embarrassing, theyre absolutely common and there are lots of ways to limit a flare ups impact on your life. In this article, we demystify what a cold sore is, explain what causes cold sores, discuss common triggers that may cause a cold sore outbreak, the symptoms of a cold sore and how to treat them.
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How Is Herpes Transmitted
The source of herpes is not known. Many researchers believe that the virus is transmitted through sexual contact, and consider it a sexually transmitted disease. Herpes may be spread through contact with the blisters at any time that they are visible. Men may have blisters in their urethras, where they cannot be seen. They may be unaware of a mild attack and transmit the disease unwittingly.
How Is Herpes Meningoencephalitis Diagnosed
If, after reviewing your medical history and symptoms, your healthcare provider thinks you may have herpes meningoencephalitis, he or she will order various tests and exams to confirm the diagnosis. Other tests may include:
Neurological exam. Your provider will do a neurological exam to look for changes in motor and sensory function, vision, coordination and balance, mental status, and in mood or behavior.
Lumbar puncture. In this procedure, your provider will take a sample of spinal fluid. Cells and other substances in this fluid may give your provider important clues.
Imaging. Your provider may want to create images of your brain using a CT or MRI scan.
EEG. An EEG measures brain waves by placing electrodes onto your scalp.
Blood tests. Testing the blood helps identify infection.
If your healthcare providers think that a newborn has herpes encephalitis resulting from infection with HSV2 while passing through the birth canal, they may check samples of the baby’s blood and spinal fluid.
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