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What you need to know about the herpes virus

If you don't have a herpes virus living somewhere in your body, you're the exception. This is one busy bug. About 150 million North Americans age 12 and older are infected with herpes simplex virus type 1 (HSV-1), the most common member of this large extended family. HSV-1 alone infects about 90 per cent of people by age 70.

You don't necessarily have to feel sick or have eruptions of sores to be infected. It's highly contagious from contact with an infected person, but you may not know you have the infection, so you may not know that you're capable of infecting someone else. Indeed, you can spread this virus even when no signs of infection are present, by a painless process known as asymptomatic viral shedding.

Herpes can cause infections mild enough to not notice, to ones that could be potentially life-threatening. It may strike once and then lie dormant in your system for decades. Or it can give frequent repeat performances off and on for years. Although the virus may linger in your body forever, medications and self-help strategies can help you co-exist comfortably with this unwanted visitor. Here's a rundown of some common infections in which herpes is the culprit, the symptoms you may experience and what's needed to help you feel better. Cold sores Also known as fever blisters, these painful sores usually appear on your lips and are most often caused by HSV-1. However, cold sores can also be caused by herpes simplex virus type 2 (HSV-2), the form that typically causes genital herpes. They're usually transmitted from person to person by saliva or direct contact. Fever, menstruation, stress and exposure to the sun may trigger an outbreak.

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Signs and symptoms: Small, fluid-filled blisters appear on your lip. The skin beneath is raised, red and painful. The blisters eventually break and ooze. Then a yellow crust forms and finally sloughs off. Duration is a week to 10 days.

Treatments: Over-the-counter creams and pain relievers such as aspirin, ibuprofen (Advil, Motrin) or acetaminophen (Tylenol, generics) can be helpful. Or you can try applying ice to help relieve pain.

Cold sores will clear up on their own, but for frequent outbreaks, your doctor may recommend antiviral medications such as acyclovir (Zovirax), which is available in both pill and ointment form, oral drugs such as famciclovir (Famvir) and valacyclovir (Valtrex), or the ointment penciclovir (Denavir).

Prevention: You can spread the virus as long as there are moist secretions coming from the blister. So don't kiss anyone and don't touch other parts of your body, especially your eyes and genital area, if you've touched the cold sore. Genital herpes Genital herpes is an infection much like fever blisters, only the sores appear in your genital area. It's almost always caused by HSV-2, although HSV-1 can cause the infection, too. Most people get genital herpes by having sex with someone who's having an outbreak. The problem is that you can pass on the virus and have no visible sores.

Signs and symptoms: Sores go through the same painful phases as fever blisters. You may have sores on your vagina, external genitals, buttocks, anus or cervix. With your first episode of genital herpes, you may have painful urination, discharge of fluid from your vagina, and you may develop flu-like symptoms such as aches and fevers.

It may take two to three weeks before your symptoms are gone. Recurrences of the infection, which may happen up to several times a year or more, are usually milder and last only about a week.

Treatments: If you're prone to frequent recurrences, antiviral medications -- like those used for cold sores -- taken every day can help suppress future outbreaks. If recurrences are infrequent, you can take these medications only when you start to get a sore. They help reduce pain and speed healing.

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Prevention: Use a latex condom during sexual contact. Avoid sexual contact when you have sores, scabs or itchiness. Always wash your hands after touching your genital area, even if sores aren't present. Herpes simplex keratitis Herpes simplex keratitis is an infection in the tissues of your eye. It causes inflammation of the white of the eye and can damage the cornea. The infection can compromise vision due to scarring, especially with repeated, untreated infections. You can get herpes keratitis by touching your eye after you've touched a cold sore or a genital herpes sore.

Signs and symptoms: You may experience tearing, light sensitivity and blurred vision.

Treatments: Topical antiviral medications are usually given. Your eye usually starts to feel better in two to four days, and complete healing occurs in most people within 2 weeks. Recurrences aren't uncommon.

Prevention: Wash your hands frequently and thoroughly whether you have obvious sores or not. Herpetic whitlow Herpetic whitlow is a painful infection of the fingertip caused by the herpes simplex virus. Dentists and health-care workers were especially vulnerable to this infection before the routine use of latex gloves. But anyone is susceptible.

The virus can enter through a damaged cuticle that has come into contact with the virus, usually from touching a herpes sore elsewhere on your body or on someone else's.

Signs and symptoms: You may experience redness, swelling and fluid-filled blisters on your infected finger.

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Treatments: Antiviral medications are typically used. These may not shorten the duration of the infection, but they reduce viral shedding and the likelihood of infecting another person. The sores usually heal in about seven to 10 days, but it may take as long as a month before your finger looks normal.

Prevention: If you know your finger has been exposed to the herpes virus, you may be able to stop herpetic whitlow from developing by taking an oral antiviral medication as soon as possible after contact and for a week afterward. But your best bet is to keep your fingers away from herpes sores and to wash your hands thoroughly after contact with a sore. Shingles (herpes zoster) The same herpes virus that causes chickenpox also causes shingles. When you have chickenpox as a child, some of the virus may remain in your body where it lies dormant inside nerve cells near your spinal cord and brain. Decades later, usually when you're past 50, the virus may become reactivated due to aging, stress or illness. When reactivated, the virus travels along sensory nerve fibres that extend to your skin and you break out in a painful red rash.

Signs and symptoms: The rash usually occurs as a band of blisters on your trunk that wraps around from your back to your chest or abdomen on one side of your body. The blisters, which resemble chickenpox, form scabs after two to three weeks and heal within a month.

Treatments: Shingles will heal with no treatment. But if you catch it early -- within three days of developing the rash -- you can take an oral antiviral medication, which may shorten the duration of the infection and help prevent postherpetic neuralgia, a complication that causes your skin to remain sensitive and painful for months or years. You can also take over-the-counter pain medications.

Prevention: The vaccine that prevents chickenpox is being studied as a means of preventing shingles in older people. Since shingles blisters carry the chickenpox virus, avoid contact with anyone who hasn't had chickenpox. You're not contagious once they scab over. Know the facts What you don't know about herpes can hurt you and others you may come in contact with. Knowing the facts about transmission and taking proper precautions can prevent you from being an unwitting Typhoid Mary.

Reprinted from Mayo Clinic Women's HealthSource. Visit the clinic's Web site at

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