“Good” herpes virus, “bad” herpes virus: The Truth about HSV-1 and HSV-2

Many thanks to the American Social Health Association for this article.

How alike are HSV-1 and HSV-2? In this feature, we look at the latest scientific facts about the two types of herpes simplex virus, as well as social attitudes toward oral and genital herpes.

When many people first tell someone they have genital herpes, they start by comparing the herpes infection to oral herpes, or cold sores. How apt is the comparison? In spite of scientific facts, the herpes stigma and emotional attitudes surrounding genital herpes can make it hard to compare it objectively with an oral infection that most people casually accept. Following the unspoken assumptions of our society, many people still believe there is a “good” herpes virus (HSV-1, the usual cause of cold sores) and a “bad” herpes virus (HSV-2, the usual cause of genital herpes).

Many people still believe there is a “good” herpes virus (HSV-1, the usual cause of cold sores) and a “bad” herpes virus (HSV-2, the usual cause of genital herpes).

In this feature, we take a look at HSV-1 and HSV-2 to see how alike and different the two viral types really are. We asked leading researchers how the two compare in terms of severity, recurrences, and transmission rates. We asked how often each occurs outside its usual site of preference, and how each behaves in the genital area. We questioned how much immunity having one type orally or genitally provides against getting the second type.

In addition, we looked at the way our society views oral and genital herpes. What’s behind the very different images the two types carry? And what can we do about it? In an interview, counselors at the National Herpes Hotline suggest ways to help replace judgmental social assumptions with a healthy attitude.

Under a microscope, HSV-1 and HSV-2 are virtually identical, sharing approximately 50% of their DNA. Both types infect the body’s mucosal surfaces, usually the mouth or genitals, and then establish latency in the nervous system. For both types, at least two-thirds of infected people have no symptoms, or symptoms too mild to notice. However, both types can recur and spread even when no symptoms are present.

The primary difference between the two viral types is in where they typically establish latency in the body — their “site of preference.” HSV-1 usually establishes latency in the trigeminal ganglion, a collection of nerve cells near the ear. From there, it tends to recur on the lower lip or face. HSV-2 usually sets up residence in the sacral ganglion at the base of the spine. From there, it recurs in the genital area.

Even this difference is not absolute either type can reside in either or both parts of the body and infect oral and/or genital areas. Unfortunately, many people aren’t aware of this, which contributes both to the spread of type 1 and to the misperception that the two types are fundamentally different.

“People don’t understand that you can have type 1 genitally or orally, that the two types are essentially the same virus,’ says Marshall Clover, manager of the National Herpes Hotline.” One type is associated with stigma, the other is “just a cold sore” — our society has a euphemism for it so we don’t even have to acknowledge that it’s herpes.”

The common myth is that HSV-1 causes a mild infection that is occasionally bothersome, but never dangerous. The reality? HSV-1 is usually mild, especially when it infects the lips, face, or genitals. However, in some cases type 1 can recur spontaneously in the eye, causing ocular herpes, a potentially serious infection which can lead to blindness. In very rare cases, HSV- 1 can spread spontaneously to the brain, causing herpes encephalitis, a dangerous infection that can lead to death. HSV-1 is also the usual cause of herpes whitlow, an infection on the finger, and “wrestler’s herpes,” (herpes gladiatorum) a herpes infection on the chest or face.

The range and potential severity of HSV-1 infections lead some experts to view the virus as more risky than usually perceived. “This is heresy, but I think type 1 is a more significant infection than type 2,” says Spotswood Spruance, MD, an oral HSV specialist at the University of Utah. “Type 1, and the morbidity associated with it, are underestimated.”

By comparison, HSV-2 is widely believed to be a painful, dangerous infection that affects only people with very active sex lives. The reality? Some 16% of adult Americans from all backgrounds, income levels, and ethnic groups have HSV-2. Like HSV-1, type 2 is usually mild — so mild that 80% of infected people don’t even know they have it. Type 2 rarely causes complications or spreads to other parts of the body. It is the most common cause of neonatal herpes, a rare but dangerous infection in newborns; however, type 1 causes up to one-third of neonatal infections.

The two types do behave somewhat differently depending on whether they are residing in their site of preference-the mouth and face for HSV-1, and the genital area for HSV-2. But both types are quite common, and under most circumstances neither is a major health threat. That’s one reason medical professionals tend to dismiss HSV -2 despite the emotional trauma a diagnosis can cause for a patient.

While HSV can be a frustrating and painful condition for some people, in general the virus is less a medical problem than a social problem. For most of us, genital herpes is no more dangerous than a cold sore.

How Many Herpes Outbreaks?

Just how much of a physical problem HSV poses for a person depends largely on three factors. The first is how well the person’s immune system is able to control the infection.

Differences in immune response may be the main reason that some people are bothered by frequent cold sores or genital herpes outbreaks while others are not. It’s also the reason that both HSV-1 and 2 can pose serious challenges for infants, who have a limited immune response; and for people with compromised immune systems, including people with cancer, AIDS, severe burns, and people taking immunosuppressant medications.

The second factor affecting outbreaks is how long a person has had the infection. Over time, recurrences of both HSV- 1 and 2 tend to decrease, for reasons that aren’t entirely clear.

In the case of oral HSV-1, many of the approximately 100 million Americans who are infected acquired the virus when they were children. By the time they’re adults, only some 5% of people are bothered enough to consider oral HSV-1 a medical problem, according to Spruance.

On the other hand, almost all of the approximately 40 million Americans infected with HSV-2 acquired the virus as teenagers or adults. In the first year, those who have recurring outbreaks experience an average of four to six episodes. Over time, as with oral infections, the number of outbreaks usually drops off.

A third factor influencing the frequency of HSV-1 and 2 outbreaks is whether the virus is established in its site of preference. While HSV can infect both genital and oral areas, both types cause milder infections when they are away from “home” territory. Outside their site of preference, both type 1 and 2 lose most of their punch.

For example, most people infected with HSV-1 in the genital area have few, if any, outbreaks after the initial episode, far fewer than is typical with either oral HSV-1 or genital HSV-2. While experts estimate that some 30% of genital herpes infections in the United States may be caused by HSV-1, only 2- 5% of recurring genital outbreaks are caused by HSV-1. Research conducted by Lawrence Corey, MD, and colleagues at the University of Washington in Seattle shows that genital HSV-2 recurs 10 times more often than genital HSV-1.

According to a study by Wald et al. (New England Journal of Medicine, 1995), among 110 women with genital herpes, the average number of recurrences per year for those with genital HSV-1 was zero. Other studies have shown an average of about one outbreak per year (Benedetti, Annals of Internal Medicine, 1994).

Similarly, HSV-2 infection in theoral area-outside its site of preference-very rarely causes problems. First of all, oral, HSV-2 infections are rare, for reasons discussed below. But even when an infection occurs, recurrent outbreaks are uncommon. In one study (Lafferty et al., New England Journal of Medicine, 1987), oral HSV-2 recurred an average of 0.01 times a year in newly infected people. “I’ve never convincingly seen an oral type 2 recurrence,” says Spruance.

A possible fourth factor affecting recurrence rate is viral type. According to the Lafferty study, genital HSV-2 infections were the most frequently recurring herpes infections, followed by oral HSV-1, genital HSV-1, and last of all, oral HSV-2.

How Easily Does Herpes Spread?

As a number of readers have attested over the years, many people with genital herpes are at least as concerned about transmission-the likelihood of spreading the virus to a partner-as about their own health. On the other hand, few people with oral herpes, share this concern. Is this because one type is more contagious than the other?

The short answer is no. Both viral types are easily transmitted to their site of preference, and can also be spread to other sites. Both are most contagious during active outbreaks, but are often spread through viral shedding when there are no recognizable symptoms. According to Spruance, people with recurrent oral HSV-1 shed virus in their saliva about 5% of the time even when they show no symptoms. In the first year of infection, people with genital HSV-2 shed virus from the genital area about 6-10% of days when they show no symptoms, and less often over time. (Both of these figures reflect shedding as detected by viral culture.)

From here, however, the question of transmissibility gets more complicated. Acquisition of one type is more difficult-though certainly possible-if you already have the other type. This is because either type, contracted orally or genitally, causes the body to produce antibodies, some of which are active against both HSV-1 and 2. This acquired immune response gives some limited protection if the body encounters a second type. When a person with a prior HSV infection does contract the second type, the first episode tends to be less severe than when no prior antibodies are present.

On a practical level, this means oral HSV-1 is often the most easily acquired herpes infection. Usually the first herpes simplex virus that people encounter, oral HSV-1, is typically spread simply by the kind of social kiss that a relative gives a child. Because children have no prior infection with any HSV type, they have no immune defense against the virus.

By the time they’re teenagers or young adults, about 50% of Americans have HSV-1 antibodies in their blood. By the time they are over age 50, some 80-90% of Americans have HSV-1 antibodies.

By comparison, almost all HSV-2 is encountered after childhood, when people become sexually active. Those who have a prior infection with HSV-1 have an acquired immune response that lowers – though certainly doesn’t eliminate-the risk of acquiring HSV-2. According to one study (Mertz, Annals of Internal Medicine,1992), previous oral HSV-1 infection reduces the acquisition of subsequent HSV-2 infection by 40%.

A prior infection with oral HSV-1 lowers the risk of acquiring genital HSV-1 even further. Studies show that genital HSV-1 infections almost always occur in people who have no prior infection with HSV of either type (Corey, Annals of Internal Medicine, 1983).

In the absence of prior oral infection, however, HSV-1 spreads easily to the genital area, usually through oral sex. In some countries, such as Japan and parts of Great Britain, genital HSV-1 is as common as genital HSV- 2, or more common.

“Prevalence rates of genital HSV-1 differ based on the practice of oral sex and on the percentage of people who are HSV-1 positive from childhood,” explains Anna Wald, MD researcher at the University of Washington at Seattle.

Finally, the question of immunity and HSV types is complicated by an additional issue. Some studies suggest that the ganglia themselves may acquire some immunity to HSV after they are exposed to one viral type.

In the laboratory, infection of ganglia with more than one virus is difficult, suggesting that it may be more difficult to acquire a second HSV type in a location where you already have HSV. A prior genital infection with HSV-1, for example, may give more protection against genital HSV-2 than a prior oral infection with HSV-1.

What does all this mean on a practical level? Let’s look at some examples to find out. Say you have genital HSV-1 and your partner has genital HSV-2. If you have unprotected sex, there is a small but real risk that you will get HSV-2, resulting in more outbreaks and more shedding. “We have documented cases where a person acquires HSV-2 after a prior genital HSV- 1 infection,” says Wald. “I don’t think it happens often, but it does happen.”

On the other hand, it’s very unlikely that your partner will get genital HSV- 1 from you. “I’ve never seen a case of a person acquiring HSV-1 on top of HSV-2,” says Wald. “It’s possible, but it would be unusual.”

What if your partner has genital HSV-2 and you perform oral sex on him or her? Will you get HSV- 2 in the mouth? Given the widespread practice of oral sex (some three-quarters of all adults practice it, according to The Social Organization of Sexuality, 1994) and the prevalence of genital HSV-2 infection, you might expect oral HSV-2 to be relatively common. It’s not.

According to one study, almost 100% of recognizable HSV-2 infection is genital (Nahmias, Scandinavian Journal of Infectious Diseases Supplement, 1990). One reason is that most adults are already infected with HSV-1 orally, which provides some immunity against infection with HSV 2. Another reason is that oral HSV-2 rarely reactivates, so even if an infection does exist, no one knows.

So far we’ve been talking about transmission of HSV-1 or 2 from its site of preference. What about transmission from another site? Say you acquire genital HSV-1 through oral sex. Can you spread the virus to a partner through genital sex?

The answer is yes, but probably not as easily as it was spread through oral sex. The main reason is that the virus reactivates and sheds less often outside its site of preference. Only about one quarter of people with genital HSV- 1 shed virus at all in the absence of symptoms, while 55% of people with HSV-2 do (Wald, New England Journal of Medicine, 1995). “Shedding data appear to parallel recurrence data, meaning that people who have a lot of recurrences also have a lot of shedding,” says Wald.

While HSV- 1 can be spread from genitals to genitals, “we think it is spread more easily through oral sex because HSV-1 reactivates more frequently in the oral area,” says Wald. However, she warns, “transmission of genital HSV-1 during asymptomatic shedding has been documented.” In other words, genital HSV-1 can be spread through genital sex, even when there are no symptoms. “Good” Virus/ “Bad” Virus

If HSV infection is as easily transmitted from the mouth as from the genitals, then why do people take steps to prevent genital but not oral infection? Why don’t we kiss through dental dams ?

“It’s ironic, isn’t it?” says Wald. “It’s not about health, it’s about social acceptability.”

Scientists can tell us all day that the main difference between the two viral types is simply their site of preference-whether they typically occur above the waist or below. But the unspoken attitudes of our society send a different message. That’s just the problem, social attitudes whisper. Below the waist is bad.

“People think of oral herpes as the “good” herpes and genital herpes as the “bad” kind,” says Glover of the National Herpes Hotline. “It’s partly that they don’t understand the similarities between HSV-1 and 2. But it’s also that good and bad is how our culture views sex and our bodies.”

The inescapable fact is that HSV-1 is usually spread through contact with infected lips, while HSV-2 usually spread through contact with infected genitals. From a social point of view, the problem is not the disease; it’s how you got it.

Whether we like it or not, the social prejudice against genital herpes, no matter which virus causes it, is a reality. “People have more trouble explaining to a new partner that they have genital herpes, even if it’s HSV- 1, than if they have a cold sore,” says Glover. “Just saying the word “genital” is like an anvil that pulls the sentence down”.

Is this topic making you crazy? For people who have trouble dealing with social attitudes toward genital herpes, the blatant double standard society applies to oral herpes can be frustrating, to say the least.

“Talk to a wise friend,” suggests Rebecca, a health communication specialist on the National Herpes Hotline. “Join a support group. Find Someone you respect and exchange ideas them. It’s always reassuring to see that not everyone lives inside the walls our society builds around sexual issues and realities. ”

It’s also worth hoping that new research on the similarities between HSV-1 and 2, as well as increased public education about genital herpes, can help lower the level of misunderstanding about both types of the virus. Today, the greatest difference between HSV- 1 and 2 appears to be the way we think about them. Tomorrow, that may change …

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Trigger to the Gun: Truth About Genital Herpes Outbreak

As our society becomes more modern, people have also become bolder. While there might still be disputes about how common genital herpes has become, the fact that a lot of people are suffering from it can't be denied. However, if truth be told, it is not exactly the virus that people are suffering from but the outbreaks.

Are you one of those people enduring the pain brought by genital herpes outbreak? Have you been searching for a more permanent solution to this lifelong malady? There is currently no permanent cure discovered for genital herpes, though there are medication-creams, tablets, and pills-formulated to suppress and perhaps eliminate the outbreaks. The only problem is that these medications are not universal. This means they are proven to work for some but are known to produce minimal to no effect in others.

"Why?"

This is because these medications do not address some of the crucial factors that trigger genital herpes outbreak. The best alternative is a natural method that familiarizes you with the real triggers of the outbreaks, which, in turn, allows you to avoid them. If you can avoid the triggers, then you can avoid the outbreaks. So, what is this natural herpes treatment we are talking about?

Understanding Genital Herpes

Before we take a closer look at the best alternative to genital herpes treatment today, let us first discuss the real triggers of genital herpes outbreak that you are probably not aware of...

Stress

Stress is such a natural occurrence and such a common word that it is something we tend to ignore. However, continuously being under stress can result not only to a tired and weak body but also frequent outbreaks. Yes, you read that right. If you are working relentlessly, if you are facing so many challenges, and if you are beating yourself to make ends meet, your body gets weaker, your immune system starts to fail you, and that's when the genital herpes virus take the opportunity to surface and cause outbreaks-an effect you will probably find more depressing.

Unhealthy Diet

As earlier mentioned, a weak body is more prone to genital herpes outbreak. That said, it's important for you consume a balanced diet of meat, vegetables, and fruits. As much as possible, though, you should avoid food are high in sugar as it is known to weaken the immune. It is also crucial to avoid intake of alcohol as it contains refined sugar and can lead to colon diseases if taken regularly and in heavy amounts. It is best to increase your water intake instead.

Menstrual Period

Females suffering from genital herpes outbreak need to be more careful when it comes to their menstrual periods, especially the seven days before the first day of cycle. This is because it's a time when the immune system is weak, as the body prepares to lose blood. The fact that hormones are not balanced during such times makes women even more vulnerable to outbreaks. Genital herpes outbreak before menstrual cycles brings not only irritation but also additional pain, especially in the pelvic region.

Natural Genital Herpes Treatments

Now that you are familiar with some of the triggers of outbreak, which most people tend to ignore, we can now better understand the alternative genital herpes solutions that are found to be easier to follow and, even better, friendlier to our pockets. These solutions are meditation, hypnosis, and neuro-linguistic programming (NLP).

You are probably asking "How can these treatments be more effective than tested and recommended medications?"

Wonders of Meditation, Hypnosis, and NLP

While proven herpes medications can really be helpful, they only focus on suppressing the virus-they ignore other factors that greatly affect the frequency of outbreaks. Through meditation, hypnosis, and NLP, you will be able to be more in tune with your body, so to say.

By relaxing your body and mind, you can easily reduce or eliminate stress, regardless of your circumstances. This takes out the number one trigger of genital herpes outbreak. On the other hand, by discovering the right food to eat and by knowing the natural ways to combat the herpes simplex virus, your body will feel better. This provides the solution to the second trigger. The third trigger, menstrual period, can't be completely eliminated as it is a natural occurrence in women. However, if you maintain a healthy diet, learn how to relax your mind and body, and retain a composed mental and hormone balance state during this period, you can highly reduce the risks of getting outbreaks.

Getting the freedom you desire from herpes can be achieved with ease. By understanding the triggers of herpes and learning the methods to avoid those triggers, you will find that the solution to herpes is actually easier than you first thought. The Solution to Herpes is exactly the program that can help you accomplish that. It has already helped and is continuously helping a lot of herpes patients. It is just waiting for you to discover the wonderful benefits of meditation, hypnosis, and neuro-linguistic programming.

There is nothing to lose when you choose to learn more about this program, so why don't you give it a try? Visit The Solution to Herpes, and you might just find the solution you have been looking for.

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The Truth About Herpes Virus and Its Treatment

What could be the solution to suppressing Herpes forever? Well, that would have been a tough question years ago, especially for some who have personally experience the pain, the itch and the tingling sensation. If you have been suffering from Herpes outbreaks for quite some time now, then worry no more! A relatively new and effective Herpes treatment has been developed.

You probably have an idea what herpes is all about. It is a sexually transmitted disease common to adults; and usually, people who are carrying the herpes virus do not have the idea they have it or maybe they are most likely in denial that they were already infected with the herpes virus. Symptoms include itching in the genital area, redness, pain in the legs and groin followed by small cracks in the skin and tiny sores.

Once you are infected by the herpes virus it never goes away, that is the truth. It then stays in your nerves and there is no way that you can destroy it completely and be permanently cured. Traditional medication can also help such as pain relievers and other anti viral medications but that's just it; virus outbreak may still occur from time to time. What is more interesting to know is that, there is this all natural herpes treatment that can help you eliminate further herpes virus outbreak; an alternative treatment which will help you free from the herpes outbreak recurrence.

This all natural way of suppressing future herpes outbreaks involves NLP approach or Neuro-Linguistic Programming, meditation and hypnosis. These programs ensure that the virus will no longer activate and will remain dormant forever. It also gives a positive result by keeping yourself free from negative emotions which are common factors that weaken our immune system. Our immune system is our body's natural defense against harmful bacteria; it prevents us from becoming susceptible to diseases and infections. These alternative methods of herpes treatment do not only help you ease the pain and irritation but lets you live a healthy life.

This must be the reason why some people who are carrying the herpes virus do not have the idea that they were already infected by the virus because they do not experience outbreaks. The reason behind is that, they have a strong immune system that helps fight back virus that attacks the body to prevent the outbreak to occur.

However, this may sound interesting, this does not mean you are permanently free of the herpes virus, and will prevent you from passing this disease to other people in case there is a skin contact. The above mentioned programs teach you various techniques to suppress the virus so you feel free and as if you don't have it any more. These all-natural treatments for herpes will not only stop you from experiencing outbreak; these will also lead you to a healthy lifestyle and a positive outlook in life. No expensive prescribed medication with horrible side effects needed. This is all about you!

If you are interested to know more about how an alternative herpes treatment works, why not try some Herpes Treatment Program and find out what difference it can do to you!

Irene is a freelance article writer who wants to help business entrepreneur find their place in the world of online business.

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The Truth About Genital Herpes

Genital Herpes is a misunderstood illness, and I hope to dispel some myths with the publication of this article. Perhaps the first thing to note is that the majority of people are infected with one strain of herpes - HSV 1, also known as the common cold sore! Of course it has less of a stigma attached, so let's look at the facts about genital herpes:

What symptoms does genital herpes carry?

The trouble with herpes is that in many people, the symptoms are so mild that they may pass unnoticed. This is good on one level as it won't affect your life, but on the other hand, you're at risk of passing the HSV 2 virus onto another unawares, who may suffer far more discomfort than you.

If symptoms do appear, They tend to appear periodically in "episodes" (or "outbreaks"). As for when, again it varies from person to person. It may be days after contracting the virus, it could be months to years. When it first strikes, the sufferer typically feels flu-like symptoms - fever, headaches and pains in the back and leg. The good news is that these symptoms usually are only present in the first outbreak of HSV 2.

From then on, most genital herpes episodes produce small blisters which then break to form painful shallow sores. After 1-2 weeks, these scab over and then heal. Often the first outbreak is significantly more uncomfortable than future episodes.

If you're thinking this sounds like a cold sore, but for the genitals, you're right. Although HSV 1 (cold sores) is not the same as HSV 2, the symptoms are similar enough for you to think of genital herpes as a cold sore that forms around the genitals, anus, buttocks and thighs. And like cold sores, the virus stays in the body once the genital herpes symptoms have vanished, and can cause recurrent outbreaks at any time.

Are recurrent outbreaks linked to any behaviour?

Yes and no. Triggers for outbreaks of genital herpes can be linked to sex, menstruation, general illness or stress, but often you'll see no explanation and an episode appears without a trigger.

It's important to note that recurrent attacks are caused by the dormant virus in the body and not by re-infection. In most causes the repeat episodes become less frequent over time, and some sufferers can look forward to a time when the attacks stop altogether.

How is HSV 2 spread?

The HSV 2 virus is spread through skin to skin contact, which means sexual contact is largely the cause. Remember that as many people show few to no symptoms, it's possible to pass on the virus to someone even if the sufferer shows no symptoms.

How do I prevent transmission?

There's no sure-fire way to prevent transmission, because it can be passed with no obvious sores, but there are ways of minimising the risk. The first is to avoid having any kind of sexual contact with someone immediately before or during an outbreak of genital herpes. Condoms will stop transmission across the area covered, but of course they only cover the penis, so if sores are elsewhere transmission can still occur.

There are a number of dating sites set up to match singles with genital herpes - of course, people cannot be reinfected, so sufferers having sexual contact with each other are not at risk from the disease!

I think I have it - what's does the test for herpes involve?

The herpes test involves taking a sample from the area of the body infected during an outbreak. The HSV 2 virus will usually grow in a swab taken from a open blister. It can then be determined which type - HSV 1 or 2 - you have. HSV 1 is rarer in a genital infection.

The other herpes test is taken via a blood sample. The advantage of this is that you don't need to be having an outbreak to take the test, but it has downsides too. It can't tell you which part of the body is infected (lips or genitals), it can't tell you whether you are likely to display symptoms or not and if can't reveal if general symptoms you've had are down to the HSV virus. Consult your doctor to discuss which herpes test is for you.

Is there a risk of transmission through childbirth?

Pregnant women with genital herpes may pass the virus onto their baby during delivery causing serious illness. This thankfully isn't common, but the medical staff should be told if you carry the virus so that risk of complications can be minimised.

Is there a cure for genital herpes?

Sadly there is no cure for HSV 2, and once the virus is in the body it is there for life. There are ways of managing the symptoms though, thankfully. Iodine paint will dry out the blisters and help prevent secondary infection, while salt baths are good at relieving discomfort.

Anti-viral medication can also be prescribed, and this will help reduce the severity of an outbreak If taken early enough (within 3 days of the symptoms appearing is best). For the unlucky few who suffer from regular outbreaks, some antiviral drugs including aciclovir, famciclovir and valaciclovir can be taken continuously. This will stop most outbreaks from occurring allowing minimal disruption.

Genital herpes has a very bad reputation, but as STDs go, it's actually comparatively harmless and certainly is no bar to living a full, happy and sexually fulfilled life. If in doubt, get a herpes test - you have very little to worry about even if you are infected!

Tim Leach is the Marketing Manager of USA Lab Testing, providers of local Herpes tests.