The 8 Herpes Secrets for Living Completely Outbreak Free

Transcription

1 The 8 Herpes Secrets for Living Completely Outbreak Free Updated Edition - Revised April 2008 Real Ways you Can Prevent Herpes Outbreaks and Start Living Your Life Again

2 Table of Contents Introduction Section One: What Causes Herpes? A Brief History of Herpes What is a Virus? The Herpes Family How does the virus work? What happens to your body during an outbreak? Growth Cycle of the Virus Chapter Review Section Two: Testing for Herpes Noticing the symptoms Available Tests for Herpes Types of Tests How to Prepare How is the Test Performed? Results Emotional side of genital herpes Emotional Side of Oral Herpes More about testing Chapter Review Section Three: Prevention of spreading the herpes virus Mother to baby Steps you can take Spreading Herpes to Yourself When is herpes most likely to be spread? Avoid spreading oral herpes Avoid spreading genital herpes What about public places? Can I get herpes through sperm? Chapter Review Section Four: Genital Herpes and Oral Herpes explained Genital Herpes Signs and symptoms of genital herpes Oral Herpes Signs and symptoms Phases of HSV Asymptomatic Warning Phase Early Redness Vesicles

3 Wet Ulcers Dry Crust Healed Other Questions Answered Chapter Review Section Five: Herpes and Stress How does stress affect herpes? Proven ways to reduce stress Beat Anger Stress Relieving Steps Get enough sleep Support Groups Chapter Review Section Six: The Importance of Diet & Nutrition with Exercise How does nutrition affect herpes? What is a healthy diet for someone with herpes virus? What foods are good for you? What foods are bad for you? What can you do at home nutrition wise to help? What herbs help suppress herpes outbreaks? What vitamins can help reduce outbreaks? How does exercise help? How to get daily exercise Importance of the Immune System Chapter Review Section Seven: Herpes Treatments Medications for herpes treatment Treatment without prescription medication Is there a cure for herpes? What are the treatments for herpes? Treating herpes naturally Can you spread herpes to others while being treated? What is being done to find a cure or vaccine for herpes? Chapter Review Section Eight: Herpes and the immune system What is the immune system? How does the immune system work? Blood cells Building a strong immune system How does herpes affect the immune system? How can vitamins help? Great Immune Boosters! Herbs for a healthy immune system

4 Get moving! Air purifiers Chapter Review Conclusions Recommended Herpes Resources.Page

5 Introduction Herpes What comes to mind when you hear that word? What do you think about? What images does it produce in your mind? What emotions does it stir up within you? What do you know about this disease? Do you have it? What about someone close to you? You might be surprised at the answers What is herpes simplex virus? Chances are you have probably heard of herpes before (especially if you ve chosen this book). You might have seen advertisements for herpes treatments on the television or in magazines or maybe you know someone who has it. In fact, growing media coverage is part of a global plan to inform more people about this virus and how it works. 80 Million people in the United States alone are believed to have this virus and there are many more in other parts of the world. You might have it yourself and not even know it. Or maybe you have been diagnosed with herpes already and you are struggling and fighting a daily battle with the virus. It can be devastating to find out you have herpes. It can truly be a life-changing event and many people have mixed feelings about it and what they should do. You might not know what to do or where to go. It s hard sometimes to know where to get the answers to questions such as these

6 You wonder how this will affect the rest of your life and what can be done to treat it. Maybe someone you love has been diagnosed with herpes and you are wondering how it will affect them and also how it will affect you if you have a relationship with them. You might not even be aware of how many people out there actually have some form of the herpes virus. These are all very common questions and concerns for you if you have been diagnosed with herpes whether it was recently or years ago. It s important that you take the time to learn all you can about this virus, how it affects you and what you can do about it. The more you learn, the better able you will be to fight the virus. There are also different types of herpes that have different symptoms and affect different parts of your body. Also, the very same type of herpes virus can cause different responses in different people who are infected with it. The biggest problem with herpes is misinformation. People are unsure of what it really is and how it spreads even though it has been around for a very long time. This misinformation leads to the condition spreading more and more and people not getting treatment they need and deserve. Another problem with information about herpes is that for so long people were afraid to talk about it. Even today, it is not as commonly discussed as you may think, even though millions of people all over the world have the virus. However, you don t have to suffer in silence. You owe it to yourself to learn more about the herpes simplex virus, whether you or someone you know has been diagnosed with it or not. It s very

7 important that everyone become aware of it and the signs, symptoms, treatment and more. You need to know that you can live outbreak free and that you can enjoy a happy and healthy life with the herpes virus. I even have a friend that has gone almost 10 years without an outbreak or recurrence! So while there might not be a definite cure at this time, with proper lifestyle changes and maintenance, you can control your herpes instead of it controlling you! But it s not just about being outbreak free. If you have herpes, you need to know that you are not alone. There are millions of people out there living with the virus. There is also a wealth of information to be obtained about this disease and how it is treated. Studies are being conducted every day and people are learning new ways to treat the virus and reduce the symptoms that come with it. There is an emotional and psychological side to the virus as well and there are support groups out there to help you. You can meet other people living with the herpes simplex virus and share stories and companionship and also learn how they cope with the virus on a daily basis. You don t have to go through this alone. Twenty-some years ago, people were contracting the herpes virus and spreading it to partners and many of them had no idea they even had the virus. Some went to doctors that misdiagnosed it or failed to recognize the symptoms. Some just ignored the problem,

8 hoping it would go away. Few people knew about the disease and even fewer about how it reacts in the body, how it can be treated and how it was spread. All of this misinformation led to it being spread more rapidly to more people and also for more people suffering because they don t know how to make it better. That is simply not true today. While it still remains a taboo topic sometimes, there is a lot more information available about this virus. Scientists understand how it works and how it affects the body. Doctors are better able to test for it, recognize it and treat it. Breakthroughs in the medical field are coming every day and there is hope in the future for herpes sufferers. There is still a long way to go and still a lot to learn about the virus but even with what is known now, you can get your herpes under control. You can learn how to live outbreak free and we want to help you with that! We are going to give you some great information and facts on herpes that you probably didn t know before as well as some valuable secrets on how you can live outbreak free. Congratulations on getting this book and taking the first step to becoming outbreak free. I have taken the time here not only to give you the facts on herpes simplex virus but also to answer some of the most commonly asked questions about herpes. We ve asked for feedback and we asked for questions from people just like you and now I m going to give you the answers here in this book. We re going to tell you what contributes to outbreaks and

9 how your lifestyle, diet and exercise can help reduce or even eliminate outbreaks and much more. Herpes doesn t have to control your life and here in this book I am going to give you the eight secrets to living completely outbreak free!

10 Section One: What Causes Herpes? Before you can understand how to prevent herpes outbreaks, you need to actually understand what herpes is and how it is contracted. The first step to living completely outbreak free is to learn all you can about your herpes and how it works. There is actually a lot of misinformation about herpes and how it works as well as what causes it and how it is spread from one person to another. Even though there are millions of people in the United States alone, not to mention people all over the world that have this virus, there are not many people that know that much about it. I hope to be able to help clear some of that up for you here in this section. So, what exactly is herpes? Herpes is defined as a contagious infection that is caused by the herpes simplex virus. There are two common types of the virus; herpes simplex virus type 1 (HSV1) and herpes simplex virus type 2 (HSV2). Type one is commonly known as herpes of the mouth because it causes cold sores (fever blisters) around the mouth and lips and inside the mouth. Herpes type 2 is most commonly referred to as genital herpes, an STD (sexually transmitted disease). It is estimated that

11 50% to 80% of adults in the United States have HSV-1 and 20% have HSV-2. Technically, both types can occur in either place of the body and in rare cases, even in different parts of the body so it s important to know they are not restricted to the specific area mentioned. This is simply where you most commonly find that type. How do you get herpes? Herpes can be spread from person to person through direct contact. HSV1 can be spread through kissing, sharing drinks and eating utensils and other items that come into contact with the sores. HSV2 is spread through intimate sexual contact with someone who is infected with the virus. A mother with genital herpes can spread it to her baby if she delivers vaginally while she has an active outbreak. Another thing you need to understand is that both types can cause outbreaks on both the genitals and the mouth. This means, you can have Type 2 on your mouth (possibly from oral sex) and you can have Type 1 in your genitals as well. Both types act very much the same way and are very similar. They are also similar in the way they are diagnosed and treated. Certain tests can determine which of the types you have if this is a concern

12 Is herpes hereditary? We will talk more in the coming sections about how herpes is contracted and spread but this is a common question. Herpes is not hereditary and you can not get it by having a parent that has it. It is not passed down through the blood from mother to child. Parents can not give it to their children unless they have direct skin to skin contact while infected. (Sometimes cold sores can be passed by sharing glasses, utensils, etc.) Congenital herpes happens when a mother with an active outbreak gives birth vaginally to a newborn baby that contracts it. If the baby is delivered via C-section, this does not occur as the virus is not in the mother s blood and can not be transferred any other way except direct contact with the lesions. Again, we will talk more about this later. Herpes can also not be spread through the air the way other viruses such as the flu is. You can t catch it just from touching someone who has it, shaking hands or being breathed on. It is also not spread through saliva, etc. However, the virus can be a bit tricky in how it is spread since people can have it and not show any symptoms yet still be a carrier and spread it to others. So what else do we know about the incurable virus called herpes? How long has it been around? What is being done to treat it? What happens to people infected with it? Let s begin with a brief history of herpes and what it is

13 A Brief History of Herpes Herpes is not some new phenomenon. In fact, the term herpes is over 25 centuries old. It goes back to Ancient Greek times. It means to creep and was so named by Hippocrates, the father of medicine. In those days, diseases were always classified and named according to how they looked or what they did to the body. While we were not very close to understanding how it works back then, doctors did have a general idea of what it did to the body and there is evidence that it has been around for a very, very long time in human history. In fact, it is even believed that Shakespeare was familiar with the herpes simplex lesions and how they are transmitted. This evidence comes from a part in Romeo and Juliet where he writes Queen Mab to say "O'er ladies lips, who straight on kisses dream, which oft the angry Mab with blisters plagues, because their breaths with sweetmeats tainted are." So history shows that some form of herpes has been around for a long time. Regardless of all this evidence, it was not until 1893 when Vidal recognized that human transmission of herpes simplex infection from one individual to another exists. Before this discovery, we didn t know much else about the condition or how to treat or prevent it. During the twentieth century, HSV research really took off. Histopathologic studies characterized the multinucleated giant cells associated with herpes virus infection

14 In 1919, Lowenstein confirmed experimentally the infectious nature of HSV that Shakespeare had only suspected back in his day. This was a breakthrough in the disease and how it is spread from one person to another. In the 1920's and 1930's, the history of HSV was widely studied and it was found that HSV not only infects the skin, but also the central nervous system. By the 1940's and 1950's, research continued on the many diseases caused by HSV. More recent research has focused on antiviral research, differences between HSV strains, and using HSV vectors for use in vaccines to help prevent the disease and find a cure. Varicella-Zoster Virus (chickenpox) also has a long recorded history. However, historical accounts often fail to distinguish between the poc marks caused by VZV and those caused by small pox. In the late eighteenth century, Heberden established a way to clinically make a distinction between the two diseases. In 1888, it was suggested by von Bokay that chickenpox and herpes zoster were due to the same type of virus or agent. It was not until Weller and Stoddard isolated viruses from both chickenpox and zoster and compared the viruses that this connection was confirmed. Chickenpox and herpes zoster are indeed due to the same virus! However, medicine s understanding of herpes has continued to come a long way since those early beginnings. We now know that herpes is caused by what is called a filterable virus. This means the virus is so small that a particle could pass through a paper filter without being discovered by a microscope

15 And yet, these filterable viruses are known for causing a great many diseases and conditions such as polio, hepatitis, influenza, rhinovirus (the common cold) and the various herpes viruses. What is a Virus? So now you know that herpes is a virus. It is not genetic and it is not caused by bacteria or in the ways that cancers and similar conditions are caused. Do you know what a virus really is? Do you understand how they work within the body? It s important that you do if you hope to understand how and why herpes acts the way it does in the human body and how you can work to prevent outbreaks. A virus is actually a very small living thing. Viruses are defined as parasites of cells, which mean they attack the cells of your body and this is how they thrive. You likely know that your entire body is made up of cells and each cell has a different function. Different viruses affect different cells and have a different affect and outcome on the body. The whole purpose of a virus is to continue to reproduce itself. It can t live on its own and it depends on DNA or RNA to continue to replicate itself. The virus is a parasite so it has to latch on to a cell in your body to be able to live and reproduce itself. This is how the family of herpes viruses acts. The different viruses will attack different cells of your body (also depending on where you received your initial

16 infection). They will attack that particular part of the body at the cellular level. The herpes virus can lie dormant in your nerves for a period of time and when it becomes active again, will travel down the nerve and to the skin usually in the same location as the original infection and cause you to have a re-episode of your symptoms. Did you know that there are different types of herpes viruses? They are all still part of the herpes family of viruses as they are similar but they cause different reactions in the body. The Herpes Family Many people do not realize how many different types of herpes there are in the herpes family and they don t realize the certain common diseases are caused by a herpes virus (such as chicken pox). There are actually 5 different types of herpes viruses in the herpes family. The term herpes has become common when referring to the HSV1 and 2 types. The focus of this book is on those types but it s good to know the other types that are in the same family so you can understand the virus and also understand why some studies say there is an estimated 90% of the population with some form of herpes virus

17 1. Herpes Simplex Virus Type 1 and 2: You know these to be the most common types that cause outbreaks on the mouth and/or genitalia. 2. Herpes Zoster (Varicella zoster): This is the herpes virus type that causes chickenpox and shingles. 3. Epstein-Barr virus: Causes mononucleosis, the kissing disease 4. Cytomegalovirus: Fairly new discovery in the herpes family. Can also cause mono and can cause hepatitis and problems in newborns. Can be transmitted sexually. 5. Human herpes virus Type 6: Causes Roseola (a viral infection that causes skin rash and fever in small children, usually below the age of three). There has also been a type 7 that is linked with this one. Studies on each of these different types and strains of the herpes virus can help progress toward better treatments and eventually a cure of HSV1 and 2. Already there is a vaccine against chicken pox and there is hope that there will one day also be one for other viruses in the herpes family

18 How does the virus work? Before you can ever hope to understand how to live herpes free, you need to understand how the virus works and what it is actually doing in your body. You need to understand what happens when you become infected and what happens each time you have an outbreak or recurrence. This will help you better understand how certain treatments work and how things like your diet and exercise can help reduce the recurrence of outbreaks if you have herpes. Now that you know that herpes is caused by a virus, do you understand how the virus works in your body? Do you know why there is no cure for herpes? This is one of the most misunderstood viruses known to affect humans and also one of the most common. Herpes simplex virus is in the same family of virus that causes chicken pox, mononucleosis and shingles (herpes zoster). There are no cures for viruses (think of the common cold) but there are treatments available to help with the symptoms. However, once you have herpes, it will be with you for the rest of your life (unless a cure is discovered in your lifetime). 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

19 There is no cure for herpes. In fact, once you have been infected with the herpes virus, it's in your body forever. There are medications that can lessen some of the discomfort that outbreaks cause and medications to help prevent outbreaks from occurring. And there are things you can do to help protect yourself - and your family -from getting infected by the virus. The best way to handle this is to inform yourself as much as possible. Sometimes people who have oral or genital herpes only have one outbreak. You may have an outbreak when you first contract the virus, or you might not. In some cases, the extent of the outbreak is so mild, you might not recognize it for what it is. Other people have many outbreaks, which are less painful and shorter than the initial episode. To understand this, you need to know that the herpes simplex virus can exist in two different stages: 1] The active stage, when lesions are growing on the skin. 2] The latent stage when the virus is lying dormant in the nervous system. The virus can move from a latent stage into an active stage and cause a reoccurrence. There are different reasons for this and different things that may cause or contribute to a reoccurrence. Also, every person s body reacts differently to the virus which is why some people have more outbreaks than others

20 What happens to your body during an outbreak? The best way to understand how the virus works is to understand what happens to your body during an outbreak. When you do not have an outbreak, the virus is lying dormant in your system. This doesn t mean you have been cured. You still have the virus. It just means that the virus is not actively causing symptoms in your body. It is still possible to spread herpes to others even if you are outbreak free. Remember the different stages that the virus can go into. Remember that it lies dormant in your nerve cells, a teeny-tiny organism feeding off your cells but it never dies and never goes away. Also remember that some people may be in the active stage with very little to no symptoms at all. You might not have large sores or lesions so you may not realize you are in the active stage and you can still spread the virus to someone else. Why is it that some people go for years without an outbreak and other people seem to have them often? Why is it you can have the herpes virus without ever having an outbreak? To understand the answers to these questions, you need to understand what happens to your body during an outbreak

21 In HSV1 blisters form on the lips and on the inside of the mouth, and soon develop into painful ulcers. You have probably heard of them called cold sores or fever blisters. The gums become red and swollen, and the tongue may develop a white coating. Other symptoms may include fever, muscle aches, trouble with eating, a generally ill feeling, irritability and swollen neck glands. These symptoms can last from two to three weeks. After your get the initial 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 activate itself during or just after some type of stress on the body such as a cold, an infection, hormone changes, menstrual periods or even a tooth extraction. Symptoms of genital herpes, HSV2 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, the blisters may appear on the thighs and buttocks. Blisters soon erupt to form painful sores that last 1 to 3 weeks. There are also some other symptoms that may appear such as pain or a burning sensation during urination; a clear mucus-like discharge from the vagina or urethra (opening for urine) in females; a

22 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. However, the virus may react differently in different people. Some people have more frequent outbreaks than others and some have more severe outbreaks. Growth Cycle of the Virus The herpes virus, like all viruses goes through a growth cycle. So what stops a viral infection? The growth cycle of the virus is halted by your body s natural immune system. Your immune system produces proteins called antibodies, which you have likely heard of before. These antibodies work together with other cells called lymphocytes and macrophages to cling to the viral participles and inactivate them. Remember, they don t destroy them or get rid of them, but they inactivate them. A healthy immune system will kill the living viral particles and clean up the sick and infected cells and make room for new and healthy cells to grow. So why doesn t this cure you of herpes? Why doesn t our body develop immunity to the virus? Well, have you ever wondered why you don t become immune to the common cold? It s kind of the same thing

23 You might be surprised to learn that you actually do develop immunity to the herpes virus. As we described above, in a healthy person, the body s immune system will attack the virus and shut it down. Then, it all gets a bit trickier. Scientists are not 100% clear on exactly how all of it works but basically; the herpes virus goes into its latent phase which is essentially, a state of hibernation. Normally, the virus will stay in a latency stage until something comes along to reactivate it. The virus lies dormant in your nerve cells not in the skin cells where you typically see signs of the infection. When something triggers the nerve and reactivates the virus, it will travel down the nerve to the site where it originally infected (such as the genitals or the lips) and will begin attacking healthy cells again. The herpes virus has an inside tricks or traveling from cell to cell instead of developing inside a cell and then bursting out of it. Since it remains inside the cell, this makes it hard for the antibodies to kill it which is why it remains in the body. This is why there is currently no vaccine for the herpes simplex virus. A strong and healthy immune system can help suppress the virus so it does not reactivate but there is currently no way to rid the body of it completely because it hides or creeps in the body s cells. We will talk more in this book about the immune system and also about treatments for herpes and ways to prevent recurrences and outbreaks. There are current studies being done to analyze how herpes reacts in the body and ways to prevent spreading it to others. There is also regular work being done to try to find a cure for this condition. There are now medications that can help suppress outbreaks

24 and help lower your chances of spreading it to a partner. However, at this time abstinence is the only 100% guarantee that you will not spread genital herpes to a partner. Below is an official statement from the Medical Advisory Board on current herpes treatments and how taking them may protect your partner. "Recent scientific research has shown that a dramatic reduction in shedding of herpes simplex virus occurs when people with genital herpes take antiviral medications such as Valtrex or acyclovir. Research studies are ongoing at this time to determine if this reduction in viral shedding will protect the (an) uninfected partner from catching herpes. The Medical Advisory Board of Herpes.org has determined that it does seem reasonable, in anticipation of the results of these transmission studies, that infected persons should consider taking their prescribed antiviral medication on a regular, suppressive basis in an attempt to help, as much as possible, to protect an uninfected sexual partner from becoming infected. At this time, the FDA does not have an official approval for the use of antiviral medications taken by infected persons for the protection of intimate partners. Infected persons interested in taking suppressive therapy in an effort to help protect an uninfected sexual partner from becoming infected with genital herpes should contact their private physicians to discuss this matter."

25 You can do your part and stay up to date on the latest herpes treatments and breakthroughs if you or someone you love has the virus. You can also learn a lot about the virus and how it works in your body from reading more into this book. Chapter Review 1. Herpes is caused by the herpes simplex virus. 2. The virus works by residing in the nerve ganglia after initial exposure to the herpes virus and then reactivating itself during certain times in the person s life. 3. During an outbreak, your skin cells are affected by the virus and an outbreak of lesions occurs. 4. Herpes simplex virus is part of a family of viruses that caused other infections such as mono, shingles and even the chicken pox. 5. Popular topical anti-septic herpes treatment is Dynamclear. 6. Popular anti-viral medication is Valtrex

26 Section Two: Testing for Herpes How do you know if you have herpes? What tests are there for herpes? Can the doctor test you for herpes simplex if you do not currently have an outbreak? How soon after possible exposure with an affected person can you be tested? There are many, many questions surrounding herpes and how it is tested and treated. This is a very important topic since many people with herpes do not even know they have it or have never had an official diagnosis. Also, in some cases, herpes is misdiagnosed so getting a test to prove it is very important. If you think that you might have herpes, you should see your doctor right away and talk to them about it. It is even better if you can go while you actually have an outbreak but even if you do not, you can still visit your doctor right away and talk to them about your symptoms and why you think you may have the virus. The doctor will then be able to tell you about possible tests to detect the virus in your body as well as other options for you if you do have the virus

27 If you have open, active sores from what you think could be a herpes virus; this is the ideal time to go to be tested. If the doctor is able to swab the sore for analysis, it is much easier to get a diagnosis. However, if you think you may have the virus but are not in the active phase, you can still talk to your doctor and there might be other tests that can detect if you have the antibodies for herpes virus in your system. Noticing the symptoms Most people do not find out they have herpes from a routine test. Most people notice the signs and symptoms first and then go to a doctor to have it confirmed. You need to be aware of what the symptoms are. Most often the initial exposure is the worst case of an outbreak you will get. This primary infection is what tells most people that something is wrong. This primary infection is worse because your body has never made any antibodies to the virus before this initial exposure to it and it takes time for your body to begin to fight it off. The primary infection may have more sores and may spread to a larger area of the skin. You might feel more generally ill and have flulike symptoms. You might have muscle aches, fever and fatigue. You might also have painful burning, itching and irritation in the genital area. With oral herpes, you might have painful irritation or sores around the mouth and possibly even inside the mouth. You might also have swollen lymph nodes with your outbreak

28 Available Tests for Herpes The best time to go to the doctor is when you have an active outbreak of the virus. If you see lesions or sores, you should see the doctor right away to get tested. The primary methods of testing for the virus are the herpes culture and HSV DNA testing. Tests for HSV are usually done only for sores in the genital area. In rare cases, the test may be done using other types of samples, such as spinal fluid, blood, urine, or tears. Below are the common methods of testing for the herpes simplex virus. Types of Tests Herpes viral culture. Cells or fluid from a fresh sore are collected with a cotton swab and placed in a culture container. A viral culture is typically considered the most specific method of diagnosing a genital herpes infection. Herpes virus antigen detection test. In this test, cells from a fresh sore are scraped off and then smeared onto a microscope slide. This test detects markers (called antigens) on the surface of cells infected with the herpes virus. This test may be done in addition to or in place of a viral culture

29 Polymerase chain reaction (PCR) test. PCR testing can be done on cells or fluid from a sore or on blood or on other fluid (such as the person s spinal fluid). PCR detects the genetic material (DNA) of the HSV virus. This test can distinguish between HSV-1 and HSV-2. The PCR test is not commonly done on the skin lesions themselves but it is best for testing spinal fluid, for rare cases in which herpes may be causing infection in or around the brain. Antibody tests. Blood tests can detect antibodies that are made by the immune system to fight a herpes infection. Antibody tests are occasionally done but are not as accurate as a viral culture at identifying the cause of a specific sore or ulcer. Antibody tests cannot distinguish between a current, active herpes infection and a past infection. Because antibodies take time to develop after the initial infection, a positive antibody test may not be present if you have recently been infected. Some blood tests can diagnose the difference between HSV-1 and HSV

30 Herpes testing is done to determine where it is in fact, the herpes simplex virus that is causing sores that may appear in the mouth or genital area. Usually the tests are performed because the person has an outbreak of sores and comes in to find out what is causing it. If you are planning a test for herpes, what do you need to do to get ready for the tests? Are there any special things you need to do, or not do? How to Prepare If you think you might have genital herpes and you are waiting until you can take the tests or get the results of your tests back, you should avoid sexual contact until you see your doctor again. Even though there is no cure for herpes, you can still spread it to others, especially if you have an active outbreak. Also, if herpes is not the cause of your sores, you still do not want to spread what you have to someone else. If the doctor will be taking a sample from the urethra, you will be advised not to urinate for 2 hours before the test. Women should not douche 24 hours before the test is done in case a cervical sample is taken. Otherwise, there is not really anything that you can do to prepare for the test

31 How is the Test Performed? Many people wonder about what exactly is done during the test. For the viral culture, viral antigen test and the PCR test, it s pretty simple. They are going to use a clean cotton swab (Q-tip) and rub it against one of the sores to collect fluid to be examined. The sample might be taken from the penis, vagina, eye, throat or skin, depending on where your outbreak is. It is much better if they can get the sample from a small and new sore. These newly formed sores will contain more of the virus, making it easier to detect in the tests. For an antibody test, you need your blood drawn. They will do this by: Wrapping an elastic band around your upper arm to stop the flow of blood. This makes the veins below the band larger so it is easier to put a needle into the vein. Cleaning the needle site with alcohol. Putting the needle into the vein. More than one needle stick may be needed. Attaching a tube to the needle to fill it with blood. Removing the band from your arm when enough blood is collected. Applying a gauze pad or cotton ball over the needle site as the needle is removed. Applying pressure to the site and then a bandage

32 This is the same method that is used for collecting blood for other tests and when you are sick and you have likely had it done several times before. There really aren t any risks involved in any of these tests and very little, if any, complications. The swab test might feel a little uncomfortable at the time of the swab but it s over in seconds and usually feels fine afterwards. So, the tests are basically nonintrusive and should not cause you any problems. You may experience some complications from having your blood drawn but they are typically mild. They could include: A small bruise at the puncture site. You can reduce the risk of bruising by keeping pressure on the site for several minutes after the needle is withdrawn. Rarely, the vein may become inflamed after the blood sample is taken. This condition is called phlebitis and is usually treated with a warm compress applied several times daily. Continued bleeding can be a problem for people with bleeding disorders. Aspirin and other blood-thinning medications can also make bleeding more likely. Results If you have been tested for herpes simplex virus, you are probably anxiously awaiting your results. The actual time it takes to get your results back can vary. Results of a viral culture can require 2 to 3 days for a rapid culture or up to 14 days with a standard culture. Antigen detection test results are usually ready in about a day. Polymerase chain reaction (PCR) test results are usually ready in 1 to 3 days

33 Results from an antibody blood test are usually available within 2 days. But again, this can vary according to the doctor you see and the lab they use so don t be surprised if it takes a little longer. However, typically if someone has HSV, the clinic or physician will try to let you know as soon as possible to prevent spreading of the disease. So, what do your test results mean? Normal: Normal results are called negative. This occurs when no HSV grows in the viral culture, no viral antigens or DNA are detected and when no herpes antibodies are present in the blood. Abnormal: Abnormal results that detect the presence of HSV are called positive. This occurs when HSV grows in the viral culture, HSV antigens or DNA is detected or Antibodies to the herpes virus are present in the blood. If the test results show that you do have herpes, the doctor will likely call you back in to discuss it with you and to make sure you understand the disease as well as to talk with you about possible treatment methods and how you can prevent spreading it to others. It s very important that you attend this appointment and also, don t be afraid to ask any questions you may have

34 Emotional side of genital herpes One of the hardest parts for many people is actually getting to the doctor to begin with. Some people have a very hard going to the doctor when they suspect they have an STD. It is embarrassing and you will typically have to call and make an appointment which will require telling a receptionist why you are there. You will then usually have to tell a nurse why you are there and then finally, the actual doctor. You might feel silly or embarrassed or like everyone in the waiting room is staring at you. The fear and anxiety that goes along with it is one thing that leads many people to never get diagnosed or treated. But what you need to understand is that no one else needs to know why you are there and the doctors and nurses are just doing their job. They do not care about who you are or really even how you got it. All they care about is diagnosing and then treating you for the virus. If they think anything at all, it will be that they are glad you made the mature decision to come in and be treated for your problem as opposed to the many people that are too afraid to do so. You also need to remember that they have seen many people just like you and they understand that you are worried, scared and even embarrassed. They can also help set you up with a support group that can help you deal with this new change in your life and your diagnosis

35 Emotional Side of Oral Herpes When it comes to oral herpes, there is less social stigma. However, many people do not seek proper treatment for this as well because they think Oh, it s just a little cold sore, no need to go to the doctor. And this is where they are wrong because where it might seem like just a little cold sore, it still needs to be properly diagnosed if it is herpes and you need to understand what you have, how it is spread and how it can be treated. Too often people tend to brush it aside as something that everyone gets and that will go away on its own and they never get the treatment they need and deserve. They might also be unknowingly passing it on to other people because they don t understand how it works. This is why it is important for both types of herpes that you understand the symptoms; seek available testing and diagnosis which can lead to treatment and more information about the herpes virus such as great ways to treat it naturally on your own. But it all begins with that first step of going to your doctor. More about testing There is often a lot of confusion about herpes and the tests for herpes. Sometimes people do not understand how the tests work, how they detect the presence of the herpes virus and how results are obtained. If you have had or will have tests for HSV, don t be afraid to

36 ask your doctor questions about the tests, what is being done and what it all means. However, to answer some fairly common questions about herpes testing, we have added this section. If you think you may have been exposed to the herpes virus, you can not immediately run out to your doctor and have a test to prove you are safe. If you want to make an appointment, this is fine and if you have physical symptoms of some type of infection, it is suggested that you go ahead and make an appointment to have it treated. However, if you have been exposed to the herpes virus, it can take time to get accurate results as to whether or not you have the virus since most tests work by checking to see if you have antibodies against the virus. So basically, if you feel you have an STD or if you suspect you might have HSV1 or 2, you can see your doctor right away but be aware that in many cases, it might take time to get accurate results back. If you have any questions or concerns regarding your tests and your results, you should be sure to ask your doctor. This is an important aspect of your life and it s important that you fully understand everything. Are there tests to show you which type of the virus you have? There are tests that will show you whether you have the antibodies for HSV1 or type 2. These new blood tests are typically referred to as Type Specific Serology

37 Not all blood tests are able to tell between the two types of herpes virus and since both can occur in either the oral areas or the genital areas, you can t always go by location either. However, for most people, herpes is herpes and sores are sores and it s not that important which particular type you have. If it is important to you, then you need to be sure you are asking your doctor for a type-specific test. Serology tests are types of tests that check for antibodies in a person s blood. If you have the antibodies in your blood, it means your body has been exposed to that particular virus and has produced these substances to fight the past infection. This will also mean that the virus is still dormant in your system which makes you are carrier of the virus. Blood tests can be done at any time, whether you have an active outbreak or not because it doesn t require taking a swab of a lesion or sore. However, many commercial tests for herpes do not distinguish between the two types of the virus so if you want to know this, you have to talk to your doctor about getting type specific tests before hand. These serology tests are more accurate that antigen testing but there are a couple things you need to keep in mind. One is that all doctors do not automatically order type-specific blood tests. The other thing is that it can take from several weeks up to three months for a person to make antibodies against the infection so if you have been recently infected, it can still take some time to get accurate test results

38 How do type specific tests work? The tests are based on antibodies to two proteins that make up part of the HSV-1 and HSV-2 virus structure. One protein is called glycoprotein gg-1 and it is found only on the outside of the HSV-1 virus or in cells infected with HSV-1 as the virus is produced. The other protein is called glycoprotein gg-2 and is found on HSV-2 virus or in cells infected with HSV-2. the virus? Are there any tests that can show you how long you have had Currently there are not any tests that can show you how long the virus has been in your system. For example, the tests will only show that you have antibodies for a particular strain of herpes virus. They can not tell you that you developed these antibodies in 1998, etc. You may hear of testing for IgG or IgM. This is testing for the lymphocytes in your body hat occur when you are exposed to the herpes virus and if your test is taken soon after exposure, it can tell you whether you have IgGs or IgMs in your body but this is not really a way to determine how long you have had the virus, particularly if you were exposed more than 3 months ago. Whether it was 3 months or 3 years, the result would be the same. To understand these tests you need to know that B lymphocytes are the cells that are responsible for antibody-mediated (this is also called humoral immunity) responses, which is what occurs when exposed to HSV. (If you look up any of the previous terms you can find

39 lots of information about how your immune system works.) These B cells are coated with immunoglobulins and that's what gives them the ability to recognize the protein in HSV and trigger an antibody reaction. There are fives classes of these immunoglobulins or antibodies. Two of them are the IgM and IgG that you mentioned. IgM's are formed during the early phase of exposure as you mentioned. IgG's are the major blood plasma antibodies that are formed in response to a virus or bacteria. symptoms? Can I be tested for herpes even if I have never had any Again, this is a fairly common question. Since many people who have been exposed to the herpes virus show no symptoms or signs, they may continue spreading the virus to other people. It is important that if you think you have been exposed, you get tested even if you show no signs or symptoms of outbreak. You can be tested even if you have no signs and have never had any symptoms but it will require a blood test instead of a swab test. However, it s important to note that you might need to take the test more than once to completely rule it out, especially if you have been exposed recently. It may take some time for antibodies to show up in your system if you have never had an outbreak

40 Chapter Review 1. Symptoms of herpes include sores or lesions on or in your mouth or on or around the genital area. General ill feeling or flu-like symptoms. 2. Doctors test for herpes by taking blood or taking a sample of an active lesion or sore. 3. Positive test results mean you have been exposed to the herpes virus. Tests can also show which type of herpes simplex virus you have. 4. You can be tested even if you have never had signs or symptoms. 5. There are tests that can distinguish which type of the herpes virus you have. There are also non-type specific tests that just check for herpes virus, not a particular strain of it