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Herepes Nostalgia

Lately, we seem to be in the throes of a "seventies" nostalgia. Everything, from bell bottoms to wedgies, Donna Summer to the BeeGees, is making a comeback. The seventies were also years famous for the herpes epidemic. Herpes, unfortunately, doesn't need to make a comeback. It has never left.

Herpes simplex virus (HSV) type 1 is described as oral herpes; HSV type 2 as genital herpes. But with the prevalence of oral-genital sex, you can find either type of infection above or below the waist. Once an infection occurs, the herpes virus never leaves. It grows in the skin or mucous membranes, then travels along nerve fibers to lie dormant deep in sensory nerve bundles, only to perhaps one day replicate in those nerves and travel back again to the skin or mucous membranes to produce new lesions.

The classic cold sore is HSV-1. Practically everyone has been exposed to it. It often flairs up with minor illness like colds, or with exposure to sunlight. If you're going skiing or to the beach, sunblocks are a good preventative. But if the lesions do develop, there's no cure. Acyclovir (Zovirax), if taken within 24 hours after symptoms develop, can shorten the time to the healing of lesions by perhaps one day. But it's a very expensive medication for a nebulous "one day" benefit. You can use creams for symptomatic relief, like Campho-phenique, Num-zit, or Orajel. It's a good idea to use Q-tips to apply these medications because the virus is contagious and sheds in the blister fluid. You can spread the lesions simply by touching other parts of your body or other people.

Genital herpes, or HSV-2, remains our most common sexually transmitted disease. About 25% of men and 35% of women have had genital herpes, and more than 700,000 new cases and more than 20,000,000 cases of recurrent genital herpes will occur in the United States each year. Although genital herpes can occur anywhere on the external genitalia, in women they can also be present and less conspicuous inside the vagina. Once contracted, there is no safe period for sexual contact because transmission can occur during periods where the virus is present without symptoms. Using condoms is advisable but condoms only prevent contact with penile skin. The herpes virus can be passed by touch with any skin area. The only therapy, oral acyclovir taken at the onset of symptoms is, as in the case of HSV-1, expensive and minimally effective.

The greatest risk of HSV-2 is infection during pregnancy which can result in spontaneous abortion during the early months of pregnancy or serious complications to a newborn who passes through an infected birth canal.

In this era of AIDS and date rape, isn't it nice to wax nostalgic about the seventies and our silly obsession then with a herpes epidemic.