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
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.