Most people have herpes, either as genital herpes, or as cold sores, the main difference is where it appears on the body. Herpes, in all its forms, is a universal problem in modern health, spanning all races, cultures and continents. The herpes viruses affect 80-90% of the world’s population. Each year in the United States alone: 40 million people experience outbreaks of cold sores (Herpes Simplex Virus Type I) and 30 million have outbreaks of genital herpes (Herpes Simplex Virus Type II).
Scientific research has identified more than 5,000 different strains of the herpes virus. Eight of these strains cause disease in humans:
Herpes Simplex Virus I: Cold Sores
Herpes Simplex Virus II: Genital Herpes
Varicella Zoster Virus: Chicken Pox and Shingles
Human Herpes Virus 6: Roseola
Human Herpes Virus 8: Kaposi’s Sarcoma
Human B-Lymphotropic Virus
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There are two types of the Herpes Simplex Virus (HSV). Type 1 manifests itself in the common cold sore; Type 2 usually manifests itself as genital lesions (although in some cases, Type 2 has shown itself in the form of a cold sore). Since the lesions commonly affect the lips or areas bordering the lips, the condition is also known as recurrent Herpes Labialis.
Once it becomes introduced to the body, the herpes virus takes up permanent residence. The peak incidence of HSV Type 1 primary infection is at two to three years of age, but new cases appear in all age groups due to the highly contagious nature of the virus. Only an estimated 15% of the population experience the primary infection as an adult. The disease is thought to be transmitted by direct contact. Virus excretion persists in the body secretions for 15 to 42 days after the onset of the primary herpes infection.
After an initial infection, some people develop effective immunity; however, 20% to 45% have recurrent lesions. In North America, an estimated 7% of the general population has two or more bouts of Herpes Labialis annually. In these cases, the virus goes into hiding, escaping the host’s immune system by remaining latent in a specific group of cells, causing no apparent harm to the host during quiescent periods. The exact cells in which they remain latent varies from one virus to the next. In cells harboring the latent virus, the viral genomes take the form of closed molecules and only a small subset of virus genes are expressed.
The incubation period for HSV ranges from two to twelve days. After an infection, the virus hides in the body by entering nerve endings and traveling to ganglia (clusters of nerve cells). The recurrence of the viral infection varies, but certain factors are known to trigger recurrence in humans, such as fever, emotional stress, physical trauma, systemic infections, ultraviolet light and menses. People whose resistance is compromised (less than normal) may experience more severe lesions with slower healing. An infection recurs when the virus is activated in the ganglia and travels down the nerve to the surface of the skin where it replicates. This recurrence takes place in phases:
1. Prodrome: Tingling and itching prior to visual outbreak; warning symptoms that last less than 6 hours.
2. Inflammation: Swelling and redness at the site before outbreak; indication that the virus and antibodies have arrived.
3. Vesicular: Blisters that appear within 1-2 days after prodrome from one or several vesicles, or tiny red bumps commonly found at the vermilion border of the lip.
4. Ulcers: Actual sores that form within 3 days after prodrome, often accompanied by pain; blisters leak fluid.
5. Crusts: Sores dry and form scabs within 4 days to indicate healing; virus diminishes and wounds heal within 2-3 days.
6. Healing: Complete within 8-10 days; new skin forms; virus replication is complete. Virus retreats to the host ganglia where it remains protected from the host’s immunological attack.