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Herpes Simplex or Herpes Simplex Virus is a contagious disease of the skin and mucous membranes caused by the virus called the Herpes Simplex Virus. Memorial Hospital Head of Obstetrics and Gynecology Department Op. Dr. N.Cihangir Yılanlıoğlu, tells what is curious about the disease.
: What is Herpes?
Kiss. Dr. N.Cihangir Yılanlıoğlu: Herpes Simplex or Herpes Simplex Virus is a contagious disease of the skin and mucous membranes caused by the virus called Herpes Simplex Virus. There are eight types of Herpes Simplex virus and three of them are the most common clinically.
: Can you tell us about these three types?
Kiss. Dr. N.Cihangir Yılanlıoğlu: HSV 1 is mostly observed in the mouth, nose and around, while HSV 2 is located in the genital area. HSV 3 is a type of Zona that causes discomfort and settles in the nerves. This type is different from the others in the form of water-filled pouches, redness and needle felt in the form of a type of pain that is sharper than others. It holds a certain area in the form of a belt and primarily starts pain. Then the rash occurs when the areas where pain is felt is limited and starting to spot redness and covering a certain area. It is located in the skin area that fits the area held by the virus. After continuing for a while, first the pain, then the rash heals without a trace.
: How do the types of Herpes Simplex affect organs?
Kiss. Dr. N.Cihangir Yılanlıoğlu: HSV 1 creates blisters filled with water inside the face, lips, nose and mouth. These bubbles open in a very short time and ulcers over them and tend to merge with other small ulcers nearby. These wounds then become crusted. Shells are yellow and white. The shells then spontaneously soften and fall. At first leaves a brown stain in place. It then turns into a brown trail.
HSV 2 involves the genital area. The groin may involve the outer lips of the vagina, the inner part of the vagina, the area between the anus and the vagina, the cervix, the penis, and especially the proximal part of the penis, rarely the penis head and testicles, hips.
: How is it transmitted?
Kiss. Dr. N.Cihangir Yılanlıoğlu: Herpes virus is transmitted by contact. Viruses are taken in contact with the person carrying the virus, such as kissing, sexual intercourse, using the same towel. Viruses enter the body through cracks in the skin and / or mucous membranes. They move along the fibers of these nerves by holding the nerve cells. They settle in the main centers of fibers called ganglions. Then they begin to form lesions on the skin or mucous membranes of that region. Viruses don't die where they settle. Therapies can be done to prevent or at least reduce disease formation, not to destroy viruses.
: What should be considered especially for herpes of the genital region?
Kiss. Dr. N.Cihangir Yılanlıoğlu: In general, both types are available when the Herpes Simplex virus is infected. In addition, especially in the genital region of herpes called HSV 2 should be remembered that sexual contact with the virus and other diseases that can be transmitted by sexual contact should be remembered. Because, as well as HSV 2 virus can be transmitted easily and other dangerous diseases that may have taken from the same person (jaundice, AIDS, syphilis, etc.). Therefore, it would be appropriate to screen other sexually transmitted diseases in individuals with HSV 2.
: Is Herpes Infection common?
Kiss. Dr. N.Cihangir Yılanlıoğlu: It is difficult to detect herpes simplex infection in individuals and to perform a very accurate prevalence rdml screening. One of the most important reasons for this difficulty is that the infection remains as a carrier after the disease is removed without symptoms. More than half (~ 65%) of individuals with the disease do not know that they have the disease. There is also a situation in individuals who have come into contact with HSV 2, even if the disease occurs, for reasons such as fear and embarrassment. Therefore, the application about the disease is actually much less than the number of individuals carrying the virus. HSV infection is also seen at different rates among populations. This rate is 20% in the USA, 35% in Sweden and 40% in Brazil. Unfortunately, there is no scientific statistics in our country. However, the estimated rate is around 30%. It is observed more frequently in socioculturally low societies. Population with low income and educational level is also a target.
: What are the risk factors for HSV-2 infection?
Kiss. Dr. N.Cihangir Yılanlıoğlu:
• Increasing the number of sexual partners
• Age progression
• Low income
• Low level of education
• Black or Hispanic ethnicity
• Being a woman
• Male gay activity
• HIV infection
: How does the disease develop and progress?
Kiss. Dr. N.Cihangir Yılanlıoğlu: Shortly after the virus has been removed (in the range of 2 to 12 days), water-filled sacs and itchy lesions begin to form. Depending on the strength of the patient's immune status, the amount is spread. More than half of the individuals in contact with the virus have no complaints. The patient has taken the virus, the cause of the disease, into the nervous system. It infects individuals with whom it has sexual intercourse. In any case where the immune system is suppressed, symptoms of the disease will occur. Sometimes the patient does not experience this process at all. However, the carriage of the virus continues. Sometimes they experience at least four attacks per year.
: In which situations does the disease manifest?
Kiss. Dr. N.Cihangir Yılanlıoğlu: In case of insufficient nutrition, excessive vitamin A intake, excessive alcohol consumption, during periods of intense stress, influenza, etc. In some diseases such as immune system, menstrual periods, periods of frequent sexual intercourse, personal hygiene disorder begins to repeat the disease. Although the symptoms are most severe when the first infection is present, the immune system plays a major role here, and can be exacerbated in any relapse. Symptoms can last up to 20 days and women may experience discharge from the cervix, painful sexual intercourse during this period.
: What can be done in cases such as contact with the disease during pregnancy or recurrence of the disease during this period?
Kiss. Dr. N.Cihangir Yılanlıoğlu: Although the disease is claimed to cause severe damage to the fetus in the first trimester of pregnancy, there is no scientific data. In addition, ultrasound detection of these damages may not be possible. For this reason, all pregnant women should be screened for this infection in the first period of pregnancy. Termination of pregnancy may be considered in cases where the virus is newly infected with active infection. There is no danger to the fetus in individuals who have already been infected and immunized. If these pregnant women experience a relapse during pregnancy, no treatment is applied, only supportive approaches are adopted. Caesarean section should be preferred in pregnant women who have genital herpes near birth to prevent contact of the baby in these pregnancies if the birth starts while lesions are present. In addition, care should be taken to minimize contact with the virus after birth.
: How is the diagnosis made?
Kiss. Dr. N.Cihangir Yılanlıoğlu: Complaints are the most important finding. Clinical findings (watery, immediate crusted itching or inflamed pouches filled with water…) Diagnosis can be made with laboratory findings. Laboratory tests include culture swabs from the wound. The presence of antibodies against HSV Type 1 and Type 2 in cytologic diagnosis and syphilis, fix drug allergies, trauma, contact allergies should be considered in the differential diagnosis of PCR.
: Is it possible to treat herpes virus, what can be done?
Kiss. Dr. N.Cihangir Yılanlıoğlu: A complete treatment of Herpes Virus is not possible. Therefore, it is necessary to take care not to catch the virus first. Avoid contact with strangers, use condoms in sexual intercourse, common towels, etc. should be avoided. We should inform the individual about whom we think we have received the virus and draw attention to the possibility of illness. In order to prevent the disease or relapse, we should strengthen the immune system and avoid excessive alcohol, fatigue, malnutrition, stress. One of the biggest problems of the disease lesions is that they can easily be re-infected with bacteria and become deeper, wider and more scarring ulcers. Therefore, we should avoid hand contact as much as possible, prefer paper towels in the period of active lesions and avoid contact. In the presence of bacteria, we should use antibiotics under the supervision of a doctor.
All wounds in the genital area are important. The most frightening is the possibility that other diseases can be skipped because of herpes. For this reason, the wound observed in each genital area must be examined by a doctor. Also important is the possibility that other sexually transmitted diseases may have been acquired in the presence of herpes infection.