FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

HERPES CAN GET UNDER YOUR SKIN AND INTO YOUR CELLS

Question: Is it possible for a man to give herpes to his sexual partner without knowing he has this disease?

Answer: Many people use the term "herpes" to describe the genital infection caused by the herpes virus, just as you have. But, there is actually a whole "family" of herpes viruses that can produce a number of different illnesses.

All of the members of the herpes family are classified as DNA type viruses. As you may know, DNA is present in every living cell and contains the "genetic code" or blueprint for the organism. DNA viruses get their name because they reproduce by injecting their DNA into the cells of the "host" organism in other words, you and me. Once inside a cell, the virus DNA uses the cell's nutrients to rapidly reproduce millions of new viruses. This interferes with the normal inner workings of the cell and may ultimately destroy it. The end result is that we get sick as a consequence of the virus' "generous" sharing of its DNA.

A person infected with one of the herpes viruses develops painful blisters, swollen lymph glands and generally feels lousy. The blisters break, leaving a red sore that clears up in a few days to weeks. The first episode is typically the worst, but it may be followed by repeated attacks, particularly when the infection produces cold sores or genital lesions.

The most common herpes infection about 90 percent of the total number of infections is the cold sore. A virus with the lovely name of "herpes simplex Type I" is responsible for this malady most of the time, creating a sore on the lip, mouth or throat. Genital infections, the ones that get most of the attention in the press and about which you asked, are usually caused by the herpes simplex "Type II" virus. Either of these two types can produce a whitlow a painful sore on the end of the finger or near a fingernail. Chicken pox and shingles are caused by yet another member of this prolific herpes family.

Individuals who have been infected with one of the herpes viruses usually but not always are aware of it. This is especially true when they have an outbreak of sores. At these times abundant numbers of viruses are present, and the infection is very easy to pass on to someone else. The most common method of transmission is by kissing, sharing drinks or eating utensils, or by sexual intercourse. Even when the infected individual is free from apparent sores, a smaller but still significant number of herpes viruses are present. This low count is all that is necessary to pass the infection to another person. So, to directly answer your question, it is possible for someone to pass herpes to his partner without knowing it.

The risk of sexual transmission of a herpes infection is reduced but not eliminated by use of a condom. You see, the virus also often infects skin areas other than those covered by a condom. A little loving skin contact is all it takes to allow the always friendly virus to share its DNA with someone new.

Question: Are there new treatments for herpes?

Answer: A cure hasn't been found, yet. Fortunately though, there is treatment that can significantly reduce the severity and frequency of attacks. The medication, acyclovir, is helpful for all types of herpes infections, not just the genital ones. It is taken by mouth for milder infections or administered by IV for more serious ones. It isn't as good as a cure, but it is a step in the right direction.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.