Herpes is a group of viruses that can cause infection in humans. Herpes virus infection is generally characterized by dry skin, blisters, or open sores that are watery. Herpes simplex virus (HSV) and varicella- zoster virus are two types of herpes viruses that quite often attack humans.
This virus can attack anyone. Having a history of contact with people with this viral infection and having a weak immune system are factors that can increase a person's risk of being infected with the herpes virus.
Overall, herpes viruses fall into three groups. The division of the herpes virus group is as follows:
Alpha herpesvirus
This group of viruses has a rapid reproduction cycle, has a latent infection phase (hidden without symptoms), and can recur. Example alpha herpesvirus are HSV types 1 and 2, and varicella-zoster virus.
Beta herpesvirus
This group of viruses has a long reproductive cycle. Infected cells often swell and the virus can hide in the body. Some of the cells that are often infected with this virus are red blood cells, kidneys, and secretory glands. Example beta herpesvirus is cytomegalovirus, herpesvirus 6, and herpesvirus 7.
Gamma herpesvirus
This group of viruses specifically attacks the T or B cells or lymphocytes in the human body. Example gamma herpesvirus is Epstein-Barr virus and human herpesvirus 8.
Causes of Herpes
There are eight types of herpes viruses that can infect humans, namely: herpes simplex virus type1 (HSV 1), herpes simplex virus type 2 (HSV 2), varicella-zoster virus (VZV), Epstein-Barr virus (EBV), cytomegalovirus (CMV), herpesvirus 6 (HBLV), herpesvirus7, and herpesvirus 8 Kaposi's sarcoma.
This article will focus on discussing groups alpha herpesvirus The most common causes of infection are:
Herpes simplex virus type 1 (HSV 1)
HSV 1 is a type of herpes virus that often causes oral (mouth) or labial (lips) herpes. However, HSV 1 can also spread from the mouth to the genitals and cause genital (genital) herpes in people who receive oral sex from people with oral herpes.
HSV 1 can be spread by direct contact from a person with herpes to a healthy person. Examples are through kissing, sharing eating utensils, or sharing lip cosmetics, such as lipstick.
HSV 1 can also be transmitted from asymptomatic HSV 1 sufferers. In fact, most people with HSV 1 are infected by people who are asymptomatic. However, the risk of transmission will be higher if there is contact with a patient who has an open wound due to HSV 1.
Herpes simplex virustype 2 (HSV 2)
HSV 2 is the main cause of genital herpes. This viral infection can recur, the frequency of recurrence will vary in each sufferer.
The HSV 2 virus is spread through direct contact with sores that people with herpes have, for example during sexual intercourse. In addition, HSV 2 can also be passed from mother to baby during delivery.
Varicella-zoster virus (VZV)
VZV is a virus that causes chickenpox (varicella) and shingles (herpes zoster). Chickenpox occurs when varicella-zoster virus infect someone for the first time.
Meanwhile, herpes zoster or also known as skin herpes occurs when the VZV virus that is experiencing a latent phase relapses or when someone is infected with this virus from someone who is suffering from herpes zoster.
VZV is mainly transmitted through direct contact with people with chickenpox. This viral infection can be recognized by the appearance of skin nodules filled with fluid (vesicles). VZV can also be transmitted through direct contact with the fluid in the vesicles or the saliva that comes out when an infected person sneezes or coughs.
Usually, the virus has been in the patient's body for 7-21 days before the rash or other symptoms appear. However, the patient can already transmit the virus varicella-zoster to another person as early as 48 hours before the appearance of the rash.
Risk Factor
Herpes can affect anyone in all age groups. However, this herpes virus infection is more prone to occur in someone who has frequent contact with people with this virus, such as medical staff or family members who care for people with herpes.
For the herpes simplex virus type 2, the following factors can increase the risk of being infected with this virus:
- Female gender
- Multiple sexual partners
- Have a weak immune system
- Suffering from sexually transmitted diseases
- Having sex at a young age
For infection with the VZV virus, several factors that make a person more at risk of infection are:
- Under 12 years old
- Have you had direct contact with someone with chickenpox?
- Work or activities in schools or special facilities for children, especially if there are children who are experiencing chickenpox
- Have a weak immune system, either due to disease or drugs
- Living with children who have chickenpox
Besides being able to cause chickenpox, the VZV virus can also cause herpes zoster. There are several factors and conditions that can increase a person's risk of developing shingles, including:
- Have you ever had chickenpox?
- Aged 60 years and over
- Are undergoing chemotherapy, radiotherapy, or taking immunosuppressant drugs
- Suffering from a disease that weakens the immune system, such as HIV/AIDS or cancer
Herpes Symptoms
Herpes infection usually occurs in several stages. Symptoms or complaints that can arise at each stage can be different. If described further, here are the stages of herpes infection:
Primary stage
The primary stage occurs on the 2nd to 8th day after the herpes infection. Symptoms that appear in this phase are: blistervesicles, or a rash of small, painful blisters on the skin.
Blister It usually contains a clear or cloudy liquid. Blister may break, causing open wounds. Areas around blister will also be reddish in color.
latent stage
At this stage, blister and the wounds that previously appeared will subside. However, at this stage, the virus is developing and spreading to the nerves near the spinal cord that are under the skin.
decay stage
The virus begins to multiply in the nerve endings of the body's organs. If the infected nerve endings are located in an organ that produces fluid, such as the testes or the vagina, the herpes virus can be contained in bodily fluids such as semen and vaginal mucus. Usually, in this phase, the patient does not complain of any special symptoms.
Recurrence stage (reappears)
At this stage, blister in the skin that occurs in the primary stage can reappear, but is usually not as severe as the previous blisters and sores. Other symptoms that can occur at this stage of recurrence are itching, tingling, and pain in the area of infection in the first stage.
As previously mentioned, symptoms or complaints when infected with the herpes virus can vary, depending on the phase that is going on, the type of virus that infects, and how the patient's immune system is.
Keep in mind, that not all people with herpes will experience the same symptoms. In some people, this condition sometimes does not cause any symptoms.
When experiencing a herpes virus infection, general symptoms of an infectious disease will appear. Some of these symptoms or complaints are:
- Fever
- Fatigue
- Headache
- Muscle ache
- Decreased appetite
- Swollen lymph nodes
Furthermore, symptoms will appear according to the type of herpes virus that infects and the location or part of the body that is infected. In HSV 1 infection or oral herpes, symptoms will appear in the mouth and the area around it. Symptoms that can appear are:
- Pain, itching, burning or stabbing at the site of infection
- Blister, which are small, reddish-gray blister-like skin lesions that may break and dry up within a few days
- Blister A rupture can cause sores with pain so that it can interfere with the eating process
For people with HSV 2 infection or genital herpes, some of the common symptoms experienced are:
- Swelling of the genital skin or the area around it that is itchy, painful, and accompanied by a burning sensation
- Painful sores on the genitals, buttocks, anus, or thighs
- Pain when urinating
- Vaginal discharge
- Penile skin is dry, sore, and itchy
Meanwhile, when infected herpes zoster virus that causes chickenpox, a itchy fluid-filled skin rash (vesicles) will appear. This chickenpox rash will be spread all over the body.
If the patient with chickenpox who has recovered then develops herpes zoster, complaints and symptoms will appear, such as pain, heat, followed by the appearance of blisters, on the skin on one side of the body.
When to go to the doctor
Check with your doctor if you experience the symptoms of herpes as mentioned above, especially if they occur blister on the skin of unknown cause.
Inspection needs to be done immediately if blister occurs in your child who is less than 8 weeks old. Herpes virus infection in babies can develop more quickly and can cause serious complications.
If you have a weak immune system, it is advisable to check with a doctor when it occurs blister on the skin. Severe infections and complications are more likely to occur in people with herpes who have weakened immune systems.
Because it can make it difficult to eat food, HSV 1 infection or oral herpes can cause dehydration. Seek immediate medical attention if you are dehydrated as a result of this viral infection, which is characterized by decreased urine output, dry mouth, fatigue, and irritability.
For pregnant women who are or have ever had genital herpes, consult a doctor regarding what to do to prevent the virus from being transmitted to the baby.
Herpes Diagnosis
To diagnose herpes, the doctor will ask questions about the patient's symptoms, activity history, and medical history. Next, the doctor will conduct an examination to see whether there is a fever, the type of rash or skin lesions that arise, and the pattern of spread of the lesions.
Doctors can diagnose herpes through questions and answers and the results of a physical examination that has been done. However, in some cases, to strengthen the diagnosis and confirm the type of herpes virus that infects, the doctor can perform several further tests, such as:
Virus culture
Herpes virus culture aims to diagnose the presence of the herpes virus. Herpes virus culture is done by taking samples through the swab method from the infected skin or genital area, for further examination in the laboratory.
This viral culture examination is mainly carried out to detect or confirm the presence of the herpes virus, as well as to determine the type of herpes virus that infects.
Tzank Checkup
The Tzank examination is done by taking samples from skin rashes for further examination under a microscope. The results of this examination can determine whether the lesions are caused by the herpes virus. However, this test cannot identify the type of herpes virus that causes the infection.
Antibody test
When attacked by a virus, the body produces antibodies in response. Antibody test aims to detect the presence or absence of antibodies against the herpes virus. Antibody test is done by taking a blood sample, then analyzed in the laboratory to check for the presence of antibodies formed due to herpes virus infection.
Antibody test results will be very helpful in diagnosis in patients who do not have sores or blisters on the skin. This test is often used to diagnose HSV 1 or HSV 2 infection.
In addition to the tests mentioned above, in some cases, doctors may consider PCR (polymerase chain reaction), to detect herpes virus infections, especially those that have caused an infection of the eyes or the central nervous system.
Herpes Treatment
In general, sores and blisters from herpes will heal on their own within 2-4 weeks. However, the virus may still exist in the patient's body without causing complaints or symptoms. Until now, there is no treatment method that can eliminate the herpes virus from the body.
The focus of herpes treatment is to help relieve symptoms, prevent the spread of herpes, and reduce the risk of complications. Some antiviral drugs can be used to treat herpes virus infections, including:
- Acyclovir
- Valacyclovir
- Famciclovir
- Penciclovir
In addition to antiviral drugs, there are several things you can do to relieve complaints and speed up recovery from a herpes virus infection, namely:
- Take paracetamol or ibuprofen as pain relievers.
- Use lukewarm water for bathing.
- Compress the skin rash with warm or cold water.
- Use cotton underwear.
- Wear loose clothing.
- Keep the wound area dry and clean.
Herpes Complications
In general, infection with the herpes virus rarely causes serious complications. Complications of herpes virus infection generally occur in certain conditions. For example, people with herpes simplex who also have HIV usually experience more severe herpes symptoms and have more frequent relapses.
Complications due to herpes virus infection can also depend on the type of virus that infects. When infected with the herpes simplex virus, the following are some of the complications that can arise:
- Spread of infection to other parts of the body
- Hepatitis
- Pneumonia
- Inflammation of the brain and the lining of the brain
- Esophagitis
- retinal tissue death
In chickenpox, the risk of complications generally increases in children, the elderly, pregnant women, or people with weakened immune systems. Some of the complications that can occur due to chickenpox are:
- The rash spreads to the eyes
- A rash followed by shortness of breath and a headache
- Rash followed by secondary bacterial infection of the infected area
If experienced by pregnant women, chickenpox that is not handled properly can increase the risk of disturbances to the baby they are carrying. These disorders can be in the form of visual disturbances, mental retardation, slow growth, or a head that has a smaller size.
Meanwhile, complications that can occur when experiencing herpes zoster are:
- Post herpetic neuralgia, namely pain that is still felt even though the lesions on the skin have disappeared
- Bacterial infection at the site of the rash
- Pain and rash that radiates to the eyes
- Ramsay-Hunt syndrome, a condition that can cause facial paralysis and hearing loss
Herpes Prevention
To prevent the spread of the herpes virus to other people, you can take the following steps:
- As much as possible avoid physical contact with other people, especially those with open wounds.
- Always wash your hands regularly.
- If given topical medication to treat rashes, apply the medication using a cotton swab so that the skin of the hands does not touch the area infected with the herpes virus.
- Do not share items that can spread the virus, such as glasses, cups, towels, clothes and utensils make-up.
- Do not perform oral sex, kissing or other sexual activity, during the appearance of symptoms of herpes.
Especially for people with genital herpes, all forms of sexual activity during the appearance of herpes symptoms should be avoided. Keep in mind that even after using a condom, the herpes virus can still be spread through unprotected skin contact.