How to get on with your life. Hi everyone. Please find a complete transcription of a Herpes Information booklet that was commissioned by the Drug Company NOVARTIS. I hope that it helps you with some answers etc.  Part 1 Happy reading Mark Introduction If you have recently experienced your first episode of genital herpes, it has no doubt come as a shock. The most important things for you to realise now are that the worst is probably behind you and that if you continue to have a problem there is help available. Herpes is not dangerous and is usually mild and manageable. The first episode of genital herpes is almost always the most severe, and some people never have another outbreak. If you do significant episodes in the future, medication can help minimise the symptoms. Treatment can also be taken on a continuing basis to make sure you don't have additional episodes. People with genital herpes often feel embarrassed or ashamed. It's important to realise that herpes is a virus anyone can get. In fact, about one in six Australians has genital herpes. Your best defence against herpes is to understand it. You should know what herpes is and what causes it, what precautions to take to keep from spreading it, how to deal with emotional and social issues, what kind of help is available and where to get it. That's what this booklet is for. What is herpes? Herpes is a common infection generally transmitted through sexual contact. You can have oral herpes (on the lips), genital herpes (on the genitals) or non-genital herpes (herpes on other parts of the body).Strains of the virus: Type 1 & 2 There are two types of the herpes simplex virus, Herpes 1 and Herpes 2.Herpes type 1 Herpes type 1 is familiar to most of us. It is the virus that most commonly causes colds sores on the lips or face. Herpes 1 is often transmitted in childhood through kissing, but can be transmitted at any age. Herpes 1 can also be transmitted to the genitals through direct skin-to-skin contact, often oral sex. It is thought that about 8 in 10 adults have herpes 1 by the time they are 25. A much smaller proportion will get obvious symptoms, i.e. cold sores.Herpes type 2 Herpes type 2 is the virus responsible for most genital herpes. It is commonly transmitted through sexual contact. It is thought that 1 in 6 Australians have Herpes 2. Of these 1 in 5 have symptoms. Those without symptoms may be unaware they have the virus. Common emotions Receiving a diagnosis of genital herpes can evoke a wide range of responses. Among the many emotions associated with herpes, it is common to feel depressed, embarrassed, angry and maybe ashamed. It is a very common misconception that only people who behave in a promiscuous way get sexually transmitted infections. This is untrue. Another misconception is that people with genital herpes are dirty; herpes in the genital area acts no differently from herpes on the face, yet most people think nothing of a cold sore. It can be useful to talk to a supportive person, at a time when you feel ready, to help you sort out helpful ideas and get emotional support when you need it. Given how common genital herpes is, the person you tell may well have herpes themselves, or know other people in the same situation. It is important that you do not have any unanswered questions about genital herpes. Discuss your questions with your healthcare practitioner. You have the right to clear supportive information. It may take time before you are confident in what you know. Symptoms The first episodeThe majority of people with genital herpes have no noticeable symptoms and do not realise they have come in contact with the virus. They may notice symptoms at a later date. For others, the first symptoms of genital herpes may show up 2-21 days after coming in contact with the virus. The first episode of herpes is often the most severe. When you first come into contact with the virus your immune system has not had time to develop protective antibodies. This means the virus can multiply rapidly leading to significant symptoms. If you are having a severe first episode of genital herpes, you may notice that your lymph glands are swollen (the glands under your arms, your neck and in your groin). You may have flu like symptoms such as sore muscles, tiredness, headaches, fever and chills. You may notice swelling, pain or itching around the genitals. This may be followed by painful red spots that can form blisters. The blisters burst to form open sores or ulcers, which crust over and heal. Some people experience a second lot of ulcers. The tenderness in the genital area can cause pain when you urinate. Women may have a discharge. Usually, symptoms heal within 2-4 weeks. They cause no long-term damage. If you experience significant pain with any outbreak it is important to be aware that antiviral medications can significantly reduce the length and severity of the outbreak.Recurrent episodes In some individuals the symptoms of genital herpes may recur. Recurrences tend to be more mild and to heal more quickly. Some people will experience symptoms more frequently, others will rarely have outbreaks. You are likely to have fewer symptoms over time. Where did I get it?It is difficult to know. You may have been recently exposed to the virus or simply be having a recurrent episode from a previous exposure, which may have been some time ago. The person who passed it to you may not have known they have the virus. Researchers do not know why some people are more affected than others.The lifecycle of the virus Herpes has two parts to its lifecycle: active, which is when the virus is present on the skin and sores may or may not be not be present, and inactive, when the virus is hidden in the body and not infectious.What causes it to reactivate? Researchers are uncertain about what causes the virus to reactivate. Some common triggers are menstruation, being run down or anything that causes skin irritation, such as friction from prolonged sexual intercourse. Triggers are different for different people and can even be different for the same person over time. Keep a record of your outbreaks and try and identify any possible triggers. This will allow you to adjust your lifestyle to best manage genital herpes. Diagnosis: Tests for herpes There are several diagnostic tests available for herpes, each with varying degrees of accuracy. Ask your health practitioner for the name and type of test you have had and write this down for future reference.Swab tests Viral culture The viral culture is the most accurate test for herpes. To increase your chance of a successful culture, you need to go to your health practitioner while you have a lesion. Do not wait for the lesion to crust over. Your practitioner will take a swab of fluid from this lesion and send it off to the laboratory. The laboratory will attempt to grow a culture of the virus. It may take 2 weeks for you to get your results back. If a culture is successfully grown it will tell you if the lesion swabbed is herpes 1 or herpes 2. If you have a negative result, it does not mean that you do not have genital herpes, it may simply mean that there was not enough fluid on the swab to grow a culture. Repeat tests may need to be done.Other swab tests There are several other swab tests available that distinguish between herpes 1 and herpes 2. They have different degrees of accuracy.Blood tests Type specific serology Type specific serology is a blood test that tells you whether you have been exposed to herpes 1 or herpes 2. Until recently it has only been available for research purposes. It is now becoming more available. This test is best done at least two weeks after you have been exposed to the virus. If you are tested before this time the results may be inaccurate. Type specific serology involves your health practitioner taking a blood sample, which is sent off to the laboratory. It will not tell you if a particular lesion has been caused by the herpes virus. Your health practitioner will need to do other tests to rule out other contributing factors. Other blood tests Most other blood tests do not accurately distinguish between herpes 1 and herpes 2. At least 80% of Australians will come up positive in these test because 80% Australians have herpes 1 (the cold sore virus) by the time they are 25 years old. As such these tests are not particularly useful useful for identifying genital herpes. Transmission: How is herpes passed on? When and how can herpes be transmitted?The most common way to pass on herpes, both oral and genital, is through direct skin contact during vaginal, oral or anal sex when the virus is active on the surface of the skin. The virus cannot be spread when it is inactive (when it is in the nerve cell). The medical terminology for the virus being released from the surface of the skin is viral shedding. Viral shedding can occur with symptoms (symptomatic herpes) and without symptoms (asymptomatic herpes). You may or may not be aware that viral shedding is occurring. Symptomatic herpesSome people get a tingle or itching feeling that may be present for a few hours or days before they develop a herpes blister. It may be accompanied by a shooting pain in the nerve that passes through the buttock or the leg. These symptoms are called a prodrome. The herpes virus may be active during a prodroome (the few days before an outbreak), while sores are present and up to 2 days after the sores have completely healed.Asymptomatic herpes Viral shedding is not always obvious. Firstly, the symptoms of herpes may be so mild they may not be noticed at all. At other times, there may be no symptoms at all. This is called asymptomatic shedding. It is currently thought that true asymptomatic shedding may occur several times a year.Herpes in non-genital areas Herpes prefers the soft skin on the genitals, lips and anal area. When herpes comes into contact with other parts of the body it is often difficult for it to get through thicker skin. If you touch a sore, reduce the risk of transmission by washing your hands in soapy water to kill the virus. Genital herpes is very rarely transferred on toilet seats or on towels. How to reduce the risk of transmission Discuss genital herpes with your partner This will assist you to decide together on the precautions which suit you best When you have symptoms choose sexual activities that do not include skin-to-skin contact with the affected area. Use condoms. Latex condoms are good all round protection against a wide range of STD's. You are protecting yourself as well as your partner. Condoms do not cover all the potential sites of viral shedding, but they do offer useful protection against asymptomatic shedding, by covering and protecting the parts of the body that are the most likely sites of transmission. Put the condom on as soon as a complete erection occurs, not just with penetration. Use dental dams. Dental dams are a thin latex sheet that can be used when giving oral sex to a woman. They will reduce her exposure to oral herpes and reduce your exposure to genital herpes. They are available from chemists. Keep yourself informed about available antiviral medication. It is now known that taking daily antiviral medication reduces the frequency of episodes of viral shedding. This may be particularly helpful when you first get the herpes virus, as the shedding is more frequent in these early days. It may be useful to discuss this with your health practitioner. Does your partner have herpes? It can be useful to know whether your partner has herpes or not. If they have the same type of herpes as you, it is highly unlikely that you can pass the virus on. This knowledge may be especially useful in longer-term relationships. Read the section on diagnosis to get a better understanding of the usefulness and limitations of diagnostic testing.