Let’s talk about herpes! Between 60%-80% of the population has been exposed to the herpes virus. Genital herpes caused by the Herpes Simplex Virus 2 (HSV-2) is generally contained to the area around the genitals, vulva, vagina, penis, scrotum, and anal rectal area. Oral herpes is caused by the Herpes Simplex Virus 1 (HSV-1) and generally occurs on the oral mucosa; the lips, around the mouth, and even the nose. But the two herpes viruses can be transmitted between their respective areas and not necessarily in a sexual way - they do not discriminate! 

Diagnosis

If you have an active legion, the simplest way to diagnose it would be with a swab. However, some people who are exposed to the herpes virus will never actually get an outbreak. We can test blood and if there has been an exposure, immunoglobulins against that virus are present.

Symptoms

Symptoms that are consistent with a herpes outbreak include:

1. A tingling or burning where you've previously had lesions or they are about to form. 
2. Ulceration of blisters appearing after the tingling or burning, lasting generally less than 10 days. 
3. Depending on their location, lesions can make urination, defecation and intercourse quite painful. 
4. Children having their first outbreak around their oral area often experience a large number of ulcers on the inside of their mouth and it can be very hard for them to eat and stay hydrated. 
5. First outbreaks are often associated with systemic feeling unwell such as fever or swollen lymph nodes

Treatment

Herpes is treated with antiviral medication, and there are two ways to use it:

• Reactively: taking medication for a few days when you feel an outbreak coming
• Preventatively: taking a daily medication that will help to prevent, but not guarantee, that outbreaks occur less frequently. This method can also help in preventing the spread of herpes to others as your viral shedding is decreased.

Because your immune system is suppressed, outbreaks during pregnancy are a bit more common. If you have a history of active herpes lesions, it is sometimes recommended starting on antivirals around the 36th week of pregnancy. If you have an active legion during pregnancy, a Caesarean Section may be recommended. In both cases, the goal is to avoid exposing your baby to the virus as the potential for a bad infection is higher in newborns. 

Prevention

Herpes is transmitted with skin-to-skin contact with a legion, but as we’ve said above the two types of herpes strains do not play zones:

1. Transmission is possible from fingertips, lips, the vulva, penis, or even the nipples. Washing hands and avoiding skin-to-skin contact with these areas is important.
2. Outbreaks often occur when the immune system is suppressed or if you are immunocompromised. Both pregnant people and newborn babies have more fragile immune systems so should practice extra caution and tell your healthcare provider.
3. Use a condom when engaging in sexual intercourse

If someone has been exposed to and carries the virus, they can transmit it even if they have never had an outbreak or symptoms themselves. So as you can see, the nature of herpes is very pervasive and nothing to be ashamed of. 

If you do get your first ever herpes infections during pregnancy please tell your care provider as your pregnancy will be monitored differently. 

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