'You can still pass on herpes even if you are practicing safe sex' - Irish doctor on the common virus herpes simplex
A lawsuit involving US artist Usher has brought the herpes virus into the media spotlight, but are you as clued up as you think when it comes to the infection?
Three people, including New York woman Quantasia Sharpton (21), have taken a lawsuit against the star accusing him of knowingly exposing them to the herpes simplex virus. They claim the Yeah singer did not inform them that he had suffered outbreaks of the virus before engaging in unprotected sex.
Although often stigmatised, herpes is a very common infection, according to Dr Shirley McQuade, Medical Director of Dublin's Well Woman's Centre.
Here are a few things you might not know about the virus.
There are two types
The herpes simplex virus is categorised into two types; herpes type 1(HSV-1) and herpes type 2 (HSV-2). Typically type one is oral herpes and presents as cold sores on the lips and mouth, while type 2 is often categorised as genital herpes. However, either type can present anywhere on the body. For example a person who suffers from cold sores can pass the herpes type one virus onto their partner's genitals through oral sex.
Ulcers and cold sores are not the only symptom of herpes
Ulcers on the genitals and mouth are often associated with herpes simplex, and while it is a symptom, Dr Shirley says some people experience accompanying symptoms typical of the virus.
"Some people have worse reactions to the herpes virus than others," said Dr McQuade.
"Symptoms of herpes typically include ulceration and sores. It can be a very painful thing. Many of the patients that present to me during their first episode might also be suffering from swollen lymph nodes in their groin. They might feel really unwell, suffering from flu-like symptoms. For women it can be a discomfort to pass urine."
"The symptoms might not be so severe and can present as small cuts on the skin."
You might not even know you have herpes (but you can still pass it on)
One-in-five people infected with herpes never display symptoms but can still pass it on to sexual partners.
"This is called asymptomatic shedding," says Dr McQuade.
"A person's body might show no signs of the virus, but they can still infect a sexual partner."
If a person has had herpes outbreaks in the past they can pass on the virus also, even if they are not having an outbreak at the time of sexual contact.
Herpes is very common in Ireland
Dr McQuade said the virus is extremely common and she treats between one and two patients experiencing their first outbreak of genital herpes each week.
The majority of Irish people have been exposed to herpes type one in the past and have built antibodies against the virus. A fifth of people have been exposed to herpes type 2.
"It's a very common infection. In fact, 80pc of Irish people have antibodies against type 1 herpes simplex, which means 80pc of people have been exposed to the virus at some point. 20pc have antibodies for type 2 herpes simplex," she said.
You can get herpes even if you're practising safe sex
Herpes is a viral infection passed on from skin to skin contact. The virus is spread through fluids found within herpes sores, which can passed on from one person to another during sex, but also during any kind of sexual intimacy. This means that even though you are practising safe sex you can still pick up the virus.
"As condoms don't cover the whole genital area the virus can be passed on even if you are practicing safe sex," says Dr McQuade.
Standard STD testing does not pick up herpes.
As so many of us have been exposed to both types of the virus at some point in our lives, many people would test positive for the antibodies related to herpes following a blood test. Standard STD testing analyses the blood for HIV, hepatitis B, hepatitis C, chalmydia, gonorrhoea and syphilis. Herpes simplex is diagnosed by taking swabs of the affected area, if ulcers or lesions present.
The first outbreak is often the worst (but you might only ever have one)
In many cases, outbreaks of the herpes virus reduce in severity over time, and for many people who have a bad reaction to the virus, the first episode can be the worst.
While some people might only ever have one outbreak, others might experience outbreaks systemically. It all depends on a person's immune system, according to Dr McQuade.
Sufferers of herpes type 2 are more likely to have re-occurrences of the virus than sufferers of type 1.
"Eventually the infection will burn out and the immune system will get to grips with it. Unfortunately for some this might take a long time," said Dr McQuade.
You might not have picked up the virus from your current partner
"If you have had a new sexual partner within the last week and have an outbreak afterwards, it is highly likely that this partner has passed on the virus. However, I have seen patients who have had first outbreaks six months after their last sexual encounter. So it's hard to know sometimes if it was their last partner or not and that can be difficult," said Dr McQuade.
You should let your doctor know you have the virus if you are pregnant
Although the risk is small, there is a risk genial herpes can be passed on to an infant during delivery. Dr McQuade says the biggest risk is if there are active lesions, which could pass on to an infant through skin to skin contact. In this case a C-section might be considered.
Herpes sufferers should also take care around newborns as the virus can pose a risk to their health.
The stigma surrounding herpes can be difficult to deal with (but know it's extremely common)
Dr McQuade says: "There is a stigma around herpes because a person can never say they are herpes free after suffering an outbreak.
Herpes can be very upsetting for people as it is something that a person has little control over. At the Well Woman Centre we do offer counselling to try and change people's mindsets about their diagnosis and not to ruminate. However, people should bear in mind that it's an extremely common virus and it really isn't the end of the world."
There are ways to manage the virus
Dr McQuade says many patients who test positive for herpes are treated with a five-day course of anti-viral medication, and also a local anesthetic gel to help with the pain.
Type Two Herpes is more likely to reoccur and a sign of a recurrence can be a tingling sensation in the days before an outbreak, which is the feeling of an ulcer forming.
People might find that they are more prone to outbreaks when they are run-down or stressed out. Outbreaks are also more common when a woman is on her period.
Those who have regular occurrences can manage the virus in a number of ways, for instant taking daily anti-virals during stressful periods, such as exam times.
You can get herpes anywhere on the body
Both types of herpes can occur on all skin. For example a herpetic whitlow is a lesion on the finger or thumb caused by the herpes virus, which can be passed on through thumb sucking or coming in contact with a herpes lesion.
If you have had outbreaks of herpes in the past it is important to full disclose this to you partner before you have sex, even if the conversation is difficult.