GET TO KNOW HERPES

• Herpes is a common, lifelong infection generally transmitted through skin-to-skin contact.

• You can get herpes on the lips (oral herpes), on the genitals (genital herpes) or on other parts of the body (non-genital herpes).

• There are two types of the herpes simplex virus – Herpes type 1 and Herpes type 2.

• Herpes type 1 is the virus that most commonly causes cold sores on the lips or face. While often transmitted during childhood through kissing, this infection can be transmitted at any age. It can also be transmitted to the genitals through direct skin-to-skin contact during oral sex.

• Approximately 8 in 10 Australians have Herpes type 1 by the time they are 25. A much smaller proportion will show obvious symptoms i.e. cold sores.

• Herpes type 2 is the virus responsible for most genital herpes. It is transmitted through sexual contact.

• Approximately 1 in 8 Australians have Herpes type 2 – 1 in 5 of whom have symptoms. Those without symptoms may not know that they have the virus.

WHAT SYMPTOMS DO MOST PEOPLE EXPERIENCE DURING THEIR FIRST EPISODE OF HERPES TYPE 2 (GENITAL HERPES)?

Most people will have no noticeable symptoms following infection and will not even realise that they have come into contact with the virus. They may notice symptoms at a later date. For others, the first symptoms of genital herpes may show up within 2 to 21 days after coming into contact with the virus. The first outbreak of herpes is usually the most severe. If you are experiencing a severe first outbreak of genital herpes, you may notice that:

• Your lymph nodes are swollen (glands or lumps in the groin).

• You may have flu-like symptoms e.g. sore muscles, tiredness, headaches, fever and chills.

• You may have swelling, pain or itching around the genitals, possibly followed by painful red spots that can form blisters.

• The blisters may burst, to form open sores or ulcers, which will later crust over and heal.

• You may experience pain when urinating due to the tenderness in your genital area.

• You may experience a vaginal discharge (women).

Usually symptoms will resolve within 2 to 4 weeks and cause no long-term damage. However, if you experience significant pain with any outbreak, you should ask your medical practitioner about antiviral medication which can reduce the duration and severity of outbreaks.

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Novartis Pharmaceuticals Australia Pty Ltd. ABN 18 004 244 160. 54 Waterloo Road, North Ryde. NSW 2113. 07/05.

WILL I GET GENITAL HERPES AGAIN?

You may experience the symptoms of genital herpes again. If so, your outbreaks will tend to be milder and heal faster. Most experience fewer symptoms over time and some people experience no further outbreaks.

WHEN DID I GET HERPES?

It is hard to say. You may have been recently exposed to the virus or you may simply be experiencing a first outbreak from a previous exposure, possibly some time ago. The person who passed herpes on to you may not have known that they carry the virus.

WHAT IS THE LIFECYCLE OF THE VIRUS?

Herpes has 2 states in its lifecycle:

1. Inactive – when the virus is hidden in the body in a sensory nerve.

2. Active – when the virus is present on the skin and sores may or may not be present.

WHAT CAUSES THE VIRUS TO REACTIVATE?

Researchers are uncertain about what causes the virus to reactivate, however menstruation and sexual activity have been shown to be associated with outbreaks. The triggers are different for different people and can even vary for the same person over time.

WHEN AND HOW CAN HERPES BE TRANSMITTED?

The most common way to pass on Herpes type 1 or 2 is through direct skin-to-skin contact during kissing or vaginal, oral or anal sex. The medical terminology for the virus being released from the surface of the skin is called viral shedding. Viral shedding can occur with symptoms (symptomatic herpes) and without symptoms (asymptomatic herpes), e.g. when you have an outbreak and also at times when there are no symptoms.

WHAT IS SYMPTOMATIC HERPES?

The earliest noticeable symptoms are a tingling or itching feeling that may last for a few hours before developing a herpes blister. These symptoms are called a prodrome. The herpes virus may be active during a prodrome and while the sores are present.

WHAT IS ASYMPTOMATIC HERPES?

Often the herpes outbreak may be so mild it may not be noticed at all. At other times, there may be no symptoms. This is called asymptomatic viral shedding and may occur at any time between outbreaks.

www.lessoutbreaks.com.au

Novartis Pharmaceuticals Australia Pty Ltd. ABN 18 004 244 160. 54 Waterloo Road, North Ryde. NSW 2113. 07/05.

HOW MIGHT I HAVE CONTRACTED HERPES IN NON-GENITAL AREAS?

Herpes prefers the soft skin on the lips, genitals and anal area. When herpes comes into contact with other parts of the body it is very unlikely to penetrate thicker skin. The most likely explanation for herpes in non-genital areas is the virus travelling down a different branch of an affected nerve to a nearby area of skin.

HOW DO I REDUCE THE POSSIBILITY OF TRANSMITTING HERPES?

You can reduce your risk of transmitting herpes by adhering to the following steps:

1. Discuss genital herpes with your partner and take safety precautions together.

2. Ask your partner if they have herpes. If they carry the same type of herpes as you, they should already have protective antibodies. This knowledge may be especially helpful if you are in a long-term relationship. Your medical practitioner can determine herpes immune status with a simple blood test.

3. When you have symptoms, choose sexual activities that do not include skin-to-skin contact with the affected area.

4. Use condoms. They offer you and your partner good protection against a wide range of sexually transmitted infections. Although condoms do not cover all of the potential sites of viral shedding, they do offer some protection against transmission of genital herpes, by covering parts of the body that are the most likely sites of asymptomatic shedding. It is essential to slide a condom on as soon as a complete erection occurs, not just at penetration.

5. Use dental dams. Dental dams are a thin latex sheet available from chemists that can be used when giving oral sex to a woman. They will reduce exposure to oral herpes and minimise exposure to genital herpes.

6. See your medical practitioner to discuss these and other options that might be suitable for your circumstances.

HOW DO I TEST FOR GENITAL HERPES?

There are several diagnostic tests available for herpes, each with varying degrees of accuracy. See your medical practitioner for testing.

ARE THERE MEDICATIONS AVAILABLE TO HELP MANAGE GENITAL HERPES?

Medication for genital herpes is available in tablet form. There are currently 3 antiviral tablet medications available in Australia for the treatment of genital herpes – famciclovir, aciclovir and valaciclovir. These work by stopping the herpes virus from multiplying.

www.lessoutbreaks.com.au

Novartis Pharmaceuticals Australia Pty Ltd. ABN 18 004 244 160. 54 Waterloo Road, North Ryde. NSW 2113. 07/05.

WHAT IS EPISODIC TREATMENT?

Episodic treatment of genital herpes involves treating the infection when it recurs i.e. managing individual outbreaks of genital herpes as necessary. Taking medication at the first signs of an outbreak will help to reduce the length and severity of symptoms. This type of treatment may be preferred by some patients. However, episodic therapy does not alter the frequency of outbreaks.

WHAT IS SUPPRESSIVE TREATMENT?

Suppressive (preventative) treatment involves taking medication every day to reduce the frequency of outbreaks occurring. Continuous suppressive treatment is particularly useful for those who are experiencing frequent or troublesome outbreaks. It also significantly reduces both symptomatic and asymptomatic viral shedding. Many doctors use suppressive treatment for herpes in people with HIV because outbreaks are common and suppressive therapy reduces viral shedding. If you have a high level of herpes-related anxiety due to the severity of outbreaks, you might find that suppressive therapy allows you to be less focused on the herpes virus. This emotional break can provide you with time to adjust to living with this infection. You may also find professional support helpful.

WHAT SHOULD I DO IF I SUSPECT I HAVE GENITAL HERPES?

If you think you might have genital herpes, it’s important to seek professional advice from your medical practitioner. For further information about genital herpes visit us at www.herpes.com.au and www.lessoutbreaks.com.au or call 1800 102 200.

FURTHER RESOURCES

Your healthcare professional Please visit your local doctor or Sexual Health Clinic for further information about herpes and its management.

Counselling You may experience mixed emotions and confusion after discovering you have genital herpes. A counsellor may prove helpful. Counsellors experienced in genital herpes can often be contacted through sexual health clinics.

Support groups Herpes support groups offer a confidential environment for discussing issues and information with others in a similar position. While some groups are facilitated by a counsellor, others have a more social focus. Contact your local sexual health clinic for information about support groups in your local area.

Internet Please note that anyone can set up a website, so the information may be of mixed quality. Verify the information you download from the Internet with your doctor.

Two Australian sites offering information about genital herpes and sexual health centre contacts are located at www.herpes.com.au (a service from Novartis) and www.ahmf.com.au (a service from the Australian Herpes Management Forum).

FOR MORE INFORMATION ABOUT GENITAL HERPES VISIT WWW.HERPES.COM.AU AND WWW.LESSOUTBREAKS.COM.AU OR CALL 1800 102 200

www.lessoutbreaks.com.au

Novartis Pharmaceuticals Australia Pty Ltd. ABN 18 004 244 160. 54 Waterloo Road, North Ryde. NSW 2113. 07/05.