MANAGING FEVER BLISTERS

A middle aged man had come for treatment in the hospital. He had multiple sores on his lips. The sores were giving him tingling and painful sensations. He said it was a symptom of malaria, that whenever sores appeared, he treated malaria (self medication) and he would be free of the sores.

Contrary to popular belief, cold sore or fever blisters is not a symptom or sign of malaria or typhoid fever. However, such recurrent sores are triggered by stress, illness, fever, menstrual periods, surgery and low immunity.Cold sores, also called fever blisters, are a common viral infection. They are tiny, fluid-filled blisters on and around the lips. 

After the blisters break, a crust forms over the resulting sore. Cold sores usually heal in two to four weeks without leaving a scar.

The World Health Organisation published a study recently, noting that two-thirds of the world’s population under 50 has the highly infectious herpes virus that causes cold sores around the mouth.

Cold sores are caused by a herpes simplex virus 1 (HSV-1), closely related to the one that causes genital herpes, herpes simplex virus type 2 (HSV-2).

Both of these viruses can affect the mouth or genitals and can be spread by oral sex. Cold sores are contagious even if the sores are not available.

Other names for cold sores caused by HSV-1 are oral herpes, mouth herpes and herpes simplex labialis.

Herpes is also a very common sexually transmitted infection. It is caused by one of two different viruses: herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2). Once herpes has been contracted, it remains in the body for life.

While HSV-1 is more often found in the oral area, it can be contracted genitally as well and, in the same vein, HSV-2 is primarily found in the genital area, but can be contracted orally.

When someone has an outbreak of sores, they are most contagious and therefore at the highest risk of transmitting the virus. However, even when someone does not have any symptoms, it is still possible to pass the virus.

Symptoms

Tingling, itching, or burning, sores; one or more painful, fluid-filled blisters may appear. Blisters break open and often ooze fluid and form a crust, before healing.

For oral herpes (HSV-1), most blisters appear on the lips or around the mouth. Sometimes blisters form on the face or on the tongue.

Although these are the most common places to find oral herpes, the sores can appear anywhere on the skin.

Genital herpes (HSV-2): Sores typically occur on the penis, vagina, buttocks or anus. Women can have sores inside the vagina. Like oral herpes, these sores can also appear anywhere on the skin.

Flu-like symptoms: Fever, muscle aches, or swollen lymph nodes (glands) in the neck (oral herpes) or groin (genital herpes) are possible.

Problems urinating: People (most often women) with genital herpes may have trouble urinating or have a burning feeling while urinating.

Eye infection (herpes keratitis): Sometimes the herpes simplex virus can spread to one or both eyes. If this happens, one can have pain, light sensitivity, discharge, and a gritty feeling in the eye.

Without prompt treatment, scarring of the eye may result. Scarring can lead to a cloudy vision and even loss of vision.

Prevention

When there is a warning sign of an outbreak, people are to refrain from sexual contacts. Warning signs may include a burning, itching or tingling feeling.

It is advisable not to have vaginal, anal, or oral sex — even with a condom. Wait until seven days after the sore heals.

Use condoms between outbreaks to reduce the risk of transmission. Also, use herpes treatments. The risk of transmission can be greatly reduced if the partner with herpes takes a small daily dose of anti-herpes medication.

Treatment

There are medications that can help speed up the healing of sores and prevent them from returning. Such medicines, when taken on a daily basis, can decrease recurrence frequency to about once per year. And if a recurrence does occur, it is generally milder and lasts for a shorter time.

I will be concluding this piece with genital herpes, herpes simplex virus type 2 (HSV-2) since this is also of serious public health importance.