STD HERPES: OUTBREAKS AND ASYMPTOMATIC SHEDDING OF THE VIRUS

As discussed previously, the classic symptoms of blisters and ulcers do not occur in everyone who has herpes. If symptoms do develop, however, they usually do so within two to twenty days of first infection. After infection with herpes, whether or not a person develops symptoms, the virus moves from the skin into the nerve endings that supply the area of the skin that was infected. It migrates along the nerve endings to the nerve root body, or ganglion, which is near the spinal cord. Here the virus remains quiet, or dormant, and then periodically migrates back out to the surface of the skin.

When the virus migrates back to the surface of the skin, a person may develop symptoms, such as a sore or itching or tingling on the skin, or he or she may remain completely symptom free. The condition in which there are symptoms is called an outbreak; when the virus comes to the surface of the skin and doesn’t cause symptoms, the condition is referred to as asymptomatic or subclinical shedding of the virus. Sometimes there is a warning that the virus is reactivating; this warning, called a prodrome, may consist of itching, tingling, or pain in the area where the outbreak takes place, but before there is any evidence on the skin. However, not everyone experiences prodromes.

Everyone who has oral or genital herpes, whether type 1 or type 2, will shed without symptoms at some point. How often this occurs varies from person to person. Why some people shed more than others, and why some people have more outbreaks than others, is not clear.

Two things are clear, however: people who are newly infected (for less than a year) have more asymptomatic shedding than those who have been infected for a longer time, and people who experience more frequent symptomatic outbreaks also tend to shed the vims more often without symptoms than those who rarely have outbreaks.

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