Genital herpes is another type of sexually transmitted disease. This disease is caused by the herpes simplex viruses (HSV) type 1 and type 2, however, most of the genital herpes recorded today are caused by HSV type 2 (Division of STD Prevention, May 2005).
Genital herpes can affect both men and women population and is highly contagious. A person with genital herpes can be found suffering from pain and sores, particularly in the genital area. Medical professionals have disclosed that the virus that is causing such disease can enter one’s body through small breaks in the skin or in the mucous membranes. Although research based information disclosed that genital herpes can only be transferred through sexual interaction (because the virus dies quickly when outside the body, hence it is almost impossible to be infected with such virus by using the objects used by an infected virus) (http://www.mayoclinic.com/health/genital-herpes/DS00179/DSECTION=8,2006), physicians, nurses and the aspiring ones should still study this disease closely so as to know and inform the public about the pertinent information connected to this disease.
Genital Herpes
Epidemiology
There is astounding statistical information regarding the transmission of the disease. First, based on studies, there is actually one in every five of the adolescent and adult population who is infected with genital herpes, and majority of these are women (one in every four women; while in men is one out of five). It is also good to note that based on records, genital herpes is more commonly transmitted via male to female sexual contract than female to male (American Social Health Association, 1998).
In America alone, there is a recorded one in every five Americans who have genital herpes and 80% of whom do not know that they have acquired such disease. From this population, 25% of which are adults and about one in every five Americans over age 12 (which is roughly 45 million individuals) are infected with HSV-2. This statistics enabled the researchers to safely predict that an estimated 1 million new HSV-2 infections may be transmitted each year in the United States (Fleming et al. 1997).
Meanwhile, in other parts of the globe, genital herpes is also becoming a problem. In Australia, a record of one in every six Australian adults has genital herpes. The Australian Herpes Management Forum (AHMF) revealed that from the said number of Australian people with genital herpes, only one of 5 from them are diagnosed and estimated 80% of cases of genital herpes are not recognized as such by clinicians.
A good number of African-Americans and the White Caucasians have also had genital herpes. Records show that 45.9% of the total African-American populations have had genital herpes while 17.6% of the White Caucasian had the same sexually transmitted disease (Institute of Medicine. 1997).
With the number of cases related to genital herpes, it is just expected that the medical expenses related to such disease is equally high. In 1994 alone, approximately $237 million was spent to medicines, hospital bills and medical costs which wad all consumed up for genital herpes cases (Institute of Medicine. 1997). These expenses are in U.S. alone, surely more other amounts were used up when combined with the neighboring countries, like the third world countries.
Causes and Symptoms
There are only two known viruses that are causing genital herpes. These are the two types of herpes simplex virus infections with HSV type 1 (HSV-1) and HSV type 2 (HSV-2). HSV-1 causes cold sores or fever blisters around the mouth spreading through the genital area during oral sex. HSV-2, on the other hand, is the most common HSV-virus causing genital herpes, that is transmitted via sexual contact and skin-to-skin contact (http://www.mayoclinic.com/health/genital-herpes/DS00179/DSECTION=8,2006).
Genital herpes is passed by having sexual contact with a person with such disease. The probability of transmission is higher if the person has open sores. Some of the symptoms of an infected person are:
itching or burning feeling in the genital or anal area having flu or slight to high fever swelling glands having pain in the legs, buttocks, or genital area moderate to frequent vaginal discharge uncomfortable sense of pressure in the area below the stomach
It should be noted that the symptoms stated above may vary depending upon the severity of the infection. In the initial occurrence of genital herpes, a person may notice the symptoms within two weeks of the sexual contact to an infected person. Such symptoms may last from two to three weeks (Division of STD Prevention, May 2005).
After several more days, an infected person may show signs of having sores or lesions in the mouth, penis or vagina which would start as a tiny red bumps and eventually into blisters. Sometimes, especially on the women, sores will also be present in the cervix or while men will sometimes have lesions on the urinary passage. As the virus progresses on the body, further symptoms may include (Division of STD Prevention, May 2005):
Continuous itching or burning in the genital area
More pain, this time including the legs, buttocks, or genital area
Continuous vaginal discharge and discomfort around the stomach
Fever, headaches and muscle pains
Discomfort or pain during urination
Continuously swelling glands in the genital area
However, there are a few numbers of cases wherein the infected person may not be showing any signs or symptoms at all. These are the reason why there are unsuspected cases. These are rare cases but are extremely dangerous for these are the reasons why some genital herpes are transmitted without the already infected person knowing it (Division of STD Prevention, May 2005). (Unfortunately, such symptoms may be gone for a time, but the virus itself never leaves the body, specifically in the nerve cells. This virus may become active again depending upon the health of the infected person. The virus may even work itself up to other parts of the body. Until now, there have no strong evidences that can prove why such symptoms recur or what causes such virus to become active again. Some people who have been infected with the virus revealed that they experience recurrence of the symptoms especially if they are under http://www.mayoclinic.com/health/genital-herpes/DS00179/DSECTION=8,2006):
Too much stress
Unusual menstruation
Poor nutrition
Other forms of illnesses
Surgery
Undefined friction that may be caused vigorous sexual intercourse
Treatment
There is no medication nor are other forms of treatment for genital herpes patients but there are several ways to prevent the virus to become active again. Some drugs that are usually prescribed by the physicians to prevent a more and severe outbreak of symptoms are acyclovir, valacyclovir, and famciclovir.
Meanwhile, while having the outbreak (may it be for the first time or as a recurring outbreak of symptoms), some of the best things to do to prevent infecting other parts of the body or spreading the disease to other people are:
Maintaining the infected area clean and dry.
Avoiding contact to the open or infected sores, or if it cannot be helped, washing the hands right after the contact.
Keeping away from having any sexual intercourse from the time the symptoms are first observed until the sores have healed.
Complications
Genital herpes infection can be linked to other forms of complications specifically for the women. There are scientific evidences which have shown that women who may have been suffering from recurring genital herpes may risk the cervix to virus causing cancer. Such risk may continuously increase HSV is present and combined with human papilloma virus (HPV), which is the known virus that is responsible for genital warts called condyloma. Moreover, pregnant women who may have had either HSV-1 or HSV-2 on the external genitalia or in the birth canal are also being risked to infect the infants. Infection of the newborn babies from the genital herpes infected mother can lead to herpetic meningitis, herpetic viremia, chronic skin infection, and even death (Gandhi, 2006).
Other possible complications related to genital herpes are the risk that can subject the immunocompromised individual or the patients with diagnosed AIDS, those that are undergoing chemotherapy or radiation therapy, or patients that are taking high doses of cortisone preparations. These people who will be infected by genital herpes will suffer in serious infections to various other organs like (Gandhi, 2006):
Herpetic keratitis which is the kind of herpes infection causing the eye to suffer from scaring within the cornea and eventual blindness
Constant infection of the mucous membranes and skin of the nose, mouth, and throat
Herpetic esophagitis or the so-called infection of the esophagus
Herpetic hepatitis which is the infection of the liver.
This may further cause inflammation of the liver to liver failure
Encephalitis, the serious infection of the brain, which if left untreated, will lead the infected person to comatose and ultimately death within just several days. Sixty to 80% of the people who have had encephalitis died in just a few days while those who were able to recover suffer from major impairment, ranging from mild neurological impairment to paralysis.
Pneumonitis, the infection of the lungs that can cause life-threatening pneumonia (Gandhi, 2006)
Life with Genital Herpes
Stress, as it was pointed out, was one of the reasons why there could be a recurrence of genital herpes symptoms. Psychological stress may have been causing it, but the recurrence itself can, of course, result to more stress to the infected person. There have been numbers of studies that show that recurrences of genital herpes are related with psychological morbidity, and the extent of which seems to be directly related to the frequency of recurrences (Taboulet, et.al., 1999). This is just an expected outcome for any person who will be diagnosed with genital herpes will not only worry about how to cure or prevent the occurrence of another outbreak, but will also worry or think about how others might view him/her as an infected person. A person with the genital virus will be feared by the opposite sex in the same manner that the infected person will of course tend to shy away from getting into another intimate relationship. As it is pointed out, the virus will never leave the body of the infected person, it will just stay there and will threat to become active again if the immune system of the person becomes very low. This is the every reason why the person will be very insecure of him/herself. This is the same reason why others will shy away from the infected person. Other people will, of course, not want to be infected by the virus. Some might even falsely think that the virus by just talking to the person or touching the things used by the infected person.
More so, a diagnosed genital herpes virus carrier will be maintaining different kinds of supplements so as to suppress the virus from getting active again. Such actions will inhibit the person from doing other activities. Needless to say, the supplements or vitamins or other forms of medications will be eating too much of the financial sources of the person, hence, will prevent him/her from doing or buying other things which he/she used to enjoy.
Credible journals and studies have really proven that patients with genital herpes had impairments in emotional role functioning, mental health, and social functioning. Other studies further proved that the recurrences of genital herpes recurrences have a very strong impact on the magnitude of quality of life impairment in a way that the patients who have had two or more recurrences were more damaged (physically, emotionally and mentally) than those with one or no recurrences (Wild, et. al., 1995).
The infected or the genital herpes patients are not the only people who are suffering from psychological, social or emotional distress. The parents, and other loved ones are also continuously suffering as they see the patients who continuously endure the pain and hurt of the said disease. Aside from the fear of being inflicted with the virus, the parents and other loved ones will worry themselves on how to help and take care of the patients.
Nursing Plans
The combination of Adaptation theory, Self-efficacy theory and Social learning theory are the three best possible approaches to dealing with the patients and (and the family) of genital herpes virus.
Since there are no medications that will eliminate the virus, only the ways on how to inhibit such virus from being active again are some of the things that the patients and the family should know. First, it is the nurses’ responsibility to inform the patient and the family about the severity of the infection and how it can be transferred or transmit. These information will enable the patient to know his/her real health status and at the same time, will calm the family in knowing that there are specific ways on how the virus can be transferred to them, hence they could always avoid such ways.
Secondly, the nurses can advice and help the patients and the family on how to adapt themselves with the disease. The things that the patient must have- such as enough rest, plenty of nutrients and/or supplements to maintain a good immune system, cleanliness in the area and in the infected body part and avoidance to any further sexual intercourse – should be detailed to the patient and the family. This way, they may set their minds to accepting the reality regarding the said virus and to committing themselves into doing the suggested practices.
Third, which is connected to the self-efficacy theory, is helping the patient understand that he/she can still work or live normally. A genital herpes virus carrier can still be productive and useful for the society or the family if he/she sets her mind and heart. It is then the nurses’ duty to maintain positive atmosphere when dealing with the patient and in motivating him/her about the possibility of no recurrences.
Proper information dissemination to the patient, the immediate family and to all other concerned individual may ensure social-learning and social acceptance. The practice of safe sex can be highlighted to the people, with or without the genital herpes virus. This is to prevent such virus and/or to prevent the transmission of such virus. It is then the nurses’ responsibility, and all other medical practitioners, to keep the public informed on what are the best methods of having safe sex.
In the same manner, the public may also need to be informed about the ways and means that such disease can only be transferred. This is to prevent the public from discriminating or shying away from the patients. One of the sources psychological stresses of the patient is the thought that other people will not talk nor be with them anymore, and there is really a big possibility that this might happen. However, if the people are aware that mere talking or being with the infected person could not transmit the disease, then emotional and psychosocial turmoil of the public and of the patients will then be prevented.
Works Cited
American Social Health Association. (1998), Sexually Transmitted Diseases in America: How Many Cases and at What Cost? Menlo Park, CA: Kaiser Family Foundation.
Fleming DT, et al. (1997), Herpes Simplex Virus type 2 in the United States, 1976 to 1994. NEJM; 337:1105-11.
Gandhi, M. (February 2006), Division of Infectious Diseases, VeriMed Healthcare Network UCSF, San Francisco, CA.
Genital Herpes,” (May 2005), Division of STD Prevention, Centers for Disease Control and Prevention. http://www.mayoclinic.com/health/genital-herpes/DS00179/DSECTION=8
Genital Herpes,” (2006) [Available online] http://www.medicinenet.com/genital_herpes_in_women/page3.htm
Institute of Medicine. Committee on Prevention and Control of Sexually Transmitted Diseases. (1997). The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Eng TR and Butler WT, eds. Washington, DC: National Academy Press
Taboulet F, Halioua B, Malkin JE. (1999). Quality of life and use of health care among people with genital herpes in France. Acta Derm Venereol.79:380-384.
Wild D, Patrick D, Johnson E, et al. (1995). Measuring health-related quality of life in persons with genital herpes. Qual Life Res.4:532-539.
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