The FAQ is in the works!  As it has been for about eight years.  Or
longer.

Yes:   Common sense, decent manners, and no spamming.  When spammers
show up, the decent manners rule is dispensed with, at least with
me.   ;-)

Also, speaking only for myself, I don't mind discussing drugs, or
drug retailers, or alternate therapies, or related material, but a
lot of what shows up in those categories seems to be the end result
of marketing efforts by the aforementioned spammers and scam
artists, so discussions can be short and sweet in those areas,
depending.

The group is mainly about giving positive information that can be
relied on for diagnosis, treatment, and dealing with the
psychological stresses associated with the virus.  I think we try to
demonstrate that having HSV is, for most people, no big deal.  For
people for whom it IS a big deal, we try to steer them in directions
that will help them treat it or cope with it.

The eternally half-done FAQ is currently here:

http://mysite.verizon.net/msoja9/sphere.html

Welcome to the alt.support.herpes FAQ

Version 3.12 - last updated December 10, 2003

"Few things are duller than feeling unspecifically off-color" -
Ogden Nash

Those encountering the Herpes simplex viruses for the first time are
often overwhelmed by the unknowns. There are the unfamiliar physical
aspects, the seeming complexity of the virus's pathology, and the
emotional stress of confronting deeply personal issues of sex and
romance. It is the aim of this FAQ to help those new to herpes to
learn enough about the disease to understand its workings and, also,
in some small way, to offer the reassurance that, not only does the
affliction soon come to resemble more of a nuisance than a
life-altering catastrophe, but that the new sufferer is by no means
alone, that there are support groups to answer questions and give
reassurance as well as to help HSV sufferers meet each other. As
with all new things, once a little of the jargon is explained, and
some of the myths dispelled, much of the puzzle falls into a
manageable perspective. In the end, if one can't say he or she is
overjoyed with the disease, most can at least claim some kind of
comfort with it.

HERPES - The Virus

What is Herpes?

Herpes is an affliction, caused by a family of viruses, that
periodically recurs in many sufferers. To the average person, the
word "herpes" (which comes from a Greek word meaning "to creep") is
usually associated with the word "genital", as in "genital herpes",
but, in fact, herpes is more wide-ranging than that. There is also
Oro-facial herpes, otherwise known as cold sores, fever blisters,
Herpes labialis, and Herpes facialis. And then there is Herpes
zoster, also known as shingles or belt herpes. Rarer presentations
are Herpes gladiatorum and Herpes rugbiosum, seen in field and
contact sports players; Ocular herpes, around the eyes; Herpes
whitlow, of the hands and fingers; and others. Many of the rarer
types are simply one of the common herpesviruses in an unusual place
(for example, Herpes whitlow is mostly caused by HSV1, the virus
usually associated with Oral herpes) or outbreaks caused by a
particular set of conditions (chicken pox and shingles are
manifestations of the same herpesvirus -- Herpes zoster -- but occur
at different times in the host's life.)

What agent causes Herpes?

Herpes is caused by any of a number of viruses from the (strangely
enough) herpesvirus family, which scientists subdivide into 3
groups, or sub-families; the alpha, beta, and gamma herpesviruses.

The herpesviruses native to humans are: Herpes simplex 1 (HSV1),
Herpes simplex 2 (HSV2), Varicella zoster virus (VZV), Epstein Barr
virus (EBV), Cytomegalovirus (CMV), Human herpesvirus 6 (HHV6),
Human herpesvirus 7 (HHV7), and Human herpesvirus 8 (HHV8). Herpes B
is a monkey herpesvirus that has the potential to infect humans.
Further down the evolutionary tree, one can find herpesviruses
native to virtually every species, and new herpesviruses are
discovered quite often.

Most people encounter Herpes zoster as children, in the form of
chicken pox, an episode dimly remembered by most adults, though the
virus still lurks within all those it invaded, and sometimes
reasserts itself later in life as painful herpetic neuraligia, or
Shingles, though generally even those episodes are one shot affairs.
The Epstein Barr virus is extremely common around the world,
infecting 90% or more of the world's adult humans, and is the cause
of that old high school and college bane, mononucleosis aka 'The
Kissing Disease', which, like VZV, usually bothers its human host
only for a single short span of time. CMV and others are beyond the
scope of this FAQ, though questions about them may be directed to
the newsgroup.

It's the two simplex herpesviruses that bother the sensibilities of
the most people, recurring periodically anywhere from once a month
to once or twice a year. And the simplex viruses also have the nasty
reputation of being associated with kissing or even (gasp!) sex, a
subject of great fear and intimidation amongst modern humans, who
cannot bear to have their virility or ardent passions tainted or
cheapened with hints of secret blemishes and blisters. And so it is
that the discussion in alt.support.herpes centers around, not the
most common herpesvirus, nor the most deadly, but the one that most
people are embarrassed about: Herpes simplex 1 and Herpes simplex 2.

Which type of virus does what?

The most common view, and one of the most widespread MYTHS
concerning HSV, is that "cold sores" are caused by HSV1 while
genital herpes is caused by HSV2, and that the two afflictions have
little or nothing to do with each other. Only on average are those
things true. The better truth is: Oral herpes and genital herpes are
merely cold sores in different locations and may be caused by either
virus. While HSV1 prefers to set up housekeeping in the ganglia of
the oral region, and HSV2 prefers to occupy the nerve network
feeding the genital region, each virus, given the opportunity, will
establish itself in the preferred site of the other, and elsewhere.

In the last quarter century, changes in sexual practices across
populations show how closely the two viruses are related. Following
the rise in the popularity of oral sex, health officials estimate
that fully 30% of new genital herpes infections in Canada and the
USA are caused by HSV1. The questions offered on A.S.H reflect just
that trend, as more and more people come to the newsgroup with the
genital version of HSV1. On the other side of the coin, confirmed
cases of HSV2 in the oral region are rarer, with some experts
contending the numbers are so low as to be negligible. Others peg
the incidence at around 5%. Theories that attempt to explain the
difference are complicated and debatable, but usually mention the
high overall incidence of HSV1 in the population, which many people
acquire as children, thereby giving them an immunity edge against
infection by the other family member, HSV2. If such things interest
you, feel free to ask the fine people on alt.support.herpes about
them!

Varicella zoster virus causes chicken pox (primarily a childhood
disease) on first infection but may reactivate later (usually in
middle or old age) to cause shingles.

While VZV is an airborne disease, and HSV1 and HSV2 rely on skin to
skin contact for transfer to a new host, the tiny viruses all have
one thing in common: once successfully inside the body they travel
along the nerves and establish themselves in the ganglia (base
clusters of nerve cells from which the nerves branch out) near the
spine, hiding beyond the reach of the body's immune system. Then,
periodically, and for reasons science has yet to pinpoint, the
latent viruses reactivate, travel back down the nerve ways,
hijacking the DNA machinery in the cells of the lower skin
(epithelium) to make copies of themselves, wrecking the skin cells
in the process (which shows as an outbreak), all in the aim of
releasing thousands or millions of new viruses with the potential of
being passed on to a new host.

How widespread are the herpesviruses?

Very widespread. The herpesviruses infect hundreds of millions of
people worldwide. HSV1 affects about 70% to 80% of the adult USA
population. The longer you live the more likely it is that you'll
have HSV1. Most people catch the virus when young. HSV2 is typically
estimated at affecting about 20% to 25% of the population in the
USA. For reference, EBV affects most of the world's population, as
does HHV6, infecting close to 90% of the world's population by two
years of age. The herpesviruses are a very, very common group of
viruses, and not everyone will get overtly sick from them.

Why is HSV so widespread?

A lot of people are simply not aware of their own infections. Some
carry the viruses but never get symptoms, some have one outbreak and
assume that it's gone once it has healed up. Others get very mild
symptoms that they do not notice, or that they attribute to
something else.

Also, HSV has the ability to spread from person to person even when
no symptoms are apparent. Through a process known as asymptomatic
shedding, HSV viruses can make their way to the skin surface where
they can be picked up and transferred to a new host. Estimates are
that shedding may occur about 3% of days in a year, but, as with
many aspects of herpes, such things are variable. Frequency of
shedding probably decreases over time, too.

Symptoms

"A plague 'o both your houses!" - Shakespeare, Romeo and Juliet

What are the Symptoms of herpes?

Herpes symptoms can be broken down into two main classifications:
None and Some. Amazingly, some seventy five percent of those
infected with HSV will never experience an outbreak, or otherwise be
affected so mildly as to not even notice, or, perhaps, to
misinterpret what it is that they do feel.

For those in the "Some" category, different people will experience
different things. The first signs of the infection generally occur
within two to twenty days of exposure, though the virus can hide out
for longer, sometimes years. Very often the initial symptoms will be
somewhat flu-like including swollen glands, sore throat, muscle
aches (especially in the lower back for new cases of genital
herpes), neuralgia (the nerves of the lower back or legs actually
hurt), pronounced lethargy, and/or fever.

If those weren't enough there comes the outbreak itself. Many
experience what can only be called a "tingling" or faint itch just
before an outbreak, called a Prodrome (from another Greek word
meaning "running before" and now being understood as a premonitory
symptom), at the site of the approaching outbreak. Within a few
hours the skin reddens and a small bump or bumps may form. For many
people that may be it, the redness or bump(s) will fade away over
the course of a week or more and, when all gone, the outbreak is
over. For others the redness rapidly turns into clusters of tiny
pimples, or, in some, the lesions are said to resemble tiny cuts in
the skin. In either case the lesions may be quite painful,
especially during the host's first, or primary, outbreak. The tiny
pimples are filled with a clear liquid, and quickly break open,
releasing the liquid, which contains untold numbers of new viruses.
Care should be taken not to transfer those viruses to other parts of
one's body, or to other people. The broken lesions, if left to
themselves, crust over in a day or two and begin healing. Tight
clothing or other friction or excessive moisture can prolong the
healing process. Eventually, the sores do heal, rarely leaving a
scar. Until the pink skin at the site of the outbreak returns to
normal color, one should assume that viruses are still present and
appropriate hygenic precautions observed. Soap and water after
touching the affected area is usually sufficient to kill any virus
on the surface. A primary outbreak can take two weeks or longer to
heal completely, while most subsequent outbreaks run their course in
from seven to eleven days.

A person's very first outbreak, called a Primary outbreak, will
usually be the most severe one experienced, owing to the fact that
one's immune system is totally unprepared to deal with the new
invader.

Shingles, a recurrence of VZV, typically recurs once in a person's
lifetime, if it happens at all. It produces a very similar set of
lesions as Herpes simplex, but they tend to be more widespread. The
classic location is around the trunk and waist, but it can occur
anywhere, and can be very painful.

What outbreaks can I expect in the future?

How people respond is very variable. Over time there is a tendency
for the virus to become less and less active and for recurrences of
outbreaks to be fewer and farther between. However, while some
people will never see a recurrence others will get continuous,
regular recurrences for some time.

Why Me?

"We were so close there was no room
We bled inside each other's wounds
We all had caught the same disease"
   -Melanie

That's the eternal question, but rest assured, herpes hasn't singled
you out for any special reason. Herpes doesn't care if you are a
virgin or have slept with 20 partners. It doesn't care if you are
rich or poor. It doesn't even care if you draw mustaches on theater
posters. All that you need to acquire herpes is one person who
already has it and then have a little skin to skin contact with that
person's infected region.

How did I get this?

HSV is almost always acquired via direct skin to skin contact with a
previously infected person. Oral infections are acquired by kissing
(or being kissed by) an orally infected individual. Genital
infections can be acquired by having an orally infected partner
administer oral sex, or by bringing one's genital region into
contact with the infected genital region of the partner. Penetration
is not required, but direct skin to skin contact is. A person only
infected with genital herpes (either HSV1 or HSV2) cannot transmit
the virus to a partner just by kissing them. Also, visible signs of
an active outbreak are not necessary for transmission to occur,
though it is more likely if there is an active outbreak occurring.
No one knows how many viruses are necessary to bring about a
successful infection, but some studies have shown that on average
asymptomatic (or subclinical) shedding of sufficient quantities of
the virus occurs about 3% of the days in a year. Such shedding is
thought to decline in an infected person's second year and beyond,
but can never be discounted entirely.

There is little to no evidence to suggest that HSV can be acquired
by any means other than direct skin to skin contact with an infected
person, which is to say that it almost certainly cannot be picked up
from toilet seats or hot tubs or towels or drinks glasses or in any
of the other myriad ways that people worry about. The HSV virus,
unlike its chicken pox cousin VZV, is not built to withstand the
rough and tumble environment of the outer everyday world, and "dies"
almost immediately upon contact with the open air. Still, while it
would be extremely difficult to transfer the HSV virus via an
inanimate object, it is only common sense courtesy to refrain from
sharing personal items during times of active outbreaks.

It is possible to spread HSV from one region on yourself to another
region, a process known as autoinnoculation. For instance, if you
itch or rub your genitals in an area where virus is present and then
stick your finger in your eye, it is possible to infect the eye with
HSV. The virus can potentially be transferred to any region where
the skin is thin or damaged. To reduce the risk of autoinnoculation,
wash your hands with soap and water after they come in contact with
a potentially infected area.

How long ago did I get this?

In most cases it is difficult to know. While a new infection can
show up in as little as two days or within three weeks, it is
possible that the virus can go right into hiding in the nerve
ganglia, to pop out months or years later. It's also possible for an
HSV host to experience low level episodes that go unnoticed or
unrecognized.

Testing / Diagnosis

"Hold you in his armchair you can feel his disease" - Beatles

It is not possible to properly diagnose a disease in a newsgroup or
over the internet. Go to a doctor for consultation, visual
inspection, and/or to get tested and diagnosed properly. Every
single person who queries the alt.support.herpes crew as to the
possibility of having contracted herpes is urged to see a medical
professional. While a classic case of herpes is fairly recognizable
to someone familiar with the disease there are a number of other
conditions and afflictions that can appear to be similar to herpes.
And remember, if having been exposed to herpes is a possibility it
is also possible that exposure to other Sexually Transmitted
Infections (STIs) occurred at the same time and other STIs may not
immediately announce themselves with noticeable symptoms. Go to a
doctor.

Where do I go to get tested?

Depending on the size of the city you live in, and your financial
situation, there are various options for consultation and diagnosis.
There's the family doctor, of course, and the emergency room at the
nearest hospital, but those options can be expensive. Many cities of
even moderate size have walk-in clinics which are less expensive
than the emergency room and don't make you wait as long. There may
even be a "free" clinic which can offer consultation and testing for
a nominal or zero fee. Some Planned Parenthoods also provide
testing, often at a very low price, and they're not just for women.
Look in the yellow pages under "Clinics", "Physicians", "Social
Service Organizations", or even "Sports Medicine". Call ahead to see
if they routinely deal with STIs. In some cities there are clinics
which specialize in STIs, offering convenient testing at reasonable
prices.

When all else fails there is the National Herpes Hotline, wherein
support and referral info can be obtained for the price of a phone
call during normal business hours. The number can be found at:
http://www.ashastd.org/hotlines/herphotline.html

How will my doctor determine whether I have HSV?

Medical professionals have a number of options when it comes to
diagnosing an HSV infection, and it is the wise patient who will
forearm himself with as much relevant information as possible before
consultation. It is sad to say but there are people nearly every
month on the group who, in telling what they heard from their
doctors, reveal that their doctor's knowledge about herpes is
woefully outdated, or, in many cases, just plain wrong.

There are a number of tests available. The gold standard positive is
the culture test. A swab of a lesion is taken and grown up and
tested. Positive results are extremely reliable both for confirming
and typing of which HSV you have. This test can give false negatives
as it is difficult to get enough virus in a swab. It also requires
an active outbreak to test.

The most common blood test for HSV is a test called an ELISA. This
is extremely sensitive, so picks up presence of antibodies very
readily. Older versions can give unreliable typing information as
the two HSV types are closely related. There are now newer ELISA
tests which do not have this problem.

There is a Western Blot specific to herpes which has been developed.
There are only a couple of laboratories in the world that carry out
this test, so blood samples must be sent off, and is therefore much
more expensive, and poorly known of.

A more recent addition is the POCkit test. This is a `while you
wait' test recently released for use in a doctors surgery in some
countries. It accurately tests for HSV2, only. Therefore it does not
help if the lesions seen or suspected are HSV1.

Other tests that get used are the IFA and the Tzank test.
Prevention

"I feel stupid and contagious" - Nirvana

Treatment
"" -

What can I do to treat it?

There are a number of Over The Counter (OTC) products designed to
ease cold sores. They are often general antiseptics that kill the
virus non-specifically. Some may also numb the pain. Any pharmacy
can list these and tell you about them.

There are a number of specific medicines that have been developed to
act against these viruses. The longest standing one is Acyclovir. It
has now come off patent so generic versions are around. Topical
creams and ointments are available as well as pills. The OTC or
prescription status of these depends on the formulation and the
country you are in. Generally most are prescription only, with the
cream being OTC in some countries.

Another topical cream is available, containing Penciclovir.

The second generation of drugs to treat herpes are Valacyclovir, and
Famciclovir. These drugs are more efficient allowing the dosing
frequency to be cut down. The nature of these drugs requires
conversion in the liver so a topical cream is not available.

Other compounds exist that are used, but generally in a hospital
situation for specific resistant forms (eg. Foscarnet), or for
certain specific uses (eg. Idoxuridine, and Brivudine.)

Treating VZV related disease is done with a number of these drugs
but the treatment used tends to be a bit more aggressive.

Once I have genital herpes can I get it again?
What about condoms?
What is Asymptomatic Shedding?
What is neuralgia, pre- and post-herpetic?
What is Shingles?
Who gave this $%(*&$^# to me? And can I sue?
Where are pictures of herpes?
What kind of doctor/clinic should I go to?
What about HSV and HIV?
Do I need to wash the toilet seat after every use?
So what is HPV then????

HPV stands for Human Papilloma virus. This virus has a number of
strains some of which are common, some of which are rarer. It
usually causes skin warts. Certain strains of HPV are associated
with cervical cancer. People have examined whether HSV has a role in
this type of cancer so there is a body of literature mentioning the
two alongside each other. HSV and HPV are not the same thing.

USENET ... A.S.H's Usage FAQ.

A PREVIOUS FAQ was maintained by Jerry (###@####.###). This FAQ
faded away from regular posting. A certain amount of style and
content came from this previous FAQ.

Contributions from the Original FAQ include:

The newsgroup alt.support.herpes was set up in October 1995. The
control message that started the group states that it is for the
purpose of "...discussing herpes affliction and treatment."

Essentially alt.support.herpes is open to discussion of any
herpesvirus related material though its primary focus is HSV related
disease. We do get the odd bit of HPV discussion, too. Dating
requests are not generally seen as there are specific groups or
forums for that.

This FAQ is NOT a substitute for good medical care and treatment,
but is an introduction to the matters discussed on this group and
the prevailing opinion of some of the more regular posters. It
should not be considered an absolute authority on any matter.

Historically the FAQ for the group has been updated irregularly, if
something needs changing shout out on the group and it can be
discussed.

As a group in the alt.* hierarchy with no located charter at
inception, it is bound by general USENET guidelines for etiquette,
part of the Acceptable Use Policy of most ISPs these days. The
newsgroup is an un-moderated forum.

For these guidelines please either read your ISP's AUP (Acceptable
Use Policy, or sometimes called "TOS", or Terms Of Service), an
introduction to USENET news or examine the following web documents:
http://www.faqs.org/usenet/

http://www.faqs.org/faqs/usenet/what-is/part1/
http://www.faqs.org/faqs/usenet/what-is/part2/
http://www.faqs.org/faqs/usenet/advertising/how-to/part1/

It should be noted that there is and has been a moderate amount of
hostility and ill-feeling on the newsgroup concerning what many have
viewed as commercial solicitation and advertising. The hostility has
arisen not just due to content but the way in which certain posts
have been made. The above web pages give the moderately strict,
distilled USENET guidelines on how to go about this sort of thing.
These guidelines must be adhered to. Hopefully, this will much
reduce any flamage seen.

One issue that has been raised more than once is the issue of
information being placed by those with a commercial interest in what
is being posted. Any such conflict of interest should be made clear
to the reader at the head of the post. This makes clear those with
commercial interest in a given topic, allows readers to make
decisions based on their experience with the poster in question, yet
does not prevent information that parties with a specific interest
may hold from being available to the group. This also will help
avoid any future flame wars based on these issues. The outlook of
the group, aware of the uncontrolled nature of information on the
internet, is such that any poster should not be surprised that
claims made, particularly on treatments, will be queried and
debated.

This is the Web Edition of the alt.support.herpes Frequently Asked
Questions (FAQ) guide. This FAQ serves as a basic introduction to
the subject of the Herpes Simplex Viruses (HSV) and as a jumping off
place for those who wish to learn more about the disease, its
effects, and its treatment.

As with all Usenet FAQs relating to medical subjects, the
information in this FAQ should in no way substitute for professional
medical consultation, care, or treatment. While the information
contained in this FAQ represents some of the collective wisdom and
knowledge of the regular posters to alt.support.herpes (few, if any,
of whom are medical professionals) in many respects it barely
scratches the surface of a deep and fascinating subject about which
new discoveries are continuously being made. This FAQ should not be
considered an absolute authority on any matter.

With all that in mind, it is hoped that this page and those to which
it leads will in some way help those who encounter them. Good luck.
Hang in there.

Contrary to some conventions, the Usenet and newsgroup related bits
of this FAQ are placed after the main body of the FAQ dealing with
the questions concerning HSV. Use the menu on the left side of the
screen to jump directly to those and other sections. There are
answers to several questions in each of the general categories
offered in the menu. An assortment of links to other web sites with
HSV related content are listed at the end.

This FAQ has been assembled from an old, outdated FAQ maintained by
a fellow named Jerry, apparently gone on to bigger, greater things,
and a newer FAQ authored by Tim Fitzmaurice, a regular poster to
alt.support.herpes and a learned fellow. The reassemblage, such as
it is, has been undertaken by a mysterious underworld figure
allegedly going by the name of Mike Soja. The process of recreating
this new FAQ has taken on all the less talked about characteristics
of that great, famous, age-old profession, sausage making, and
should be thought of fondly in that light.

Any and all comments, suggestions, criticisms, updates and
corrections, etc., are more than welcome and may be directed to:
msoja9@newsguy.com
or, of course, to:
alt.support.herpes

Most of the alt newsgroup type of message boards have some sort of FAQ. It
just depends on which reader you are using. Otherwise... most hopefully know
how they should or shouldn't be behaving... but then again... maybe not.

Angela :)