It happened two weekends ago. It had been a particularly exhausting week. I didn’t know where the time had gone- it felt like we had just arrived on campus, but somehow, it was already the middle of the semester and I was suddenly besieged by increased workloads, both inside and outside of the classroom. In the course of five days, I was charged with the mission of preparing for two major exams and a presentation, attending and directing nightly rehearsals for my a cappella group, and fulfilling various other extracurricular commitments, such as tutoring other students, giving tours, and facilitating projects. By Friday, I was dangerously deprived of sleep and nutrition, and the first thing I wanted to do when I woke in the morning was to fall right back into the welcoming comfort of unconsciousness. However, the inkling caused by a familiar tingling sensation on my lip led my sleepy figure to stumble to the dresser and look in the mirror, and there I saw it, slowly rising out of its dormancy, just as I had feared: a cold sore.
If you are part of the majority, then you may have winced with me at the description of this situation. Frequently referred to as a “fever blister,” a cold sore is an outbreak of a painful blister around the most sensitive and moist areas on your face –such as the lips or the nose– and is unfortunately quite common. Up to 85% of American adults are plagued with this problem, and yet there is no cure for it, because it’s caused by the HSV1, a strain of the extremely contagious herpes simplex virus commonly known as herpes. Although cold sores may seem harmless and bothersome at most, it is a symptom of the HSV 1, whose alternate strain, HSV2, is responsible for genital herpes, one of the most feared sexually transmitted diseases. With that being said, it is crucial to acknowledge that cold sores and genital herpes share a common base and that both are equally contagious and dangerous, and to gain an understanding of the causes of cold sores in order to prevent a further spread of this condition that affects the majority of the American population, including children. Although this has nothing to do with critical thinking or leadership, I share this information with you in the hopes to provide the student leaders of Penn State with some crucial knowledge -because at college (read: a breeding ground for disease), things like this can easily spread, and more importantly, if you’re ignorant about this, it could turn into a disaster.
Contrary to popular belief, the two strains of the virus are similar. They look virtually the same under a microscope, sharing approximately 50% of their DNA. Both infect the body’s mucosal surfaces through skin to skin contact and establish latency within the nervous system, lying dormant until proper bodily conditions allow them to emerge into forms of blisters. For both types, at least two thirds of those infected show no symptoms or symptoms too mild to notice, but they can still be transmitted with no visible signs. With so much in common, the only significant difference between the two is where each strain establishes latency, the “sites of preference” where the symptoms appear. As mentioned above, HSV1 outbreaks are usually upon the face, while HSV2 outbreaks are usually around the genitals. It is important to note that the word “usually” has been used here, to indicate that it is possible for either strain to appear on parts of the body other than its site of preference –for example, HSV1 can be easily transmitted from the mouth of a carrier to the genitals of another through oral sex. However, it is unusual for one strain to be transferred to another part of the body of the same person, once it has established latency and the first outbreak has already occurred, although it is still possible for the person to be also infected with the other strain (Herpes.com).
With the difference in sites of preference comes a secondary difference: the way we think about each strain. This depends largely on the area of infection, on whether it is above or below the waist. Because the first strain tends to erupt around the mouth, and the second around the genitals, oral herpes are regarded as rather harmless, whereas the genital herpes are viewed as marks of disgrace reserved only for the sexually immoral; however, the two strains are fundamentally the same. “People don’t understand that you can have type 1 genitally or orally, that the two types are essentially the same virus,” says Marshall Clover, manager of the National Herpes Hotline. “One type is associated with stigma, the other is ‘just a cold sore’- our society has a euphemism for it so we don’t even have to acknowledge that it’s herpes.”
The relative social acceptability of the first strain can easily mislead an infected person to brush aside its dangers and regard cold sores as nothing more than occasional discomforts, but specialists would argue that the HSV1 is an even more of a threat than HSV2. “I think type 1 is a more significant infection than type 2,” says Spotswood Spruance, MD, an oral HSV specialist at the University of Utah. In describing the general public’s lack of concern, he stated, “Type 1, and the morbidity associated with it, are underestimated.” What most people do not know is that, although HSV 1 infections usually have mild symptoms when it affects the mouth, nose, or genitals, the consequences can be quite serious when it spontaneously recurs in the eye and causes ocular herpes, which may lead to blindness. In some rare cases, HSV1 can even lead to death by spreading to the brain, causing herpes encephalitis. HSV1 is also the usual cause of herpes whitlow, an infection on the finger, and herpes gladiatorum, an infection on the chest or face. Because the symptoms of HSV1 mostly occur in places above the waist where contact is common, it has more opportunities to spread, especially to children and teenagers who have had limited exposure to the virus and are infinitely more vulnerable to it. They can be easily infected through a variety of ways such as being kissed by a relative, using the same towel as a teammate or a family member, or sharing makeup or cutlery with a friend. Considering the abundance of possibilities for a HSV1 infection and the degree of its potential dangers, it is crucial to take proper measures to keep the virus contained and prevent it from spreading further, especially to the our college-aged generation who may be oblivious to the harsh realities of the HSV1.
Since the threat of HSV 1 contagion is the highest when a cold sore is present, perhaps it would be helpful to know what triggers the outbreaks of cold sores. According to Medical News Today, the sudden eruptions can be attributed to multiple factors, including stress, deep sadness or upset, an injury to the affected area, intense sunlight, and for women, menstruation. These situations cause the strength of our immune system and the numbers of anti-bodies to decrease, induce hormone changes to create acid environments in which the virus can thrive, and increase the levels of arginine in our system, a protein that serves as the primary ingredient for cold sores. Given any or a combination of these conditions, the virus that is hiding in the root cells of the nervous system can be activated, reproducing and emerging as cold sores, shedding from the surface and contaminating through contact. This period of contagion, which may begin from the time a first sign of the sore appears –such as an itching or a tingling sensation on the lip –to a few days after it has completely healed. In 5% of the cases, the virus sheds even when the physical evidence of the virus is not visible, contributing to its quiet and effortless spread.
Now that we have become informed with the truth about the seemingly innocent cold sores, we must take personal responsibility to become aware of our state as non-carriers or carriers, and to act accordingly. If you have not yet been infected, then take care to watch for the signs of infection in your partners, and to be careful while coming in contact with another person’s possessions. If you are part of the majority, like me, taking simple measures such as putting on sunscreen for protection from UV rays, sleeping well and eating healthy to promote a strong immune system, and exercising regularly to help eliminate stress can go a long way in preventing outbreaks. If, even after these measures, an outbreak still occurs, then remember that the cold sores can be treated with prescription for antiviral drugs or over-the-counter ointments with acyclovir or penciclovir, but also keep in mind that although the virus can be contained, it cannot be cured or eliminated –once the virus enters your system, it stays there, hibernating in your nerve cells waiting for the right conditions to arise. Finally, remember that although the acquirement of the virus may not have been under your control and you may have been unknowingly affected, the eruption and spread of the virus can be controlled, with a bit of effort on your part –so don’t let the virus get to you, and don’t let it get to the others.
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Works Consulted
“Causes of Cold Sores – This May Be Your Last Sore.” Zimbio. Livingly Media Inc., 1 Dec. 2008. Web. 7 Apr. 2013. <http://www.zimbio.com/Home remedies/articles/170/Causes Cold Sores May Last Cold Sore>.
“Cold Sores and Fever Blisters.” What Causes Fever Blisters & Cold Sores? Colgate, n.d. Web. 5 Apr. 2013. <http://www.colgate.com/app/CP/US/EN/OC/Information/Articles/Oral-and-Dental-Health-Basics/Common-Concerns/Canker-Sores-Cold-Sores-Infections/article/Cold-Sores-and-Fever-Blisters.cvsp>.
“Herpes Simplex Virus.” University of Maryland Medical Center. University of Maryland School of Medicine, 29 Sept. 2011. Web. 5 Apr. 2013. <http://www.umm.edu/altmed/articles/herpes-simplex-000079.htm>.
“”I Know My Cold Sore Triggers.”” What Are Your Cold Sore Triggers? – Abreva. Glaxo Smith Kline, n.d. Web. 5 Apr. 2013. <http://www.abreva.com/cream/cold-sore-triggers>.
Nordqvist, Christian. “What Are Cold Sores? What Causes Cold Sores?” Medical News Today. MediLexicon International, 27 Nov. 2009. Web. 5 Apr. 2013. <http://www.medicalnewstoday.com/articles/172389.php>.
“The Truth about HSV-1 and HSV-2.” Herpes. Herpes.com, n.d. Web. 6 Apr. 2013. <http://www.herpes.com/hsv1-2.html>.
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