One strange type of transmission must be discussed at this point as it fits into the classification of increased exposure to he virus. This type of problem is that of person who has no symptoms of Herpes – but who has active virus which can transmit the disease to others. This individual, who may not even be aware that he or she has such a problem, is called asymptomatic carrier.
Both Herpes Type 1 and Type 2 can be listed under the infrequent but not altogether rare type of transmission. The virus, in these instances, seems to be vigorous enough to maintain itself in certain tissues of the body, tissues where there are many crevices in which to hide. The tonsils, the prostate, and the cervix are three of the most common areas where the virus hibernates.
Basil lived with Barbara, one of my patients. She had lesions of the vagina and ulcers of Herpes on the cervix but denied having had sex with anyone except Basil. Their relationship had been happy for ﬁve years. Each was concerned with the other person and both were very disturbed about the diagnosis of Herpes. He also denied having sex outside of their relationship.
Basil’s urine cultures were positive for Herpes virus Type 2. Apparently the virus had been mildly active somewhere in the urinary tract, probably in the prostate gland, and had caused Barbara’s infection. During the time I saw Basil, no lesions were never observed.
He was an asymptomatic carrier.
ACTIVATION OF DORMANT VIRUS PARTICLES
The second type of outburst is more difficult to explain. As I previously described, the virus particles get into the nerve cells and then lie sleepily. They are probably within the cel1s of the nerves and apt to be within the nuclei of those cells. Months or years may pass without any alteration in this status. Then suddenly there are skin lesions. Why?
The answer to this question lies in the change of the environment which surrounds those tiny virions. This change is the result ‘of very subtle chemical alterations that may be almost imperceptible. A trigger has been sprung and has set off a new series of circumstances and the body had difficulty coping. The virus particles embedded in the nerve cell nuclei begin to replicate, to take over the DNA of the cell, and to stimulate the nerve filaments to unnatural reactions. Even though the virions are exceedingly small, replication proceeds rapidly and within hours there are enough present to being to have an effect.
My grandfather told me when I was a boy, how, If I would save only one penny today, and two pennies tomorrow, four pennies the day after and eight the following day, and each day double my savings, within a month I would be very rich. I tried this several times, but I never got beyond the fourth day. Viruses, however, can keep up this process until they overwhelm our body’s defenses.
Virginia was irritated when I told her she had Herpes genitalis. “How can I have Herpes? I’ve never had sex with anyone but my husband”
I believed her. She continued, “Doctor Bill, I’m sure my husband never plays around either. It’s breaking us apart!” Both of them came to counsel with me and I believed their statements. All of them. Because this does happen.
The virus can enter the body without causing symptoms. And it does often. It is estimated that one hundred percent of adults have the Herpes Type 1 virus within our bodies. A similar report by world recognized authorities of the Center for Disease Control states that probably 70 to 80 percent of Adults cary signs of the Herpes Type 2 virus.
Let us assume that Virginia reported truthfully that she had no sex except with her husband. Let us also assume that his report that he had been completely faithful to her is truthful. The factor of probability is that one of the two, or both, have the virus particles somewhere in their bodies. One of the two is a carrier who has no symptoms. Some happened to start the change in Virginia’s physiology.
Let us further suppose that, two weeks ago, Virginia’s youngest boy fell off his bicycle and broke his leg. Last week her best friend was found to have breast cancer. Virginia’s husband just lost his job and doesn’t have another one, and the landlord is asking for the rent. Today she started a menstrual period. In addition, the cake she was baking for her daughter’s birthday party just fell on the ﬂoor upside down.
Virginia has more than her share of stress. Her physiologic make-up begins to lose its resiliency and worries build up. She becomes depressed and frustrated. Her whole body chemistry alters. Her menstrual cycle causes the hormone make-up to change. These changes are signaled to the virus nestled in the Cauda equina and the particles begin to replicate. Soon there is enough stimulation in those nerve endings to cause as wild irritation and Virginia has the lesions which are typical of Herpes genitalis.
Not only does Virginia have lesions for the ﬁrst time but also the blebs and ulcers of those lesions now carry a discharge which is loaded with the same active infections virus as any other type of Herpes. She can now transmit the infection to her husband.
Don was also diagnosed as having Herpes. I did not make the original diagnosis for it was made in the regular medical clinic service of the University. He was referred by that service to the Herpes study, and he had no idea what his trouble was. He had never heard the word “Herpes.”
Don was very new to our institution and was only seventeen years old. A prodigy. He did not understand when I began to describe Herpes and to ask him questions. He had almost never heard the word “sex” for he was a reclusive loner. A new student who lived at home, Don stated he had never dated and had not had any sexual encounter. His parents had never talked about sex nor shown much love or emotion with him or each other. He had trouble comprehending my questions about sex with girls and even more trouble with my necessary query about dates with other boys. His love was mathematics, and it was also his entire life and experience.
But he had Herpes. The enormous increase in stress of university life was a major struggle for such a young man physically and emotionally and was proving to be more than he had the maturity to handle. A similar set of stressful circumstances brought out the lesions in Don that caused the reaction in Virginia’s case. The change in body chemistry and physiology activated the virus.
Though I do not have any specific studies to back up my opinion, my clinical experiences convinces me that perhaps ten percent of all primary cases of Herpes occur without exposure to the lesions of other persons. In the cases of Virginia and On, the diagnosis of Herpes does not fit the definition of being sexually transmitted. Virginia, Don, and the thousands of women and men like them who innocently contract the initial episode of Herpes, should not be labeled with the stigma of having a veneral disease.
There are a number of virsuses that are similar to the Herpes simplex virus and cause “first cousin” diseases. Examples of these maladies are Herpes zoster or shingles, mono, polio, and CMV. In order not to be confused as to their elation to Herpes, it is important to discuss them in some details.