Useful Information On Cold Sores And Fever Blisters

An infection of the lips or mouth which results in a blistery sore that is caused by Herpes simplex type 1. Most Americans think of it as a cold sore that comes and goes. But the Herpes Virus is a highly contagious microbe that never really leaves.

Eight out of every 10 American adults are infected with the herpes simplex virus, or HSV. The virus is either dormant within a variety of tissues or is activated and highly contagious. As a contagious virus, HSV is either the direct cause or a cofactor associated with a number of different diseases and disorders. Its best-known manifestation: the common cold sore. The cold sore, or herpetic lesion, typically shows redness, swelling, pain and heat over an eight-to-10 day period. After that, its clinical signs and symptoms appear resolved, leaving no apparent scar. But the virus leaves with a promise to return.

The virus, infecting the lips, oral mucosa or tongue, can be transmitted to the hand or eyes--and it can be transmitted to another person, expanding the sphere of influence of this highly contagious microbe.

HSV also can be associated with other diseases or disorders that compromise the immune system such as protein-calorie malnutrition and AIDS. The virus provides oral health professionals an excellent opportunity to reassess their appreciation of infection and immunity. We can learn from HSV.

For thousands of years, redness and swelling, with pain and heat, have been recognized as the four cardinal signs of inflammation. Aulus Cornelius Celsus in the first century described the typical reaction of flesh to microbes. Since then, astute health care professionals have appreciated that inflammation is the host's response to traumatic injuries as well as to microbe infections.

Inflammation is our protective response to dilute, destroy or compartmentalize both the infectious agent (infectious microbes such as viral, bacterial, fungal or parasitic invasion) and the injured tissue. Redness, swelling, pain, heat and loss of function are clinical characteristics of HSV.

The inflammatory process activates the inflammatory reaction with increased blood flow (redness), increased vascular permeability (swelling), increased leukocyte migration and infiltration with attendant production of cytokines and eventual destruction of the infectious agents (pain, heat and possibly loss of function).

From a Darwinian perspective, infection-meets-immunity is high drama. It is a drama that presents a sophisticated confrontation of the opportunistic microbe (virus, bacteria, fungi, parasite) vs. the highly evolved human immune system, with its enormous capacity to confront diversity and provide an advantage for the host against a changing microbial environment.

The "simple" cold sore has many lessons to teach. Humanity's recognition of cold sores is so long-standing that it has led to complacent acceptance. Descriptions of the infection have been documented in early Greek manuscripts, particularly in the writings of Hippocrates (460-377 B.C.). Scholars of Greek civilization define the word herpes to mean "creep or crawl," describing the spreading nature of the visual skin lesion. The early, imprecise visual descriptions of the sore ended in the 20th century when, in 1919, Lowenstein described the infectious nature of the causative virus (herpes simplex) and demonstrated that the virus retrieved from the lesions of the sore produced a similar lesion on the cornea of a rabbit.

Like many viruses, the herpes viruses take up permanent residence in the body once they are introduced. After an initial infection, the virus goes into hiding, escaping the host's immune system by remaining latent in a specific group of cells, causing no apparent harm to the host. The exact cell in which they remain latent varies from one virus type to the next. In cells harboring the latent virus, the viral genomes take the form of closed molecules and only a small subset of virus genes are expressed. Production of infectious progeny virus is invariably accompanied by the irreversible destruction of the infected cell. All of the human herpes viruses have been detected in the saliva sometime during infection.

Primary infection with HSV can produce great variability in clinical symptoms--from being totally asymptomatic to suffering with combinations of sore throat, ulcerative and vesicular lesions, gingivostomatitis, edema of the mucosal membranes, localized lymphadenopathy, anorexia and malaise.

The incubation period for HSV ranges from two to 12 days. In children, the infection characteristically involves a swelling of the gingival and buccal mucosa, making it difficult or impossible to swallow liquids. The clinical illness, accompanied by fever and pain from the lesion, generally lasts two to three weeks. After infection, the virus goes into hiding, entering nerve endings and traveling to ganglia (clusters of nerve cells).

For most people, a herpes outbreak is confined to recognizable variations of the classical symptoms. While outbreaks can be physically and emotionally uncomfortable, and sometimes painful, the infection is usually self-limiting and results in complete healing of the infected site.

The virus in the inflamed site, however, is infectious and can be transmitted to a new site on the host's body (autoinoculation) or to another person through contact with any part of the body where the virus finds a way to penetrate the skin.

Transmission in most cases requires direct skin-to-skin contact between the infected site and a receptive site. Risk of transmission is highest when the virus is active. But first outbreaks or primary lesions are the most infectious because they include more virus particles on the skin, and the lesions persist for a longer period.

Treatment includes the use of antiviral creams (acyclovir) and oral medications (acyclovir). Pre-treatment with oral acyclovir, in those prone to cold sores (prior to sun exposure, etc.) has been shown to decrease exacerbations.

Research on drug therapies for HSV has focused mainly on treating genital herpes to prevent sexual transmission and the effects on newborns. Since its introduction in 1985, oral acyclovir has been the preferred treatment for genital herpes. It also has been found effective in treating oral herpes. The U.S. Food and Drug Administration is reviewing an application that would extend oral acyclovir's use in treating oral herpes.

People who suffer from frequent bouts of HSV can take acyclovir daily for up to one year. Unfortunately, though, it is not a cure for the virus that remains in the body. The drug interferes with virus expression; it doesn't kill it.

Oral herpes is usually treated by the time-tried methods of keeping the blisters clean and dry, being careful not to touch the sores and spread the virus to new sites, and avoiding contacts with people in ways that could transmit the virus.

The following Combinations are those recommended for the treatment of Cold Sores.

Vitamins :-	B Complex, C (Large doses)
Minerals :-	Calcium, Zinc
Amino Acids :-	L-Lysine
Food Supplements :-	Acidophilus

The nutrients mentioned above reflect the major nutritional supplements that may help the condition. Please do remember however that nutritional supplementation is an adjunct to medical treatment and in no way replaces medical treatment.