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To Your Good Health: Herpes difficult to treat

If a person has been exposed, verified by blood test, to herpes 1 and 2, can that person be a blood donor? Could a person catch herpes by sitting on a toilet seat that has been used by an infected person? Are scientists working on a cure for herpes?

There remains a stigma against people with genital herpes, which is almost always caused by herpes simplex virus type 2. However, most people with genital herpes will not have major disruptions to their lives provided they take some precautions.

First off, a person with herpes simplex virus type 1, about half of the population between ages 18 and 49, higher in older people, or HSV-2, about 12% of the same population, certainly can donate blood.

Second, being exposed doesn’t guarantee infection. Third, blood testing is not perfect. Fourth, getting any kind of sexually transmitted infection from a toilet seat is very unlikely.

Herpes viruses have a very difficult time getting through intact skin, which is why most exposures come through mucus membranes, especially of the genitals and mouth.

There is a type of herpes — usually HSV-1, occasionally HSV-2 — in wrestlers, called herpes gladiatorum or “mat herpes,” and it can be transmitted from person to person through skin-to-skin contact, especially if the skin is raw or chafed.

Once a person has herpes of either variety, there is no cure. The virus stays in the nerve cells. There is extensive work being done both on preventing transmission and curing existing infections, but herpes viruses are very good at escaping the immune system. This makes herpes difficult to treat.

Should a person be concerned about serious side effects from long-term use of Claritin-D? My son has been using the medication continuously for about nine years. He has had allergy shots, which were minimally helpful. He cannot use nasal rinses or sprays because they cause nosebleeds. He does have some sleeping problems, but since he’s been taking Claritin-D for so long, it’s hard to tell if that medication is the cause.

Claritin-D is a combination of the antihistamine loratadine and the decongestant pseudoephedrine. Loratadine is considered safe in most people. Pseudoephedrine is safe for younger people, but it can raise blood pressure and pulse, and in older men, can cause urinary symptoms.

He might try plain Claritin, which is just the loratadine, and save the Claritin-D for his worst days. Less pseudoephedrine is probably better.

I read your comments to I.T. with interest, as I had my gallbladder removed way back in 1968. I feel you left out a side effect that follows the procedure for many patients: the “dump” syndrome, or diarrhea. This result has plagued me and several others for years. I found some relief by taking cholestyramine before eating.

That’s a very good point, and one I did not highlight. “Dumping syndrome” refers to bile being delivered to the intestine suddenly, causing diarrhea.

It isn’t common, fortunately, and I, too, have found that cholestyramine can be very effective, in addition to eating smaller, more-frequent meals.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@ med.cornell.edu. 2020 North America Synd., Inc.

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