How Long Does a Herpes Outbreak Last?

1. How long do herpes outbreaks last?
2. Herpes outbreak treatment options
3. Alternative treatment options
4. What triggers a herpes outbreak?

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

How long a herpes outbreak lasts depends on a few factors: Is this your first outbreak or have you had an outbreak before? Also, the length of an outbreak can depend on whether you have oral herpes (cold sores) or genital herpes.

When you hear the word “herpes,” the image that comes to mind is probably one of a sore at the edge of your lip that crops up every time you have a cold or a fever. But herpes is a little more complicated that that. Believe it or not, most people who have herpes have absolutely no idea. That’s because, for the most part, the virus can be entirely asymptomatic. Usually the first infection when it comes to oral herpes happens sometime during childhood and not from sexual contact, and the symptoms are a lot more like a cold. In severe cases, the initial outbreak can involve a fever, swollen lymph nodes, swollen gums, and sores in your mouth, throat, or on your tongue. An initial herpes outbreak lasts around 14 days but can take up to six weeks for sores to fully heal (Saleh, 2020). 

Later outbreaks aren’t re-infection with the same virus. They’re the same virus “waking up.” Herpes viruses remain in your body and park themselves in your nerves. For the most part, your immune system works to keep them dormant. But if you catch a cold or another illness, or if you’re experiencing stress and your immune system is “distracted,” the virus can break free and cause a cold sore. Triggers vary and everyone is different, but on average, recurrent cold sores last from one to two weeks if you include the tingling or burning sensation that appears before the outbreak occurs. Recurrent outbreaks are shorter and last one to two weeks. One study found that discomfort from these outbreaks generally lasts about seven days without treatment (McCarthy, 2011).

While oral herpes is most commonly caused by herpes simplex virus 1 (HSV-1), genital herpes is more frequently cause by herpes simplex virus 2 (HSV-2).

Much like oral herpes, an initial genital herpes infection can last a lot longer than subsequent outbreaks and may be accompanied by fever and other whole-body symptoms and some symptoms may persist for weeks. Recurrent genital herpes outbreaks cause symptoms like itching, redness, and irritation in the genital area, but like oral herpes, genital herpes can also be asymptomatic (Mathew Jr., 2020). A genital herpes outbreak may begin with pain in the genitals and shooting pains or tingling in your legs, hips, or butt. These symptoms usually occur before you can see any blisters or lesions (CDC, 2021). 

Unlike the first infection, later outbreaks tend to cause less discomfort and heal much faster. Sores from a recurrent genital herpes outbreak can heal in 3–7 days (ACOG, 2019). The number of outbreaks people experience with symptoms also decreases naturally over time (CDC, 2021).

At-home chlamydia tests: are they right for you?

Chlamydia

Last updated: May 21, 2021

7 min read

Even without treatment, most herpes outbreaks go away on their own. There are treatments available, however, which have been proven to shorten and even prevent future outbreaks. These antiviral medications work by preventing the virus from making copies of itself and spreading through your cells to cause an outbreak. If you suffer from oral herpes, a healthcare provider may recommend a topical cream or ointment that you should apply at the first sign of an outbreak. If you experience recurrent genital herpes outbreaks, you may be offered oral herpes treatments which are pills you take by mouth. Examples of antiviral drugs include acyclovir, famciclovir, and valacyclovir (brand name Valtrex; see Important Safety Information). These are all standard options proven to help decrease the severity and length of outbreaks from herpes (CDC, 2015).

Prescription antiviral treatments are usually very effective at prevent future outbreaks, reducing the chance of experiencing an outbreak by 70–80%. Many people on antiviral therapy report experiencing no herpes symptoms at all (CDC, 2015). Using medication within the first 24 hours of symptoms can shorten outbreaks by several hours or days, ultimately reducing any discomfort in the long run (Albrecht, 2019).

There is some evidence that low-level laser therapy may help shorten the length of a herpes outbreak. While it hasn’t been shown to prevent outbreaks, it likely won’t hurt. The procedure is typically performed by a dermatologist.

LLLT uses mild lasers to stimulate healing and reduce inflammation and pain. There are LLLT devices designed for at-home use, but they’re typically used to stimulate hair growth. There also aren’t any on the market at this time that have been shown to shorten herpes outbreaks.

One study found that using an LLLT device three minutes a day for two days was enough to reduce healing time by 2–3 days (Cauthen, 2018).

Side effects of acyclovir: a treatment for herpes

Drugs

Last updated: May 05, 2021

6 min read

As we mentioned, following you first herpes infection, the virus lies dormant in your nerves. Your immune system usually keeps it at bay.

But your immune system can only deal with so much at once. That means if you have dormant herpes and your immune system needs to fend off another virus or bacteria, it may get “distracted,” allowing herpes to crop up. That’s why cold sores are called cold sores or fever blisters—they typically appear when you catch another bug (Campbell, 2012).

Different types of stress can also trigger outbreaks. Psychological stress, especially the stress caused by extreme emotional upset, can lead to an outbreak (Yan, 2020).

Things that cause physical stress can also contribute. Sunlight is a common trigger of oral herpes outbreaks, while friction from tight clothing or sex, and even hormone changes associated with menstruation, are common triggers of genital herpes outbreaks (Lautenschlager, 2020).

Speak to a healthcare provider about your options and which treatments might be effective for preventing or shortening your outbreaks.

1. Albrecht, M. A. (June 11, 2019). Patient education: Genital herpes (Beyond the Basics). Retrieved Feb. 26, 2021, from https://www.uptodate.com/contents/genital-herpes-beyond-the-basics/print 
2. The American College of Obstetricians and Gynecologists (ACOG). (2019). Genital herpes. Retrieved Feb. 6, 2021, from https://www.acog.org/womens-health/faqs/genital-herpes 
3. Campbell, J., Trgovcich, J., Kincaid, M., Zimmerman, P. D., Klenerman, P. , Sims, S., et al. (2012). Transient cd8-memory contraction: A potential contributor to latent cytomegalovirus reactivation. Journal of Leukocyte Biology, 92(5), 933-937. doi:10.1189/jlb.1211635. Retrieved from https://jlb.onlinelibrary.wiley.com/doi/full/10.1189/jlb.1211635 
4. Cauthen, A. (2018). Does low-level light therapy accelerate healing time of oral herpes simplex lesions? PCOM Physician Assistant Studies Student Scholarship. PA Systematic Reviews, 363. Retrieved from https://digitalcommons.pcom.edu/pa_systematic_reviews/363 
5. Centers for Disease Control and Prevention (CDC). (June 5, 2015). 2015 STD Treatment Guidelines. Retrieved from https://www.cdc.gov/std/tg2015/tg-2015-print.pdf  
6. Centers for Disease Control and Prevention (CDC). (January 19, 2021). STD facts – genital herpes (detailed version). Retrieved Feb. 6, 2021, from https://www.cdc.gov/std/herpes/stdfact-herpes-detailed.htm 
7. Crimi, S., Fiorillo, L., Bianchi, A. , D’Amico, C., Amoroso, G., Gorassini, F., et al. (2019). Herpes virus, oral clinical signs and qol: Systematic review of recent data. Viruses, 11(5), 463. doi:10.3390/v11050463. Retrieved from https://www.mdpi.com/1999-4915/11/5/463/htm 
8. Lautenschlager, S. (2020). Human Herpes Viruses. In: Plewig, G., French, L., Ruzicka, T., Kaufmann, R., Hertl, M. (eds). Braun-Falco´s Dermatology. Springer, Berlin, Heidelberg. doi:10.1007/978-3-662-58713-3_9-1. Retrieved from https://link.springer.com/referenceworkentry/10.1007%2F978-3-662-58713-3_9-1 
9. Mathew Jr, J., Sapra, A. (November 20, 2020). Herpes Simplex Type 2. StatPearls Publishing. Treasure Island, FL. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK554427/ 
10. McCarthy, J. P., Browning, W. D., Teerlink, C., & Veit, G. (2011). Treatment of Herpes Labialis: Comparison of Two Otc drugs and Untreated Controls. Journal of Esthetic and Restorative Dentistry, 24(2), 103-109. doi:10. 1111/j.1708-8240.2011.00417.x. Retrieved from https://onlinelibrary.wiley.com/doi/full/10.1111/j.1708-8240.2011.00417.x 
11. Modi, S., Van, L., Gewirtzman, A., Mendoza, N., Bartlett, B., Tremaine, A., et al. (2008). Single-day treatment For Orolabial and Genital HERPES: A brief review OF pathogenesis and pharmacology. Therapeutics and Clinical Risk Management, 4(2), 409-417. doi:10.2147/tcrm.s1664. Retrieved from https://www.dovepress.com/single-day-treatment-for-orolabial-and-genital-herpes-a-brief-review-o-peer-reviewed-article-TCRM 
12. National Institutes of Health (NIH). (November 15, 2019). Acyclovir: Medlineplus drug information. Retrieved Feb. 4, 2021, from https://medlineplus.gov/druginfo/meds/a681045.html 
13. Patel, R., Alderson, S., Geretti, A., Nilsen, A., Foley, E., Lautenschlager, S., et al. (2011). European guideline for the management of genital herpes, 2010. International Journal of STD and AIDS, 22(1): 1-10. doi:10.1258/ijsa.2010. 010278. Retrieved from https://pubmed.ncbi.nlm.nih.gov/21364059/ 
14. Saleh, D., Yarrarapu, S. N. S., & Sharma, S. (November 21, 2020). Herpes Simplex Type 1. StatPearls Publishing. Treasure Island, FL. https://www.ncbi.nlm.nih.gov/books/NBK482197/ 
15. Wald, A., & Johnston, C. (December 17, 2020). Treatment and prevention of herpes simplex virus type 1 in immunocompetent adolescents and adults. Retrieved Feb. 26, 2021 from https://www.uptodate.com/contents/treatment-and-prevention-of-herpes-simplex-virus-type-1-in-immunocompetent-adolescents-and-adults 
16.  Wilson M., & Wilson P. J. K. (2021) Genital Herpes. In: Close Encounters of the Microbial Kind. Springer, Cham. doi: 10.1007/978-3-030-56978-5_29. Retrieved from https://link.springer.com/chapter/10.1007/978-3-030-56978-5_29 
17. Yan, C., Luo, Z., Li, W., Li, X., Dallmann, R., Kurihara, H., et al. (2020). Disturbed Yin–Yang balance: Stress increases the susceptibility to primary and recurrent infections of herpes simplex virus type 1. Acta Pharmaceutica Sinica B, 10(3), 383-398. doi:10.1016/j.apsb.2019.06.005. Retrieved from https://www.sciencedirect.com/science/article/pii/S2211383519302692 

Yael Cooperman is a physician and works as a Senior Manager, Medical Content & Education at Ro.

How Long Does Herpes Last?

Despite how common it is, a herpes diagnosis can be scary. There’s no cure for herpes, meaning you could be dealing with flare-ups your whole life. This could leave you with a lot of questions, like, “does herpes go away on its own?” and “how long does a herpes sore last?”

The Different Types and Forms of Herpes

Herpes infections are caused by a herpes virus, either the herpes type 1 virus (HSV-1) or the herpes type 2 virus (HSV-2). Both types of virus can cause irritating, painful blisters and flu-like symptoms during the initial outbreak. The primary difference between the two is where on the body these sores appear. HSV-1 usually causes oral herpes, while HSV-2 causes genital herpes.

Genital Herpes

Occasionally, genital herpes infections are caused by HSV-1, but usually, they’re caused by HSV-2. Genital herpes is primarily spread through sexual contact. You can contract genital herpes from direct contact with genital surfaces, skin, sores, or body fluids of an infected individual. HSV-1 can be spread genitally through oral sex.

The World Health Organization estimates that about 491 million people ages 15-49 have HSV-2 worldwide. Women are more likely to have genital herpes than men are, as it’s more easily transferred from men.

Individuals with genital herpes are at a higher risk of contracting HIV, because the HIV virus appears to replicate well within genital herpes sores. Genital herpes can also lead to complications such as bladder problems, rectal inflammation, and occasionally, meningitis.

Neonatal Herpes

For most people, herpes can be irritating or slightly painful. However, infants often don’t have a strong enough immune system to fight the virus, which can lead to severe complications and even death.

An infant can contract herpes in a few ways, but the most common cause of neonatal herpes is a herpes outbreak in the pregnant patient during delivery. And 90% of neonatal herpes cases are caused by the baby contracting the virus in the birth canal.

Most of the time, babies born to infected individuals are perfectly healthy. The risk for neonatal herpes increases if the pregnant patient has their first herpes infection during the last trimester of pregnancy.

If you’re pregnant and have herpes, your doctor may prescribe an antiviral treatment toward the end of your pregnancy to reduce the chance of an outbreak at the time of delivery. If you do have an outbreak when it is time to deliver, they may recommend a C-section to avoid exposure to the virus in the birth canal.

Less commonly, infants can also contract herpes in the womb or after birth. Individuals with herpes should avoid kissing newborns, especially on the mouth.

Neonatal herpes can cause skin blisters, but it can also lead to inflammation of the brain and a disseminated herpes infection. In a disseminated herpes infection, the virus spreads throughout the infant’s body and affects multiple organs. Untreated, this can be fatal.

Oral Herpes

Oral herpes is caused by HSV-1. HSV-1 is incredibly common; WHO estimates that 3.7 people under the age of 50 have HSV-1 globally. Oral herpes results in a sore or sores, often called cold sores or fever blisters, around the mouth. Your first oral herpes outbreak may also come with flu-like symptoms.

Oral herpes is spread by contact with the herpes sores or saliva of an infected individual. This can happen while kissing or by sharing things like eating utensils, drinks, or toothbrushes. The best way to avoid contracting oral herpes is by avoiding contact or sharing things like utensils with someone having an active outbreak.

How Long Do Herpes Symptoms Last?

There is no firm herpes outbreak timeline. The length of time your symptoms last will depend on the strain of virus you have, your overall health, and whether it’s your first infection or a subsequent infection. Some people never experience an outbreak or symptoms of herpes.

Initial Outbreak vs Future Outbreaks

After you’re exposed, the incubation period, or time it takes for infection to appear, can range from 2-21 days. Your first herpes infection is usually the most severe, and includes not just the typical sores but also flu-like symptoms. The first herpes infection is usually the longest, lasting on average 20 days.

After your initial herpes outbreak, future outbreaks are often shorter, possibly because your body begins building antibodies against the virus. On average, these outbreaks last about 17 days.

Fever Blisters

Only about 20-40% of people with HSV-1 develop fever blisters. They usually last 1-2 weeks and develop in stages:

• Stage 1: You may notice a tingling, itching, or burning where the sore is about to form.
• Stage 2: A couple days later, small, fluid-filled blisters form, usually on the side of the mouth. This is a fever blister or cold sore.
• Stage 3: The blister bursts and may be very painful. You are most contagious during this time.
• Stage 4: About three days later, the blisters start to scab. This is the beginning of the healing time.
• Stage 5: About 2-3 days after the scabbing starts, the scab falls off and the sore heals completely.

Genital Infection

The genital herpes infection follows nearly the same timeline as an oral herpes infection. An outbreak typically lasts 1-2 weeks, and the length of the outbreaks may shorten as time goes on. Like oral herpes, the first sign of an outbreak is tingling, itching, or burning in the affected area, followed by sores that burst, scab over, and eventually heal.

Body Aches and Flu-Like Symptoms

Often, your first herpes outbreak includes flu-like symptoms, such as:

• Body aches
• Fatigue
• Fever
• Headache
• Swollen lymph nodes

These can last the duration of your outbreak, meaning the flu-like symptoms can persist for 2-3 weeks with your initial outbreak. While flu-like symptoms can sometimes accompany subsequent outbreaks, it’s not as common.

What Can You Do if You’re Suffering Recurrent Herpes Outbreaks?

On average, an infected person with HSV-1 has one outbreak in the year after initial infection, while someone with HSV-2 averages four outbreaks in the following year.

Common triggers for HSV flare-ups include:

• Fatigue
• Illness, ranging from mild colds to more severe conditions
• Menstrual periods
• Stress
• Trauma to the affected area

If you’re experiencing frequent outbreaks, try to do what you can to limit triggers.

While most herpes outbreaks go away on their own, treatment options like antiviral medication can help reduce how frequently you get outbreaks, reduce your risk of transmitting the virus, and ease symptoms. Speak to your healthcare provider for more guidance.

Get Tested Today

Herpes simplex, as well as many sexually transmitted diseases, can lie dormant in your body without showing symptoms. Despite this, you can still infect others. If you’re sexually active and not in a long-term, monogamous relationship, it’s important that you test yourself at least once a year. MyLAB Box offers a range of STD screening tests so you can stay safe and take control of your health.

How to protect yourself from herpes?

Herpes simplex virus is a very common viral infection. It manifests itself in different parts of the body, but most often the area of ​​\u200b\u200bthe mouth and genitals suffer. In this article, we will look at where this infection comes from, how it spreads, and whether it can be cured.

There are 2 varieties of this infection:

1. Type 1 virus – known as oral herpes. As the name implies, this type of virus causes sores or wounds to form around the mouth or on the face.
2. Type 2 virus – usually affects the genitals and anus.

Note that any of these types of virus can cause the formation of sores both on the face and in the genital area.

Most people become infected with virus type 1 while still an infant or child. This virus can pass to a child through skin contact with an infected adult. By the way, the infection spreads even if the adult does not have a characteristic symptom – sores around the mouth or on the face.

Herpes type 2 is usually spread through sexual contact.

• Women
• People who have had a large number of sexual partners
• People with past or current sexually transmitted infections
• People who are immunocompromised due to illness or medication.

The herpes simplex virus is spread from person to person through close physical contact. You can become infected after touching the sore. However, in most cases, this disease is transmitted through contact with a person who has no visible symptoms of the infection.

Under what conditions does herpes appear around the mouth?

A person who is infected with type 1 virus spreads the infection through:

• Kissing,

0008

• Sharing items: forks and spoons, lip balms, razors.

Under what conditions does genital herpes appear?

In most cases, the culprit is the type 2 virus, which is transmitted during sexual contact. Although in some, the cause of the formation of wounds on the genitals is a type 1 virus. If there are sores on the lips or mouth and the person has oral sex, type 1 herpes can cause sores to form in the genital area.

Pregnant women and their children are at particular risk. If a woman “caught” herpes during pregnancy, she can pass the infection to her baby during childbirth. The baby can develop serious complications. That is why all planning pregnancy or pregnant women should be diagnosed.

Once a person is infected with herpes, the virus never leaves the body. After the first contact, it moves from skin cells to nerve cells and stays there forever. But do not worry about this – the virus is “sleeping” and is simply stored in our body. However, it should be understood that it is able to re-activate. This happens under the following conditions:

• During stress,
• During illness,
• Due to fever,
• Sun exposure,
• During menstrual periods,
• After surgery.

How to recognize the signs of herpes?

It is important to understand that not every infected person will show visible symptoms. This is where the danger lies, because many people spread the infection and are not even aware of it.

Herpes symptoms may include:

• Blister sores in the mouth or genitals,
• Pain during urination (possible symptom of genital herpes),
• Itchy skin.

Sometimes flu-like symptoms appear:

• Fever,
• Swollen lymph nodes,
• Headaches,
• Fatigue.

Rarely, the infection affects the eyes, causing a condition called herpetic keratitis. In this case, there is pain and a burning sensation in the eyes.

How is herpes diagnosed?

Diagnosis is usually based on a physical examination of the patient. The doctor examines the body for characteristic blisters and asks about additional symptoms. Sometimes laboratory diagnostics are required. You will learn more about diagnostic methods from this material.

How to cure herpes?

There is currently no specific treatment for this infection. The main task of the doctor is to save the patient from ulcers and reduce the frequency of repeated activations of the virus. In this case, it is likely that the infection will go away on its own and the blistering wounds will disappear. However, this does not exclude the need to visit a doctor. Based on the patient’s medical history and symptoms, a specialist may prescribe herpes pills. The most commonly prescribed drugs are one or more of the following:

• Acyclovir,
• Famciclovir,
• Valaciclovir.

These antivirals help reduce the risk of spreading the infection to others. Also, taking cold sore pills can help reduce the frequency of virus outbreaks and ease the severity of symptoms. By the way, drugs are available not only in tablets, but also in the form of creams. Well, in the most severe cases, drugs can be administered in the form of injections.

How to prevent herpes?

Although there is no specific treatment, measures can and should be taken to avoid an outbreak and transmission of the virus to others.

In the event of an outbreak of the first type of virus , which manifests itself in the form of blisters in the mouth area, it is necessary: ​​

• Try to avoid direct physical contact with other people for lips and other personal items,
• Completely refrain from sexual intercourse and kissing,
• Wash hands thoroughly with soap and water.

Persons with herpes type 2 should avoid all sexual intercourse, including oral sex, during an outbreak. If a person is diagnosed with an infection but does not show symptoms, a condom must be used during intercourse. However, even when using a condom, the virus can still be transmitted to a partner through skin contact.

If a pregnant woman is infected with the virus, she may need to take medication to prevent the infection from spreading to her fetus.

The World Health Organization estimates that 3.7 billion people under the age of 50 are infected with the herpesvirus type 1 worldwide. Type 2 virus infects 417 million people aged 15-49 years. The saddest thing is that people with the herpes virus type 2 increase the risk of facing a deadly disease – HIV. For this reason, you need to beware of promiscuity and undergo regular diagnostics.

You can get diagnosed for herpes and other TORCH infections at our medical center. To make an appointment for analysis, call the numbers listed at the top of the site.

Sources:

1. Herpes simplex virus, World Health Organization,
2. Herpes simplex, American Academy of Dermatology,
3. Herpes Simplex, HealthLine.

Why you might not be afraid of coronavirus if you have a cold

March 23, 2021

Updated March 24, 2021

Subscribe to our ”Context” newsletter: it will help you understand the events.

Image copyright, Getty Images

Image caption,

If a person has a cold, they are much less likely to catch the coronavirus at the same time. As soon as the virus gets inside these houses, it can leave the door open to let other viruses in, or it can close it behind itself and enjoy loneliness in the house, that is, in the cage. This is exactly how the flu virus behaves, for example, one of the most selfish and most widespread viruses in the world.

Scientists from the University of Glasgow suggest that the rhinovirus that causes the common cold may protect the human body from infection with the coronavirus. Of course, we are not talking about permanent immunity, but about the period of time when the rhinovirus is in the cells.

They came to this conclusion as a result of an experiment in which a copy of the mucous membrane of our respiratory tract, made from cells of the same type, was simultaneously infected with a coronavirus and a rhinovirus.

It turned out that if both viruses get access to the cells at once, then the rhinovirus wins and prevents the new coronavirus from getting inside. Moreover, as experience has shown, this happens in any of three scenarios: if the rhinovirus is launched 24 hours earlier than SARS-CoV-2; if both viruses gain access to cells at the same time; and if the coronavirus was given a daily head start by letting it in 24 hours earlier than the rhinovirus.

“It turns out that the rhinovirus suppresses the coronavirus, and in the season of common colds, there will be much less infection with the coronavirus,” Dr. Pablo Murcia told the BBC.

Image copyright, Getty Images

Image caption,

Some viruses want to be the sole invaders in human cells – and thus protect them from other infections prevents the coronavirus from multiplying by creating copies of itself.

However, one should not forget that Scottish scientists conducted experiments in laboratory conditions, infecting artificially grown cells of the respiratory tract with both viruses.

A host of other processes take place in a living organism that can have a significant impact on how viruses interact with cells and with each other. Therefore, the conclusions of laboratory experiments should be treated with caution.

However, similar cases have been observed before. So, there is a version that it was a large outbreak of rhinovirus that could delay the swine flu pandemic in 2009.year in some parts of Europe.

However, do not flatter yourself, scientists warn. A person can become infected with the coronavirus after the cold has passed and the rhinovirus has left the body.

“Hygiene measures, as well as interaction between viruses, can significantly reduce the incidence of coronavirus, but vaccination is still the most effective,” says Dr. Murcia.

• Coronavirus: scientists have identified genes that determine the severity of the disease
• Covid-19 vaccination: my side effects, where do they come from and what do they mean
• “Russian roulette” or a triumph of Russian diplomacy? Does the EU need a Sputnik vaccine

Professor Lawrence Young of the University of Warwick School of Medicine agrees with a colleague that rhinovirus, which is much more contagious than the coronavirus, can slow the spread of the coronavirus infection during the autumn and winter months.

However, it is not yet clear how cold seasons will develop in the next few winters. Most likely, the coronavirus will not disappear anywhere, but other infections that have hardly spread recently due to restrictive measures introduced around the world will not only return, but will also have a stronger effect on people who have spent a whole year with almost no social contacts and thereby weakened their immunity.