Genital herpes
is a sexually transmitted disease (STD) caused by
the herpes simplex viruses type 1 (HSV-1) and type 2
(HSV-2). Most genital herpes is caused by HSV-2.
Most individuals have no or only minimal signs or
symptoms from HSV-1 or HSV-2 infection. When signs
do occur, they typically appear as one or more
blisters on or around the genitals or rectum. The
blisters break, leaving tender ulcers (sores) that
may take two to four weeks to heal the first time
they occur. Typically, another outbreak can appear
weeks or months after the first, but it almost
always is less severe and shorter than the first
outbreak. Although the infection can stay in the
body indefinitely, the number of outbreaks tends to
decrease over a period of years.
How common is genital
herpes?
Results of a nationally
representative study show that genital herpes
infection is common in the United States.
Nationwide, at least 45 million people ages 12 and
older, or one out of five adolescents and adults,
have had genital HSV infection. Between the late
1970s and the early 1990s, the number of Americans
with genital herpes infection increased 30 percent.
Genital HSV-2 infection is
more common in women (approximately one out of four
women) than in men (almost one out of five). This
may be due to male-to-female transmissions being
more likely than female-to-male transmission.
How do people get genital
herpes?
HSV-1 and HSV-2 can be
found in and released from the sores that the
viruses cause, but they also are released between
outbreaks from skin that does not appear to be
broken or to have a sore. Generally, a person can
only get HSV-2 infection during sexual contact with
someone who has a genital HSV-2 infection.
Transmission can occur from an infected partner who
does not have a visible sore and may not know that
he or she is infected.
HSV-1 can cause genital
herpes, but it more commonly causes infections of
the mouth and lips, so-called "fever blisters."
HSV-1 infection of the genitals can be caused by
oral-genital or genital-genital contact with a
person who has HSV-1 infection. Genital HSV-1
outbreaks recur less regularly than genital HSV-2
outbreaks.
What are the signs and
symptoms of genital herpes?
Most people infected with
HSV-2 are not aware of their infection. However, if
signs and symptoms occur during the first outbreak,
they can be quite pronounced. The first outbreak
usually occurs within two weeks after the virus is
transmitted, and the sores typically heal within two
to four weeks. Other signs and symptoms during the
primary episode may include a second crop of sores,
and flu-like symptoms, including fever and swollen
glands. However, most individuals with HSV-2
infection may never have sores, or they may have
very mild signs that they do not even notice or that
they mistake for insect bites or another skin
condition.
Most people diagnosed with
a first episode of genital herpes can expect to have
several (typically four or five) outbreaks
(symptomatic recurrences) within a year. Over time
these recurrences usually decrease in frequency.
What are the complications
of genital hereps?
Genital herpes can cause
recurrent painful genital sores in many adults, and
herpes infection can be severe in people with
suppressed immune systems. Regardless of severity of
symptoms, genital herpes frequently causes
psychological distress in people who know they are
infected.
In addition,
genital HSV can cause
potentially fatal infections in babies.
It is important that women avoid contracting herpes
during pregnancy because a first episode during
pregnancy causes a greater risk of transmission to
the baby. If a woman has active genital herpes at
delivery, a cesarean delivery is usually performed.
Fortunately, infection of a baby from a woman with
herpes infection is rare.
Herpes may play a role in
the spread of
HIV,
the virus that causes AIDS. Herpes can make people
more susceptible to HIV infection, and it can make
HIV-infected individuals more infectious.
How is genital herpes
diagnosed?
The signs and symptoms
associated with HSV-2 can vary greatly. Health care
providers can diagnose genital herpes by visual
inspection if the outbreak is typical, and by taking
a sample from the sore(s) and testing it in a
laboratory. HSV infections can be difficult to
diagnose between outbreaks. Blood tests, which
detect HSV-1 or HSV-2 infection, may be helpful,
although the results are not always clear-cut.
Is there a treatment for
herpes?
There is no treatment that
can cure herpes, but antiviral medications can
shorten and prevent outbreaks during the period of
time the person takes the medication. In addition,
daily suppressive therapy for symptomatic herpes can
reduce transmission to partners.
How can herpes be
prevented?
The surest way to avoid
transmission of sexually transmitted diseases,
including genital herpes, is to abstain from sexual
contact, or to be in a long-term mutually monogamous
relationship with a partner who has been tested and
is known to be uninfected.
Genital ulcer diseases can
occur in both male and female genital areas that are
covered or protected by a latex condom, as well as
in areas that are not covered. Correct and
consistent use of latex condoms can reduce the risk
of genital herpes only when the infected area or
site of potential exposure is protected. Since a
condom may not cover all infected areas, even
correct and consistent use of latex condoms cannot
guarantee protection from genital herpes.
Persons with herpes should
abstain from sexual activity with uninfected
partners when lesions or other symptoms of herpes
are present. It is important to know that even if a
person does not have any symptoms he or she can
still infect sex partners. Sex partners of infected
persons should be advised that they may become
infected. Sex partners can seek testing to determine
if they are infected with HSV. A positive HSV-2
blood test most likely indicates a genital herpes
infection.