Genital herpes is a sexually transmitted disease caused by herpes simplex viruses type 1 (HSV-1) and type 2 (HSV-2). Most genital herpes is caused by HSV-2 and results in a disease that infected people carry for life. Almost one quarter of adults in the US are infected. Nationwide, that¬ís at least 45 million people, or roughly one out of five teenagers and adults. Having genital herpes doubles the risk of getting HIV during unprotected sex. You can get them from having sex (vaginal, anal, or oral) with someone who has 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 symptoms?
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.
The majority of people who have herpes donít know it. HSV-1 and HSV-2 are released from genital lesions, but there can be viral shedding from skin that does not appear to be broken or to have a sore. Also, there may be years between the time that a person acquires herpes and the time a person has their first outbreak. When a person has genital herpes, the virus lies dormant in the bundle of nerves at the base of the spine. When the virus reactivates, it travels nerve paths to the surface of the skin, sometimes causing an outbreak. The nerves in the genitals, upper thighs and buttocks are connected, so an outbreak can occur in the vagina, penis, anus, vulva, scrotum or buttocks.
Small blisters or sores appear on or around your penis, vagina, anus, or mouth. The sores often hurt or itch. You may see them in two days to a few weeks after sex with someone who has herpes. You may also feel like you have the flu. The sores heal in about two weeks. But the herpes virus stays in your body forever. Some people with herpes never get the sores again. In other people, sores may come back. Others may never see any sores or feel sick, but they can still infect their sex partners with herpes.
How is it treated?
Herpes canít be cured, but there are medicines which can control the disease and make sores heal faster. Tell your sex partner(s) that they may have herpes and need to get checked. If you get pregnant, tell your doctor you have herpes. Herpes is most often passed just before or during the time you can see sores, but herpes can be passed even when there are no sores. If you have sores, donít touch them.
Complications associated with Herpes
Women can give herpes to their babies during births. You can continue to spread the disease without knowing what to look for. It is most often passed just before or during the time you can see sores, but herpes can be passed even when there are no sores.
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 it prevented?
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.