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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.
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.
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
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.
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.
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
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.
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.
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
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.
to buy home test kits for
contributing factors of this condition