Genital herpes is an infection caused by
the herpes simplex virus or HSV. There are two types of HSV, and
both can cause genital herpes. HSV type 1 most commonly infects
the lips causing sores known as fever blisters or cold sores, but
it also can infect the genital area and produce sores there. HSV
type 2 is the usual cause of genital herpes, but it also can
infect the mouth during oral sex. A person who has genital herpes
infection can easily pass or transmit the virus to an uninfected
person during sex.
Both HSV 1 and 2 can produce sores (also called lesions) in and
around the vaginal area, on the penis, around the anal opening,
and on the buttocks or thighs. Occasionally, sores also appear on
other parts of the body where the virus has entered through
broken skin.
HSV remains in certain nerve cells of the body for life, and can
produce symptoms off and on in some infected people.
How does someone get genital
herpes?
Most people get genital herpes by having
sex with someone who is having a herpes outbreak.
This outbreak means that HSV is active. When active, the virus
usually causes visible sores in the genital area. The sores cast
off (shed) viruses that can infect another person. Sometimes,
however, a person can have an outbreak and have no visible sores
at all. People often get genital herpes by having sexual contact
with others who dont know they are infected or who are
having outbreaks of herpes without any sores.
A person with genital herpes also can infect a sexual partner
during oral sex. The virus is spread only rarely, if at all, by
touching objects such as a toilet seat or hot tub.
What are the symptoms?
Unfortunately, most people who have genital
herpes dont know it because they never have any symptoms,
or they do not recognize any symptoms they might have. When there
are symptoms, they can be different in each person. Most often,
when a person becomes infected with herpes for the first time,
the symptoms will appear within two to 10 days. These first
episodes of symptoms usually last two to three weeks.
Early symptoms of a genital herpes outbreak include:
itching or burning feeling in the
genital or anal area.
pain in the legs, buttocks, or genital
area.
discharge of fluid from the vagina.
feeling of pressure in the abdomen.
Within a few days, sores appear near where
the virus has entered the body, such as on the mouth, penis, or
vagina. They also can occur inside the vagina and on the cervix
in women, or in the urinary passage of women and men. Small red
bumps appear first, develop into blisters, and then become
painful open sores. Over several days, the sores become crusty
and then heal without leaving a scar. Some other symptoms that
may go with the first episode of genital herpes are fever,
headache, muscle aches, painful or difficult urination, vaginal
discharge, and swollen glands in the groin area.
Will I ever have outbreaks again?
If you have been infected by HSV 1 and/or
2, you will probably have symptoms or outbreaks from time to
time. After the virus has finished being active, it then travels
to the nerves at the end of the spine where it stays for a while.
Even after the sores are gone, the virus stays inside the nerve
cells in a still and hidden state, which means that its
inactive.
In most people, the virus can become active several times a year.
This is called a recurrence. But scientists do not yet know why
this happens. When it becomes active again, it travels along the
nerves to the skin, where it busies itself by making more viruses
near the site of the very first infection. That is where new
sores usually will appear.
Sometimes, the virus can become active but not cause any sores
that can be seen. At these times, small amounts of the virus may
be shed at or near places of the first infection, in fluids from
the mouth, penis, or vagina, or from barely noticeable sores. You
may not notice this shedding because it often does not cause any
pain or feel uncomfortable. Even though you might not be aware of
the shedding, you still can infect a sex partner during this
time.
After the first outbreak, any future outbreaks are usually mild
and last only about a week. An infected person may know that an
outbreak is about to happen by feeling a tingling feeling or
itching in the genital area, or pain in the buttocks or down the
leg. For some people, these early symptoms can be the most
painful and annoying part of an episode. Sometimes, only the
tingling and itching are present and no visible sores develop. At
other times, blisters appear that may be very small and barely
noticeable, or they may break into open sores that crust over and
then disappear.
The frequency and severity of the recurrent episodes vary
greatly. While some people have only one or two outbreaks in a
lifetime, others may have several outbreaks a year. The number
and pattern of repeat outbreaks often change over time for a
person. Scientists do not know what causes the virus to become
active again. Although some people with herpes report that their
outbreaks are brought on by another illness, stress, or having a
menstrual period, outbreaks often are not predictable. In some
cases, outbreaks may be connected to exposure to sunlight.
How does the doctor diagnose
genital herpes?
Because the genital herpes sores may not be
visible to the naked eye, a doctor or other health care worker
may have to do several laboratory tests to try to prove that any
other symptoms are caused by the herpes virus. A person may still
have genital herpes, however, even if the laboratory tests
dont show the virus in the body.
A blood test cannot show whether a person can infect another
person with the herpes virus. A blood test, however, can show if
a person has been infected at any time with HSV. There are also
newer blood tests that can tell whether a person has been
infected with HSV 1 and/or 2.
What is the treatment?
Although there is no cure for genital
herpes, your doctor might prescribe one of three medicines to
treat it:
Acyclovir (Zovirax¨) treats the first
and/or later episodes of genital herpes.
Famciclovir (Famvir¨) treats later
episodes of genital herpes and helps prevent future
outbreaks.
Valacyclovir (Valtrex¨) treats later
episodes of genital herpes.
During an active herpes episode, whether
the first episode or a repeat one, you should follow a few simple
steps to speed healing and avoid spreading the infection to other
places on the body or to other people:
Keep the infected area clean and dry
to prevent other infections from developing.
Try to avoid touching the sores.
Wash your hands after contact with the
sores.
Avoid sexual contact from the time you
first feel any symptoms until the sores are completely
healed, that is, the scab has fallen off and new skin has
formed where the sore was.
Can genital herpes cause any other
problems?
Usually, genital herpes infections do not
cause major problems in healthy adults. In some people whose
immune systems do not work properly, genital herpes episodes can
last a long time and be unusually severe. (The bodys immune
system fights off foreign invaders such as viruses.)
If a woman has her first episode of genital herpes while she is
pregnant, she can pass the virus to her unborn child and may
deliver a premature baby. Half of the babies infected with herpes
either die or suffer from damage to their nerves. A baby born
with herpes can develop serious problems that may affect the
brain, the skin, or the eyes. If babies born with herpes are
treated immediately with acyclovir, their chances of being
healthy are increased. Therefore, if you are pregnant and
infected with genital herpes, you should stay in close touch with
your doctor before, during, and after your baby is born.
If a pregnant woman has an outbreak and it is not the first one,
her babys risk of being infected during delivery is very
low.
If a woman is having an outbreak during labor and delivery and
there are herpes lesions in or near the birth canal, the doctor
will do a cesarean section to protect the baby. Most women with
genital herpes, however, do not have signs of active infection
with the virus during this time, and can have a normal delivery.
Is genital herpes worse in a person
with AIDS?
Genital herpes, like other genital diseases
that produce sores, increases a persons risk of getting
HIV, the virus that causes AIDS. Also, prior to better treatments
for AIDS, persons with HIV (because of lower protection from
their immune systems) had severe herpes outbreaks, which may have
helped them pass both genital herpes and HIV infections to
others.
How can I protect myself or my sexual
partner?
If you have early signs of a herpes
outbreak or visible sores, you should not have sexual intercourse
or oral sex until the signs are gone and/or the sores have healed
completely. Between outbreaks, using condoms during sexual
intercourse may offer some protection from the virus.
Is any research going on?
The National Institute of Allergy and
Infectious Diseases (NIAID) supports research on genital herpes
and on herpes simplex virus, HSV-1 and HSV-2, the viruses that
cause it. Studies are currently under way to develop better
treatments for the 67 million people who suffer from genital
herpes. While some scientists are carrying out clinical trials to
determine the best way to use existing drugs, others are studying
the biology of herpes simplex virus. NIAID intramural scientists
have identified certain genes and enzymes that the virus needs to
survive. They are hopeful that drugs aimed at disrupting these
viral targets might lead to the design of more effective
therapies.
Meanwhile, other researchers are devising methods to control the
virus' spread. Two important means of preventing HSV infection
are vaccines and topical microbicides. Several different vaccines
are in various stages of development. These include vaccines made
from proteins on the HSV cell surface, peptides or chains of
amino acids that present important targets to the immune system,
and the DNA of the virus itself. Topical microbicides,
preparations containing microbe-killing compounds, are also in
various stages of development and testing. These include gels,
creams, or lotions that a woman could insert into the vagina
prior to intercourse to prevent infection in both herself and her
partner.
How can I get help if Im upset about having herpes
or having an infected partner?
Genital herpes outbreaks can be distressing,
inconvenient, and sometimes painful. Concern about transmitting
the disease to others and disruption of sexual relations during
outbreaks can affect personal relationships. If you or your
partner has genital herpes, you can learn to cope with and treat
the disease effectively by getting proper counseling and
medicine, and by using preventive measures as mentioned above.
Your local or state health department may be able to offer you
counseling. In addition, if you have questions and concerns, you
can call the American Social Health Association and the Health
Advice Company hotlines:
National Herpes Hotline - 919/361-8488
9 a.m. to 7 p.m. Eastern Time, Monday through Friday
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