Genital Herpes

Infection with Herpes Simplex Virus Type 2 (HSV-Type 2) usually results in sores on the buttocks, penis, vagina, or cervix, 2-20 days after contact with an infected person. Sexual intercourse is the most frequent means of getting the infection. Both primary and repeat attacks can cause problems including: a minor rash or itching, painful sores, fever, aching muscles, and a burning sensation with urination. HSV-Type 2 may also occur in other locations, but it is usually found below the waist.

Most people get type two infections, which causes genital sores, following sexual contact with an infected person. The virus affects anywhere between 5 and 20 million people, up to 20% of all sexually active adults in the United States.

There are two kinds of infections – Primary infections and recurrent infections.  Although most people get infected when exposed to the virus, only 10% will actually develop sores. The sores of a primary infection appear 2 – 20 days after contact with an infected person and can last from 7 to 10 days.  The number of blisters varies from one to a group of blisters. Before the blisters appear, the skin may itch, sting, burn, or tingle. The blisters can break as a result of minor injury, allowing the fluid inside the blisters ooze and crust. Eventually the crust falls off leaving behind a slightly red healing skin.  The sores from a primary infection heal completely and rarely leave a scar.  However, the virus that caused the infection remains in the body. After the blister heals, the virus moves into the nearest nerve cells remains in a resting state.  The virus will hide in this nerve until the immune system drops due to sickness or stress. When this happens people may have a recurrence either in the same location as the first infection or in a nearby site.   Recurrent infections tend to be mild and can be triggered by a variety of factors including fever, sun exposure, menstrual period, trauma, or nothing at all.

Herpes lesions have a classic clinical appearance that are typically described as a cluster of tiny testicles on a pink/erythematous base.  Herpes infections can be diagnosed based off of clinical appearance and history alone. If a diagnosis is uncertain, a swab from the infected skin for culture or smear may be taken and sent to the laboratory for analysis. Laboratory tests include special microscopic examinations and blood test for antibodies. Some tests are only valid for the early stages and more than one of these tests may be required to confirm the presence of herpes.

Oral antiviral medications such as acyclovir, or valacyclovir are very effective for treating herpes infections. These medications can be used to treat an outbreak or can be used consistently to suppress herpes occurrences, reduce outbreaks, and spreading by viral shedding.

Yes.  Most people are aware that if they kiss someone while having a fever blister or have sex with a partner with an outbreak of genital herpes, they are likely to transmit the virus. However, most herpes is transmitted it in the absence of lesions! It is estimated that over 80% of all genital herpes is transmit it when there are no lesions and no symptoms. This is due to a phenomenon called asymptomatic viral shedding.  Taking antiviral medications daily reduces both viral shedding and disease transmission.

It is estimated that between 200,000 and 500,000 people “catch” genital herpes each year and the number of HSV-Type 1 oral infections is even higher.  Unfortunately, there’s no vaccine that prevents this very contagious disease but other methods of prevention before and during an outbreak are important.  Tingling, burning, itching, or tenderness in an area of the body where there is a history of herpes infection are common symptoms of an impending outbreak.  A person with oral herpes should avoid kissing, sharing cups, or lip balms. A person with genital herpes should avoid sexual relations, including oral/general contact during the period of symptoms or active lesions. Condoms can help prevent transmission of genital herpes between sexual partners and should always be used. However, they will not protect against the virus that maybe living on nearby general skin that is not covered by the condom.

A pregnant woman who has genital herpes at the time of childbirth may transmit the disease to her baby as it passes through the birth canal. If the birth occurs during the mothers first episode of genital herpes, the baby may suffer severe damage. Women who know that they had General herpes in the past or think they may have it during their pregnancy should tell their physician so the baby can be protected.

Pregnant women should avoid sexual contact with a partner who has active genital herpes, especially late in pregnancy, or they must routinely use condoms.

The newborn can also be infected by exposure to the virus from non-genital lesions. If the mother or person working in the nursery has active blisters on the lips or hands, the baby can become infected. Family members and friends with active HSV should not handle a newborn child.