Genital
herpes is a sexually transmitted disease (STD) caused by the
herpes simplex viruses type 1 (HSV-1) or 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. Over the past decade, the percent of Americans with
genital herpes infection in the U.S. has decreased.
Genital HSV-2 infection is more common in women
(approximately one out of four women) than in men (almost one
out of eight). This may be due to male-to-female transmission
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 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.
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
never have sores, or they have very mild signs that they do not
even notice or that they mistake for insect bites or another
skin condition.
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. It is possible that
a person becomes aware of the “first episode” years after the
infection is acquired.
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 lead to potentially fatal
infections in babies. It is important that women avoid
contracting herpes during pregnancy because a newly acquired
infection during late pregnancy poses 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.
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 diagnosed between outbreaks by the use of a
blood test. Blood tests, which detect antibodies to HSV-1 or
HSV-2 infection, can be helpful, although the results are not
always clear-cut.
There is no treatment that can cure genital 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 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.
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 and they should use condoms to reduce the risk.
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.
Division of STD Prevention
(DSTDP)
Centers for Disease Control and Prevention
Personal health inquiries and information about STDs:
CDC-INFO Contact Center
1-800-CDC-INFO (1-800-232-4636)
Email: cdcinfo@cdc.gov
National Herpes Hotline
(919) 361-8488
National Herpes Resource
Center
herpesnet@ashastd.org
Resources:
CDC National
Prevention Information Network (NPIN)
P.O. Box 6003
Rockville, MD 20849-6003
1-800-458-5231
1-888-282-7681 Fax
1-800-243-7012 TTY
E-mail: info@cdcnpin.org
American
Social Health Association (ASHA)
P. O. Box 13827
Research Triangle Park, NC 27709-3827
1-800-783-9877
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