Information about
Genital Herpes
The definition of genital herpes
Genital herpes is an infection caused by the herpes simplex virus
(or HSV). There are two types of Herpes Simplex Virus, and both
can cause genital herpes.
- Herpes Simplex Virus 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 genital herpes sores.
- Herpes Simplex Virus type 2 is the usual
cause of
genital herpes, but it also can infect the mouth. 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 genital herepes lesions (also called genital
herpes sores) in and around the vaginal area, on the penis, around
the anal opening,
and on the buttocks or thighs. Sometimes, herpes sores
also appear on other parts of the body where the virus has
entered through
broken skin.
The Herpes Simplex Virus remains in certain nerve cells of the
body for a lifetime, and can produce herpes symptoms on and off
in some infected people.
According to the U.S. Centers for Disease Control and Prevention,
45 million people in the United States ages 12 and older, or 1
out of 5 of the total adolescent and adult population, are infected
with the Herpes Simplex Virus-2.
Nationwide, since the late 1970s, the number of people with genital
herpes infection has increased 30 percent. The largest increase
is occurring in young teens. Herpes Simplex Virus-2 infection
is more common in three of the youngest age groups which include
people aged 12 to
39 years.
How is Herpes Simplex Virus transmitted?
Most people get genital herpes by having sexual intercourse with
someone who is having a genital herpes outbreak. This
outbreak means that the Herpes Simplex Virus is active. When
active, the herpes virus usually causes
visible
sores (lesions) in the genital area. The sores (lesions) shed
(cast off) herpes viruses that can infect other people. Sometimes,
however,
an infected
person
can have a herpes outbreak and have no visible lesions at all.
People often get genital herpes by having sexual contact
with others who aren't aware that they are infected
with herpes or who are having outbreaks of herpes without any lesions
(sores).
A person with genital herpes also can infect a sexual partner
during oral intercourse. The virus is spread only
rarely, if at all, by touching
objects such as a hot tub or a toilet seat.
The Symptoms of Genital Herpes
Unfortunately, most people who have genital herpes are unaware
of it because they never have any symptoms, or the herpes symptoms
are unrecognized. When there are symptoms, they can
be different in each infected person. Most often, when a person
first becomes infected with genital herpes,
the symptoms will appear
within 2 to 10 days. These first outbreaks of symptoms usually last
2 to 3 weeks.
Early symptoms of a Genital Herpes
These are the early symptoms
- 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, herpes sores
appear near where the herpes 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 herpes
sores. Over several days, the herpes sores become crusty and
then heal without leaving
a scar.
Other genital herpes symptoms that may go with the first outbreak
of genital herpes are muscle aches, headaches, painful or difficult
urination,
swollen
glands in the area of the groin, and vaginal discharge.
Do the genital herpes outbreaks recur?
If you have been infected by Herpes Simplex Virus 1 and/or 2,
you'll probably have herpes 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 awhile. Even after the
herpes sores
are gone, the herpes virus stays inside the nerve cells in
a still and hidden state, which means that it’s inactive.
In most people, the genital herpes 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 makes more herpes viruses near
the site of
the very first infection. That is where new herpes lesions usually
will appear.
Sometimes, the herpes virus can become active but not
cause any visible herpes lesions. At these times, small
amounts of the herpes 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 sexual partner during
this time of shedding.
Future genital herpes outbreaks
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 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 outbreak. 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 lesions that crust over and afterward disappear.
The severity and frequency of recurrent herpes outbreaks
differ 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 genital herpes outbreaks often change over time for a
person. Scientists do not know what causes the herpes virus to
become active again.
Although
some people with genital herpes report that their outbreaks are
brought on by another illness, stress, or having a menstrual period,
outbreaks
are often unpredictable. There are some genital herpes outbreaks
that may be connected to exposure to sunlight.
Diagnosing genital herpes
Because the genital herpes sores may not be visible to the naked
eye, a physician or other health care worker may have to do several
laboratory tests to try to prove that symptoms are caused by
the herpes virus. A person may still have genital herpes, however,
even if the laboratory tests do not show the virus in the body.
A blood test cannot show whether a person can infect another
with
the herpes virus. A blood test, however, can show if a person
has been infected at any time with the herpes virus. There
are also newer blood tests that can tell whether a person has been
infected with Herpes Simplex Virus
1 and/or 2.
Treatment for Genital Herpes
Although there is no cure for genital herpes, your health care
worker might prescribe one of three medicines to treat it as
well as to help prevent future outbreaks.
- Valacyclovir (Valtrex)
- Famciclovir (Famvir)
- Acyclovir (Zovirax)
- Recently, the Food and Drug Administration
approved Valtrex for use in preventing transmission of genital
herpes.
During a genital herpes outbreak, whether the first outbreak 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 herpes infected area clean and dry, in order to prevent
other infections from developing.
- Try to avoid touching the herpes lesions.
- Wash your hands after contact
with the herpes sores.
- Avoid sexual contact from the time you first
feel any symptoms until the genital herpes sores are completely
healed, that is, the scab has
fallen off and new skin has formed where the genital herpes sore
was.
Genital herpes and associated 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 outbreaks can last a long time
and be unusually
severe (The body’s immune system fights off foreign invaders
such as viruses).
Herpes and Pregnancy
If a woman has her first outbreak of genital herpes while she
is pregnant, she can pass the genital herpes virus to her unborn
child and may deliver
a premature baby. Half of the babies infected with genital
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.
If a pregnant woman has an outbreak, which is not the first outbreak,
her baby’s risk of being infected with herpes during delivery
is very low. In either case, if you are pregnant and infected with
genital
herpes, you should stay in close touch with your physician before,
during, and after your baby is born.
If a woman is having an outbreak during labor and delivery and
there are genital herpes lesions in or near the birth canal, the
physician will do a cesarean section to protect the baby. Most
pregnant women
with genital herpes, however, do not have signs of active infection
with the herpes virus during this time, and can have a normal delivery.
Genital herpes and HIV
Genital herpes, like other genital diseases that produce lesions,
increases a person’s risk of getting HIV, the virus that
causes AIDS. Also, prior to better treatments for AIDS, persons
infected with HIV had severe genital herpes outbreaks, which
may have helped them pass both genital herpes and HIV infection
to
others.
Protecting a sexual partner from infection
If you have early signs of a genital herpes outbreak or visible
herpes lesions, you should not have sexual intercourse or oral
sex until the
signs are gone and/or the herpes sores have healed completely.
Between herpes episodes,
using male latex condoms during sex may offer
some protection from the herpes virus. When used with these
precautions, Valtrex can also help prevent infecting your partner during heterosexual
sex.
Current research
The National Institute of Allergy and Infectious Diseases (NIAID)
supports research on genital herpes and on herpes simplex virus
(HSV-1 and HSV-2). Studies are currently underway to develop
better treatments for the millions of 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 the herpes simplex virus. NIAID 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 treatments.
Meanwhile,
other researchers are devising methods to control the virus'
spread. Two important means of preventing Herpes Simplex
Virus infection
are vaccines and topical microbicides. Several different vaccines
are in various stages of development. These include vaccines made
from proteins on the Herpes Simplex Virus cell surface, peptides
or chains of amino acids, 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.
Coping with the stress of herpes - Where to seek help
Genital herpes episodes can be distressing, inconvenient, and
sometimes painful. Concern about transmitting the disease to other
people and disruption of sexual relations during outbreaks can
affect personal relationships. If you or your sexual partner
has genital herpes,
you can learn to cope with and treat the disease effectively by
getting proper counseling and medicine, and by using ways to prevent
getting infected or infecting someone else, as mentioned above.
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