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Genital Herpes: What You Need to Know

Genital Herpes: What You Need to Know

Genital herpes is a sexually transmitted infection caused by 2 viruses: Herpes Simplex Virus type 1 (HSV-1) and Herpes Simplex Virus type 2 (HSV-2). HSV-1 is mainly transmitted by oral-to-oral contact and is commonly referred to as “cold sores” or “fever blisters”. While most people become infected with HSV-1 during their youth from saliva (non-sexual contact), many have no symptoms. Genital herpes is almost exclusively sexually transmitted (HSV-2) but can also be caused by HSV-1 through oral sex.

· 1 out of every 6-8 people have HSV-2

· An estimated 87.4% are unaware they are infected with HSV-2

Symptoms: Genital Herpes

None whatsoever

First outbreak: One or more small, painful or tender blisters on or around the genitals or rectum.

· The blisters break and leave painful ulcers that may take 2 - 4 weeks to heal. Pain is often worsened with walking or sitting, when underwear rubs against it, and for females, with urination and wiping

· The first outbreak has a longer duration of lesions, increased shedding of the virus (making transmission more likely), and body symptoms, including fever, body aches, swollen lymph nodes, or headache

Recurrent outbreaks:

· Prodromal symptoms (symptoms before the blisters and ulcers appear): localized genital pain, burning, or tingling, or shooting pains in the legs, hips or buttocks which occur hours to days before the eruption of lesions

Transmission

·         Contact with HSV in herpes lesions, mucosal surfaces (lining of the mouth, vagina, and anus), genital secretions, and oral secretions. Transmission can occur with genital-to-genital contact, regardless whether there was sexual intercourse or not

·         HSV-1 and HSV-2 can be shed from normal-appearing mucosa or skin but is most contagious when moist blisters are present

·         Commonly occurs from contact with an infected partner who does not have visible lesions and who may not know that they are infected

·         The average incubation period (time from exposure to first symptoms) for an initial herpes infection is 4 days

Diagnosis: HSV 1 and 2

· Sample taken directly from an ulcer

· Blood test that detects herpes antibodies: If negative and infection is still suspected, repeat test in 12 weeks. It can take the body that long to make antibodies that can be found in a blood test

Complications

· Painful genital ulcers can be severe and persistent in persons with suppressed immune systems, such as HIV or cancer

· Increases the risk of acquiring HIV

· Neonatal herpes can occur when an infant is exposed to HSV in the genital tract during delivery

· The infection can lead to social stigma and psychological distress, impacting one’s quality of life and sexual relationships

Treatment: Anti-viral medications (acyclovir, famciclovir, and valacyclovir) are the most effective treatment available for people infected with HSV. These can help to reduce the severity and frequency of symptoms but can’t cure the infection.

· Episodic: medication is taken only during outbreaks

· Maintenance: medication is taken daily to prevent recurrent infection and reduce the likelihood of spreading HSV to uninfected partners

Prevention

· Correct and consistent use of condoms can reduce, but not eliminate, the risk of transmitting or acquiring genital herpes, because herpes virus transmission can occur in areas that are not covered by a condom

· Abstain from sexual contact, or be in a long-term mutually monogamous relationship with a partner who has been tested for sexually transmitted infections and is known to be uninfected

· Persons with herpes should abstain from sexual activity with partners when herpes lesions or other symptoms of herpes are present

· Even if a person does not have any symptoms, they can still infect sex partners

· Partners of infected persons should be advised that they may become infected

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