What
is Herpes?
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. HSV 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 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.
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 HSV-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. HSV-2 infection is more common in
three of the youngest age groups which include people aged
12 to 39 years.
How does
someone get genital herpes?
Most people
get 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 lesions
in the genital area. The lesions shed (cast off) 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
don’t 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 don’t 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 2
to 10 days. These first episodes of symptoms usually last 2
to 3 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.
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.
Can outbreaks
recur?
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 lesions are
gone, the virus stays inside the nerve cells in a still and
hidden state, which means that it’s 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 makes 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 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 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 is
genital herpes diagnosed?
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 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 HSV.
There are also newer blood tests that can tell whether a person
has been infected with HSV 1 and/or 2.
How is
genital herpes treated?
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 episodes.
- Acyclovir
(Zovirax)
- Famciclovir
(Famvir)
- Valacyclovir
(Valtrex)
Recently,
the Food and Drug Administration approved Valtrex for use
in preventing transmission of genital herpes. (See section
below: How can I protect myself or my sexual partner?)
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 body’s 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.
If a pregnant
woman has an outbreak, which is not the first episode, her
baby’s risk of being infected 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 doctor before,
during, and after your baby is born.
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 HIV infection or AIDS?
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 herpes outbreaks, which
may have helped them pass both genital herpes
and HIV infection 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 male latex condoms during sexual intercourse may offer
some protection from the virus. When used with these precautions,
Valtrex can also help prevent infecting your partner during
heterosexual sex.
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). 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 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 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, and the DNA of the virus itself.
NIAID
and GlaxoSmithKline Biologicals are supporting a large clinical
trial in women of an experimental vaccine that may help prevent
transmission of genital herpes. The trial is being conducted
at more than 20 sites in 15 states nationwide. For more information,
click here Herpevac Trial for Women.
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.
Where
can I get help if I’m upset about having genital herpes or
I have 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 ways to prevent getting infected or infecting someone
else, as mentioned above.
gential, genetal herepes, geniteal herepe, herpe virus
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