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Health Information
Genital Herpes -
(Herpes Simplex Virus [HSV]—Types 1 and 2)
Definition
Genital herpes
is an infection that causes small, painful,
fluid-filled blisters on the genitals,
buttocks, or thighs. These blisters break
open leaving an indented sore or ulcer.
These
blisters
and/or ulcers may occur on
other parts of the body, including the
mouth, face, or eye.
Causes
Genital
herpes
is caused by the herpes simplex virus.
Although it was previously believed that
type 1 was responsible for lesions from the
waist up and type 2 for those from the waist
down, this has been shown to be incorrect.
Genital lesions may be of either type 1 or
type 2, and some sources report that
currently up to 40% of newly acquired cases
of genital herpes are from type 1 virus. The
virus enters the body through a break in the
skin or through mucous membranes. After the
first outbreak of genital herpes, the virus
migrates to nerve endings at the base of the
spine, and lies dormant until the next
outbreak.
The virus is
spread through:
- Sexual
contact, including intercourse and oral
and anal sex
- Fluid from
herpes blisters that gets on other parts
of the body
- An infected
mother passing it on to her child during
pregnancy or childbirth
The virus is
most contagious when blisters are present.
It is also contagious during the "shedding"
stage, before blisters or sores are visible.
The virus may also spread when inactive
between visible outbreaks.
Risk Factors
A risk factor is
something that increases your chance of
getting a disease or condition. The
strongest risk factor for getting the herpes
simplex virus is unprotected sexual contact
with a partner infected with the virus.
Once the herpes
simplex virus is present in the body, other
risk factors can trigger the blisters to
form. Often, the exact cause of an outbreak
of genital herpes is unknown.
Risk factors for
an outbreak of genital herpes in people
already infected with the virus include:
- Fever
- Illness or
infection
- Stress
- Weakened
immune system
-
Menstruation
- Long
periods of exposure to sunlight
Symptoms
Symptoms vary
depending on whether this is the patient’s
first (primary) episode or a recurrent
episode. The virus remains dormant between
outbreaks. During this period, the patient
may not have any noticeable symptoms but may
still be shedding (releasing) the virus and
able to spread it to a sexual partner. When
the virus is active, symptoms also vary and
some people still have no symptoms. The
frequency of
genital herpes outbreaks varies
from person to person. Most people have
outbreaks at least once per year.
Primary Infection
This occurs
in a patient who is newly exposed to
HSV. Although there may not be any
noticeable symptoms (asymptomatic), many
people experience a flu-like syndrome,
which includes fever and muscle aches.
The lesions may be genital and/or
present on other areas of the body,
including the mouth, lips, and tongue.
Additionally, the lesions are usually
larger in size and number than those
occurring in repeat or recurrent
episodes. The primary infection usually
resolves within two weeks unless the
patient gets a second infection with a
skin bacteria or fungus, in which case,
the lesions may persist for up to six
weeks.
Recurrent Infection
This
represents a reactivation of the "herpes
virus". The recurrence will vary from
patient to patient in terms of severity,
duration, and amount of virus shed. In
general, though, recurrences tend to
result in fewer, smaller ulcers which
usually last only 3-7 days. Symptoms are
usually limited to the area around the
blister or ulcer. It is important to
remember that viral shedding can occur
with or without visible lesions and that
asymptomatic (no symptoms or sores)
lesions are currently responsible for
over 50% of new infections.
Diagnosis
The doctor will
ask about your symptoms and medical history,
and perform a physical exam, particularly of
the blisters and/or ulcers. Herpes lesions
may look like other infections and may not
be immediately visible if inside the urinary
tract, vagina, or cervix. The doctor may
need to open a blister to swab it and send
it to the lab or may take a blood sample for
testing.
Treatment
Treatments to
ease pain include:
-
Nonprescription pain relief drugs
- Antiviral
creams and ointments
- Cool cloths
placed on blisters or sores
- Lukewarm
baths
- Wearing
loose-fitting clothes
Treatments to
speed healing include:
- Oral
antiviral medications
- Keeping
blisters/sores dry when not bathing
Treatments for
bacterial infection of the blisters/sores
include:
Prevention
To prevent the
spread of the herpes simplex virus:
- Avoid
sexual contact with an infected partner
from the time the partner feels initial
symptoms until blisters/sores have
completely healed.
- If your
partner is infected, use latex condoms
during sex when your partner shows
symptoms of genital herpes.
- Avoid oral
sex if your partner has herpes blisters
on the mouth or genital area.
- Avoid
touching blisters to prevent spreading
to other parts of the body.
- If you are
pregnant and infected with the herpes
virus, tell your doctor. Medication
given to newborns immediately after
birth can decrease the chance that they
will be infected. If you have active
herpes blisters when it is time to
deliver your baby, the doctor may
recommend that you deliver by
Cesarean section.
RESOURCES:
The American College of Obstetrics and
Gynecology
www.acog.org
American Social Health Association
www.ashastd.org
MayoClinic
www.mayo.edu
International Herpes Alliance
www.herpesalliance.org
CANADIAN RESOURCES:
Sex Information and Education Council of
Canada
www.sieccan.org
Sexualityandu.ca
www.sexualityandu.ca/home_e.aspx
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