Genital Herpes, NIAID Fact Sheet: NIAID
Article title: Genital Herpes, NIAID Fact Sheet: NIAID
Conditions: Genital Herpes, HSV-1, HSV-2
Source: NIAID
March 2001
Genital Herpes
What is genital herpes?
Genital 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
there. HSV type 2 is the usual cause of genital herpes, but it also
can infect the mouth during oral sex. 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.
How does someone get genital herpes?
Most people get genital
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 sores in the genital area. The sores cast off
(shed) 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 two to 10 days. These first episodes of
symptoms usually last two to three 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. Some 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.
Will I ever have outbreaks again?
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 sores 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 busies itself by making 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
feeling 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
the 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 does the doctor diagnose genital herpes?
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 any other symptoms are caused by the herpes
virus. A person may still have genital herpes, however, even if the
laboratory tests don’t show the virus in the body.
A blood
test cannot show whether a person can infect another person 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.
What is the treatment?
Although there is no cure for genital
herpes, your doctor might prescribe one of three medicines to treat
it:
- Acyclovir (Zovirax®) treats the first and/or later episodes of
genital herpes.
- Famciclovir (Famvir®) treats later episodes of genital herpes
and helps prevent future outbreaks.
- Valacyclovir (Valtrex®) treats later episodes of genital
herpes.
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. Therefore, 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 pregnant woman has
an outbreak and it is not the first one, her baby’s risk of being
infected during delivery is very low.
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 AIDS?
Genital
herpes, like other genital diseases that produce sores, increases a
person’s risk of getting HIV, the virus that causes AIDS. Also,
prior to better treatments for AIDS, persons with HIV (because of
lower protection from their immune systems) had severe herpes
outbreaks, which may have helped them pass both genital herpes and
HIV infections 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 condoms
during sexual intercourse may offer some protection from the virus.
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, the viruses that cause
it. Studies are currently under way to develop better treatments for
the 67 million 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 intramural 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 therapies.
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 that present
important targets to the immune system, 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 in both herself and her partner.
How can I get help if I’m upset about having herpes or having 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
preventive measures as mentioned above. Your local or state health
department may be able to offer you counseling. In addition, if you
have questions and concerns, you can call the American Social Health
Association and the Health Advice Company hotlines:
National Herpes Hotline - 919/361-8488
9
a.m. to 7 p.m. Eastern Time, Monday through Friday
Where can I get more written information?
Herpes
Resource Center
American Social Health
AssociationP.O. Box 13827
Research Triangle Park, NC
27709-9940
800/230-6039
http://www.ashastd.org/The
American College of Obstetricians and Gynecologists409
12th Street, S.W.
P.O. Box 96920
Washington, DC
20090-6920
202/863-2518
http://www.acog.org/
NIAID is a component of the National Institutes
of Health (NIH). NIAID supports basic and applied research to
prevent, diagnose, and treat infectious and immune-mediated
illnesses, including HIV/AIDS and other sexually transmitted
diseases, tuberculosis, malaria, autoimmune disorders, asthma and
allergies. NIH is an agency of the U.S. Department of Health and
Human Services.
Prepared by:
Office of Communications
and Public Liaison
National Institute of Allergy and Infectious
Diseases
National Institutes of Health
Bethesda, MD 20892
Public Health Service
U.S. Department of Health and
Human Services
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