Article title: Genital Herpes: NWHIC
Conditions: Genital Herpes
Source: NWHIC
Click here for Easy to Read version.
What is genital
herpes?
What are
the symptoms of genital herpes?
Can genital herpes
recur?
What is
the treatment for genital herpes?
Are there any
complications of genital herpes during pregnancy?
See also...
Genital herpes is a contagious viral infection that affects an estimated 30 million Americans. Each year, as many as 500,000 new cases are believed to occur. The infection is caused by the herpes simplex virus (HSV). There are two types of HSV, and both can cause the symptoms of genital herpes. HSV type 1 most commonly causes sores on the lips (known as fever blisters or cold sores), but it can cause genital infections as well. HSV type 2 most often causes genital sores, but it can also infect the mouth. The virus remains in certain nerve cells of the body for life, causing periodic symptoms in some people. Most people who are infected with HSV never develop symptoms.
The symptoms of genital herpes vary widely from person to person. When symptoms of a first episode of genital herpes occur, they usually appear within 2 to 10 days of exposure to the virus and last an average of 2 to 3 weeks. The early symptoms can include an itching or burning sensation; pain in the legs, buttocks, or genital area; vaginal discharge; or a feeling of pressure in the abdominal region.
Within a few days, sores (also called lesions) appear at the site of infection. Lesions can also occur on the cervix in women or in the urinary passage in men. These small red bumps may develop into blisters or painful open sores. Over a period of days, the sores become crusted and then heal without scarring. Other symptoms that may accompany a primary episode of genital herpes can include fever, headache, muscle aches, painful or difficult urination, vaginal discharge, and swollen glands in the groin area.
In genital herpes, after invading the skin or mucous membranes, the virus travels to the sensory nerves at the end of the spinal cord. Even after the skin lesions have disappeared, the virus remains inside the nerve cells in an inactive state. In most people, the virus reactivates from time to time. When this happens, the virus begins to travel along the nerves to the skin, where it multiplies on the surface at or near sites of the original infection, in genital or oral secretions, or from unapparent lesions. This shedding is infrequent, however, and usually lasts only a day, but it is sufficient to infect a sex partner.
The frequency and severity of the recurrent episodes vary greatly. While some people recognize only one or two recurrences in a lifetime, others may experience several outbreaks a year. The number and pattern of recurrence often change over time for an individual. Scientists do not know what cause the virus to reactivate. Although some people with herpes report that their recurrences are brought on by other illness, stress, or menstruation, recurrences often are not predictable. In some cases, exposure to sunlight is associated with recurrence.
During an active herpes episode, whether primary or recurrent, it is important to follow a few simple steps to speed healing and to avoid spreading the infection to other sites of the body or to other people: keep the infected area clean and dry, try to avoid touching the sores, wash hands after contact, and avoid sexual contact from the time the symptoms are first recognized until the sores have healed.
In 1982, the first antiviral drug for genital herpes, acyclovir, was approved by the Food and Drug Administration for use as a topical ointment in persons suffering from an initial episode of infection. Over the next few years, investigators at the National Institute of Allergy and Infectious Diseases (NIAID) and elsewhere subsequently proved that an oral form of acyclovir is a superior treatment capable of benefiting persons with first or recurrent episodes of genital herpes. The oral form of the drug markedly shortens the course of a first episode and limits the severity of recurrences if taken within 24 hours of onset of symptoms. People who have very frequent recurrent episodes of the disease can also take oral acyclovir daily for up to 1 year to suppress the virus’ activity and prevent most recurrences. Acyclovir is not a cure for herpes -- the virus remains in the body, but while taken regularly, the drug interferes with the virus’ ability to reproduce itself.
A pregnant woman who develops a first episode of genital herpes can pass the virus to her fetus and may be at higher risk for premature delivery. Newborns rarely become infected with herpes; however, half of those who become infected either die or suffer neurologic damage. With early detection and therapy, many serious complications can be lessened. The newborn's chances of infection depend on whether the mother is having a recurrent or a first outbreak. If the mother is having her first outbreak at the time of a vaginal birth, the baby's risk of infection is approximately one in three. If the outbreak is a recurrence, the baby's risk is very low. Because of the danger of infection to the baby, however, the physician will perform a cesarean section if herpes lesions are detected in or near the birth canal during labor. Some physicians also perform a viral culture at the time of delivery to detect shedding in women known to have had genital herpes outbreaks in the past. A baby born with herpes can develop encephalitis (inflammation of the brain), severe rashes, and eye problems. Acyclovir can greatly improve the outcome for babies with neonatal herpes, particularly if they receive immediate treatment.
You can find out more about genital herpes by contacting the following organizations:
Centers for Disease Control and Prevention, Office on Women's Health, (404) 639-7230
Herpes Resource Center, (800) 230-6039
National Herpes Hotline, (919) 361-8488
National Institute of Allergy and Infectious Diseases
This information was abstracted from fact sheets prepared by the National Institute of Allergy and Infectious Diseases.
All material contained in the FAQs is free of copyright restrictions, and may be copied, reproduced, or duplicated without permission of the Office on Women's Health in the Department of Health and Human Services; citation of the sources is appreciated.
Publication date: 1998
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