Genital herpes is most often caused by the herpes simplex virus type 2 (HSV-2). It also possible to contract genital herpes from the herpes simplex virus type 1 (HSV-1). Although this is a less common means of infection, it is becoming more common to have a genital HSV-1 infection and is typically less troublesome then HSV-2 infections. Genital herpes outbreaks can manifest in different ways for those infected – many people will never experience symptoms of genital herpes, while some will develop blisters on or around the genitals. For those that do develop physical signs of infection, the initial outbreak will normally begin with flu-like symptoms and swollen glands, before blisters begin to appear. The blisters of genital herpes can range from very severe to extremely mild (so mild that some people may even mistake an outbreak for something as insignificant as insect bites or jock itch). Because of the wide range of severity, and high potential for never even developing symptoms, many infected with genital herpes have no knowledge of their infection until they are tested for HSV-2. Most standard STD testing done in clinics and public health departments does not include HSV-2 testing.
Most people infected with HSV-2 are not aware of their infection. However, if signs and symptoms occur during the first outbreak, they can be quite pronounced.
The first outbreak usually occurs within two weeks after the virus is transmitted, and the sores typically heal within two to four weeks. Other signs and symptoms during the primary episode may include a second crop of sores, and flu-like symptoms, including fever and swollen glands. However, most individuals with HSV-2 infection never have sores, or they have very mild signs that they do not even notice or that they mistake for insect bites or another skin condition.
People diagnosed with a first episode of genital herpes can expect to have several (typically four or five) outbreaks (symptomatic recurrences) within a year. Over time these recurrences usually decrease in frequency. It is possible that a person becomes aware of the "first episode" years after the infection is acquired.
The prevalence of genital herpes within the United States has increased drastically over the past several decades. In fact, the number of Americans infected with HSV-2 increased by 30 percent between the 1970’s and 1990’s. To this day, genital herpes remains common in the United States – a recent study by the CDC estimated that over 45 million people are infected with the virus. In simpler terms, approximately one out of every five teenagers and adults are currently infected with HSV-2. The national average of 1 in 5 is not evenly split between women and men. Statistics released by the CDC show that women are more prone to infection than men (approximately one out of every four women are infected with HSV-2, while about one out of eight men are infected). Although the reason behind this higher rate of infection is debatable, it may be due to male-to-female transmission being more likely than female-to-male transmission.
Herpes Simplex 2 is transmitted from skin to skin contact, normally during sexual activity, with an individual who already carries the HSV-2 virus. Although transmission most commonly occurs by coming into contact with the sores caused by the genital herpes virus, it is also possible to transmit (and consequently contract) genital herpes in between outbreaks (or any time no sores are present). As many of those infected never experience actual symptoms of genital herpes, it is not safe to assume that your partner (or yourself) is not infected solely because no blisters are visible.
The only sure way to prevent HSV-2 (genital herpes) infection, as well as infection by any STD, is to abstain from sexual intercourse – whether that is oral, vaginal, or anal sex. You can also lower your risk by being in an exclusive and monogamous relationship where both partners are fully aware of their sexual heath, and are known to be free from infection. Additionally, the use of latex condoms is always recommended for sexual activity, but one should understand that genital herpes can occur in areas not covered by a condom – making transmission possible even when using a latex contraceptive. Also important to note, is that an infected individual can still transmit genital herpes even when sores are not currently present.
While the severity of symptoms can range quite widely from person to person, HSV-2 infection can lead to a variety of different health complications, including:
Psychological Distress: Many of those infected with Genital Herpes experience varying types of mental distress due to the frequency, severity, and public nature of the virus’ symptoms.
Pregnancy Complications: Transmission of genital herpes from a mother to her baby is possible (although rare) and, in some cases, can even be a fatal infection for the newborn. Because of this, it is imperative that pregnant women (especially those in the late stages of pregnancy) avoid contracting the HSV-2 virus. In the chance a woman has an active outbreak of Genital Herpes at the time of delivery, a Cesarean section is normally performed to limit the risk of transmission from mother to child.
Higher Susceptibility to HIV: Recent research has shown that those infected with HSV-2 are more prone to infection by the HIV Virus (the virus that causes AIDS). In turn, studies have also shown that those who are infected with the HIV virus, and have also contracted Herpes 2, become more infectious – more easily spreading HIV to a sexual partner.
There are different ways to screen for genital herpes, but the CDC recommends is a test called the Simplex Virus Type 2 IgG (HerpeSelect™), which looks for the presence of antibodies that are specific to the Herpes Simplex 2 virus. This specific genital herpes test, which is the same offered at getSTDtested.com, requires a blood sample.
Those that display physical symptoms of infection (blisters around the genital area), can also be tested by a simple visual inspection, or by providing their health care provider with a sample from the herpes sores for testing.
There is no medicine that can cure the herpes virus (neither HSV-1 nor HSV-2). Fortunately, there are certain antiviral medications (such as Valtrex) that can not only decrease the number of annual outbreaks, but also decrease the probability of transmission to a partner.