HERPES

Herpes is a common, recurrent infection caused by the herpes simplex virus (HSV), of which there are two subtypes: HSV-1 and HSV-2. Both HSV-1 and HSV-2 can cause blisters and ulcers on the mouth, face, genitals, or around the anus. Once a person is infected with herpes, he or she remains infected for life. However, the virus often remains "latent" and does not cause symptoms for long periods of time.

Herpes spreads through intimate skin contact with an infected individual. Although the virus can be spread through contact with lesions or secretions, most transmission occurs from unrecognized lesions or asymptomatic shedding of the virus. Transmission of the virus can occur when the infected partner does not have an active outbreak of blisters, ulcers, or other symptoms. Some individuals may never have any symptoms and may not know that they are infected with the herpes virus. However, they can still transmit the virus to others. Oral herpes can be spread through kissing. Genital herpes is transmitted through sexual contact (vaginal, anal, and oral). The virus can be transmitted from oral to genital regions and vice versa during oral sex.

Risk Factors

The primary risk factors for herpes include:
• Engaging in sex without a male or female condom
• Having sex with more than one partner
• Having sex with someone who has multiple sex partner

Prevention

The chance of becoming infected with herpes can be reduced by avoiding risky sexual behaviors.
To reduce your risk:
• Use latex or polyurethane condoms during sex. While this may help reduce the risk of transmission, transmission may still occur if herpes lesions are on parts of the body not covered by the condom.
• Limit the number of your sex partners.
• Avoid any contact with a partner who has sores until the sore are completely healed.
• Avoid having sex until the sores are fully healed or use a male or female condom during anal, oral, or vaginal sex (however, transmission can still occur if the condom does not cover the sores).
• Avoid having sex just before or during an outbreak, since the risk for transmission is highest. If possible, encourage your partner to let you know at the first sign(s) of an outbreak so that you both can avoid sex then.
• If possible, ask any potential sexual partners if they have ever had a herpes outbreak, and encourage them to see a health care provider or clinic for more information—even if they do not have any symptoms.

Symptoms

The initial herpes infection may be accompanied by flu-like symptoms, such as fever, fatigue, headaches, muscle aches, and swollen glands (lymph nodes) in addition to blisters and ulcers on and around the genitals, thighs, buttocks, and anus or on the lips, mouth, throat, tongue, and gums. Lesions may also be found within the vagina and on the cervix. In the case of genital infection there may also be pain and itching where the sore is located or burning with urination. These blisters eventually crust over, form a scab, and eventually heal, usually within 1-3 weeks.

Once the initial infection has resolved, some people experience outbreaks of genital blisters, ulcers, or small sores, which can occur on the penis, vulva, anus, buttocks, and/or thighs. Itching and tingling in the genitals are often an early warning sign that an outbreak is soon to occur. The frequency and severity of outbreaks varies from one person to the next. Sores that occur during outbreaks generally last 3-7 days and are not as painful as those of the initial infection, and systemic symptoms are rare. However, some people may experience recurrent, painful genital ulcers. In addition, people with suppressed immune systems may experience severe, persistent ulcers.

Although genital herpes usually causes mild symptoms, some people may experience recurrent painful genital ulcers, which can be especially severe in people with suppressed immune systems. Like other STIs, herpes may also increase the risk for transmitting or acquiring HIV infection.

Testing/Treatment

Herpes can be diagnosed by testing a sample taken from an ulcer or blister. There is no readily available reliable blood test for the virus, and there is no certain diagnosis for individuals who are asymptomatic.

There is no cure for herpes. Once an individual is infected with herpes, he or she carries the virus in his or her body for life. Certain antiviral drugs and creams (such as Acyclovir), may be used to decrease the severity of the symptoms, the duration of an outbreak, and the frequency of recurring outbreaks. Infected individuals can also avoid some of the known causes of outbreaks to prevent recurring outbreaks. During an outbreak, symptomatic relief may be obtained by keeping the area clean and dry, taking pain relievers (such as aspirin, acetominophin, or ibuprofen), and, for genital herpes by taking sitz baths (sitting in the tub with warm water covering the hips).