Herpes

What is Herpes?

Herpes is an infection that is caused by a herpes simplex virus (HSV). Oral herpes causes cold sores around the mouth or face. Genital herpes affects the genitals, buttocks or anal area. Genital herpes is a sexually transmitted disease (STD).

How Common is Herpes?

Results of a nationally representative study show that genital herpes infection is common in the United States. Nationwide, at least 45 million people ages 12 and older, or one out of five adolescents and adults, have had genital HSV infection. Over the past decade, the percent of Americans with genital herpes infection in the U.S. has decreased.

Genital HSV-2 infection is more common in women (approximately one out of four women) than in men (almost one out of eight). This may be due to male-to-female transmission being more likely than female-to-male transmission.

As many as 90 percent of people living with Herpes are unaware that they have the virus.

How can I get Herpes?

Any person who is sexually active can get genital herpes.

HSV-1 and HSV-2 can be found in and released from the sores that the viruses cause, but they are also released between outbreaks from skin that does not appear to have a sore. Generally, a person can only get HSV-2 infection during sexual contact with someone who has a genital HSV-2 infection. Transmission can occur from an infected partner who does not have a visible sore and may not know that he or she is infected.

HSV-1 can cause genital herpes, but it more commonly causes infections of the mouth and lips, so-called “fever blisters.” HSV-1 infection of the genitals can be caused by oral-genital or genital-genital contact with a person who has HSV-1 infection. Genital HSV-1 outbreaks recur less regularly than genital HSV-2 outbreaks.

What are the symptoms of Herpes?

A person may show symptoms within days after contracting genital herpes, or it may take weeks, months, or years. For this reason, it can be difficult for people to know when and from whom they may have contracted the virus.

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. 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.

Herpes' triggers (what leads to an outbreak/recurrence) are highly individual, but with time, many people learn to recognize, and sometimes avoid, factors that seem to reactivate HSV in their own bodies. Illness, poor diet, emotional or physical stress, friction in the genital area, prolonged exposure to ultraviolet light (commonly for oral herpes, such as a beach trip or skiing weekend), surgical trauma, and steroidal medication (such as asthma treatment) may trigger a herpes outbreak. The frequency of outbreaks can often be managed through effective stress management, and getting adequate rest, nutrition, and exercise.

What are the complications of Herpes?

Genital herpes can cause recurrent painful genital sores in many adults, and herpes infection can be severe in people with suppressed immune systems. Regardless of severity of symptoms, genital herpes frequently causes psychological distress in people who know they are infected.

In addition, genital HSV can lead to potentially fatal infections in babies. It is important that women avoid contracting herpes during pregnancy because a newly acquired infection during late pregnancy poses a greater risk of transmission to the baby. If a woman has active genital herpes at delivery, a cesarean delivery is usually performed. Fortunately, infection of a baby from a woman with herpes infection is rare.

Herpes may play a role in the spread of HIV, the virus that causes AIDS.

Is Herpes Treatable?

NO! There is no treatment that can cure herpes, but antiviral medications can shorten and prevent outbreaks during the period of time the person takes the medication. In addition, daily suppressive therapy for symptomatic herpes can reduce transmission to partners.

• Three antiviral medications (in pill form) are approved by the Food and Drug Administration (FDA) for the treatment of herpes: Zovirax® (acyclovir), Famvir® (famciclovir), and Valtrex® (valacyclovir). All of these medications, which are taken orally, work by attacking the herpes virus and disrupting its ability to multiply.

• Each of these medications can be used during a recurrence (outbreak) to help speed the healing process of an outbreak.

• All three drugs are FDA-approved for daily, suppressive therapy to help reduce the frequency of outbreaks.

• Zovirax is also available in the form of an ointment, but the medication has been proven to be much more effective for genital herpes when taken orally as a pill.

• Valtrex, when taken daily (suppressive therapy) by a person with recurrent genital herpes, can reduce the risk of transmission to a partner.

• According to the manufacturers, the most common short-term side effects reported are nausea and headaches. A large volume of research suggests that the medications are safe and have few or no side effects. These medications have never been noted to cause any long-term side effects.

• Using medication to treat genital herpes is not required. However, if a person would like to use antivirals, speaking with a health care provider can help determine which treatment may be right for them.

• Over-the-counter creams and/or ointments are not recommended for genital herpes, since they can interfere with the healing process in a number of ways, causing genital outbreaks to last longer. Keeping the area clean and as dry as possible and allowing the area to get air can help to speed the healing process.
 

Can Herpes be Prevented?

YES! The surest way to avoid transmission of sexually transmitted diseases, including genital herpes, is to abstain from sexual contact, or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected.

Genital ulcer diseases can occur in both male and female genital areas that are covered or protected by a latex condom, as well as in areas that are not covered. Correct and consistent use of latex condoms can reduce the risk of genital herpes.

Persons with herpes should abstain from sexual activity with uninfected partners when lesions or other symptoms of herpes are present.

It is important to know that even if a person does not have any symptoms he or she can still infect sex partners.

Sex partners of infected persons should be advised that they may become infected and they should use condoms to reduce the risk. Sex partners can seek testing to determine if they are infected with HSV. A positive HSV-2 blood test most likely indicates a genital herpes infection.

The Center for Disease Control and Prevention (CDC) and Evanston Health Department do not recommend regular use of the spermicide nonoxynol-9 (“N-9”) as it can cause irritation in the genital area, making it easier for some STDs to be transmitted. If a spermicide is used, it should be used with a condom, not in place of one.

If you share your sex toys with a partner, you should put a condom on the sex toy, remove it after use on one partner, and thoroughly clean the toy before using it on a different person or location (mouth versus anal or vaginal area).