Genital Herpes - CDC Fact Sheet
Genital
herpes is a sexually transmitted disease (STD) caused by the
herpes simplex viruses type 1 (HSV-1) or type 2 (HSV-2). Most
genital herpes is caused by HSV-2. Most individuals have no or only
minimal signs or symptoms from HSV-1 or HSV-2 infection. When signs
do occur, they typically appear as one or more blisters on or
around the genitals or rectum. The blisters break, leaving tender
ulcers (sores) that may take two to four weeks to heal the first
time they occur. Typically, another outbreak can appear weeks or
months after the first, but it almost always is less severe and
shorter than the first outbreak. Although the infection can
stay in the body indefinitely, the number of outbreaks tends to
decrease over a period of years.
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.
HSV-1 and HSV-2 can be found in and released from the sores that
the viruses cause, but they also are 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.
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.
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. Herpes can make people more susceptible to HIV
infection, and it can make HIV-infected individuals more
infectious.
The signs and symptoms associated with HSV-2 can vary greatly.
Health care providers can diagnose genital herpes by visual
inspection if the outbreak is typical, and by taking a sample from
the sore(s) and testing it in a laboratory. HSV infections can be
diagnosed between outbreaks by the use of a blood test. Blood
tests, which detect antibodies to HSV-1 or HSV-2 infection,
can be helpful, although the results are not always clear-cut.
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.
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.
Division of STD Prevention (DSTDP)
Centers for Disease Control and Prevention
www.cdc.gov/st
Personal health inquiries and information about
STDs:
CDC-INFO Contact Center
1-800-CDC-INFO (1-800-232-4636)
Email: cdcinfo@cdc.gov
National Herpes Hotline
(919) 361-8488
National Herpes Resource Center
http://www.ashastd.org/hrc
herpesnet@ashastd.org
Resources:
CDC National Prevention
Information Network (NPIN)
P.O. Box 6003
Rockville, MD 20849-6003
1-800-458-5231
1-888-282-7681 Fax
1-800-243-7012 TTY
E-mail: info@cdcnpin.org
American Social
Health Association (ASHA)
P. O. Box 13827
Research Triangle Park, NC 27709-3827
1-800-783-9877
Sources
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Corey L, Wald A, Patel R et al. Once-daily valacyclovir to
reduce the risk of transmission of genital herpes. New England
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Wald A, Langenberg AGM, Link K, et al. Effect of condoms
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Wald A, Link K. Risk of human immunodeficiency virus infection
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