What is it?
Genital Herpes is a sexually transmitted disease caused by the Herpes Simplex Virus (HSV). There are two types of herpes virus that can cause genital herpes, Type 1 (HSV-1) and Type 2 (HSV-2). In the past, HSV-1 was usually known as the cause of cold sores or fever blisters on the lips or face, while HSV-2 was the cause of sores or blisters on the genitals. However today, both Type 1 and Type 2 can be the cause of genital herpes.
What are the symptoms?
Herpes sores usually appear two to 12 days after contact with an infected person. Symptoms with the initial infection are usually more severe than with a recurring outbreak. In women, sores may appear on the cervix, vagina, vaginal lips and surrounding skin, upper legs and buttocks. In men, sores usually appear on the penis, and in the anus and rectum of those engaging in sex with other men. There is often tingling or burning feeling, fever, muscle aches, painful urination and swollen glands in the groin area prior to or during an outbreak.
Some people have one blister (sore) during an infection; others have several. It may take two to three weeks to feel better. Some people have recurrences (i.e. repeat outbreaks) monthly, some every few months, and about 10% never have another recurrence. Recurrence of genital sores is less common with HSV-1 then HSV-2. In between outbreaks, the virus remains in the body in an inactive state.
How is it spread?
Herpes virus is very contagious, especially if blisters or sores are present. Both Type 1 and Type 2 can be accidentally spread from the original site to other parts of the body (transmission to the eye can be particularly serious). Be careful to wash and dry hands well after touching herpes sores. Do not kiss infants or children if sores are in or near the mouth.
With initial infection HSV can remain infectious for up to seven weeks after the first appearance of lesions. In recurrent lesions, infectivity is usually shorter, up to five days. Spreading of the virus is still possible from the skin even after the lesion has healed.
Some people with herpes never develop symptoms or blisters, but can transmit the virus in oral or genital fluids, thus spreading the virus to others.
The virus is spread only rarely, if at all, by touching objects such as a toilet seat or hot tub.
How is it diagnosed?
A culture (swab) of the fluid from the sore(s), taken soon after first appearance, will usually detect the herpes virus. A positive blood test tells very little. Herpes antibody of some type may be present in 50-80% of people by the age of 20.
Is there a treatment?
At present, there is no cure for herpes. However, a drug called Acyclovir (Zovirax) may help healing and helps reduce the spread of the virus and the number of repeat attacks. Zovirax must be prescribed by a doctor or a nurse practitioner.
Recurrences vary from person to person. Triggers such as stress, menstruation, poor nutrition, lack of rest, illness, and exposure to extreme heat, cold or sunlight seem to cause recurrences for some people. Others don’t notice any special triggers.
What can I do to avoid spread?
Spread of the virus by a person with no symptoms can definitely occur, but spread is more likely when sores are present. Do not have intercourse, oral or anal sex when sores are present or when either partner notices the first signs of the herpes outbreak (e.g., slight tingling or redness). Wait until the sores are completely healed and the skin looks and feels normal. Between outbreaks, using male latex condoms during sexual intercourse may provide some protection from the virus.
Latex condoms are especially important during pregnancy if the man has herpes and the woman does not. A first attack of herpes during pregnancy is a serious risk for the baby. Recurrent outbreak is less risk for the baby but some risk still does exist.
Pregnant women must tell their doctor as soon as possible if they or their partner have a history of herpes. Keep regular prenatal appointments and watch for signs of repeat outbreaks close to the due date. A caesarean section is sometimes necessary.
Women with herpes should have yearly PAP tests. PAP results indicating pre-cancerous changes are slightly higher in women with herpes.
For more information, please contact a member of Haldimand-Norfolk Health Unit’s Infectious Disease Team.
Simcoe Office: 519.426.6170 / 905.318.6623
Caledonia Office: 905.318.5367