Genital Herpes
What is
genital herpes?
What are the symptoms of genital herpes?
Can
genital herpes recur?
What is the treatment for genital herpes?
Are there any complications of genital herpes during
pregnancy?
Also
See:
Sexually Transmitted Diseases
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What is genital herpes?
Genital herpes is a
contagious viral infection that affects an estimated 30 million Americans.
Each year, as many as 500,000 new cases are believed to occur. The
infection is caused by the herpes simplex virus (HSV). There are two types
of HSV, and both can cause the symptoms of genital herpes. HSV type 1 most
commonly causes sores on the lips (known as fever blisters or cold sores),
but it can cause genital infections as well. HSV type 2 most often causes
genital sores, but it can also infect the mouth. The virus remains in
certain nerve cells of the body for life, causing periodic symptoms in
some people. Most people who are infected with HSV never develop symptoms.
What are the
symptoms of genital herpes?
The symptoms of
genital herpes vary widely from person to person. When symptoms of a first
episode of genital herpes occur, they usually appear within 2 to 10 days
of exposure to the virus and last an average of 2 to 3 weeks. The early
symptoms can include an itching or burning sensation; pain in the legs,
buttocks, or genital area; vaginal discharge; or a feeling of pressure in
the abdominal region.
Within a few days,
sores (also called lesions) appear at the site of infection. Lesions can
also occur on the cervix in women or in the urinary passage in men. These
small red bumps may develop into blisters or painful open sores. Over a
period of days, the sores become crusted and then heal without scarring.
Other symptoms that may accompany a primary episode of genital herpes can
include fever, headache, muscle aches, painful or difficult urination,
vaginal discharge, and swollen glands in the groin area.
Can genital herpes recur?
In genital herpes,
after invading the skin or mucous membranes, the virus travels to the
sensory nerves at the end of the spinal cord. Even after the skin lesions
have disappeared, the virus remains inside the nerve cells in an inactive
state. In most people, the virus reactivates from time to time. When this
happens, the virus begins to travel along the nerves to the skin, where it
multiplies on the surface at or near sites of the original infection, in
genital or oral secretions, or from unapparent lesions. This shedding is
infrequent, however, and usually lasts only a day, but it is sufficient to
infect a sex partner.
The frequency and
severity of the recurrent episodes vary greatly. While some people
recognize only one or two recurrences in a lifetime, others may experience
several outbreaks a year. The number and pattern of recurrence often
change over time for an individual. Scientists do not know what cause the
virus to reactivate. Although some people with herpes report that their
recurrences are brought on by other illness, stress, or menstruation,
recurrences often are not predictable. In some cases, exposure to sunlight
is associated with recurrence.
What is the
treatment for genital herpes?
During an active
herpes episode, whether primary or recurrent, it is important to follow a
few simple steps to speed healing and to avoid spreading the infection to
other sites of the body or to other people: keep the infected area clean
and dry, try to avoid touching the sores, wash hands after contact, and
avoid sexual contact from the time the symptoms are first recognized until
the sores have healed.
In 1982, the first
antiviral drug for genital herpes, acyclovir, was approved by the Food and
Drug Administration for use as a topical ointment in persons suffering
from an initial episode of infection. Over the next few years,
investigators at the National Institute of Allergy and Infectious Diseases
(NIAID) and elsewhere subsequently proved that an oral form of acyclovir
is a superior treatment capable of benefiting persons with first or
recurrent episodes of genital herpes. The oral form of the drug markedly
shortens the course of a first episode and limits the severity of
recurrences if taken within 24 hours of onset of symptoms. People who have
very frequent recurrent episodes of the disease can also take oral
acyclovir daily for up to 1 year to suppress the virus’ activity and
prevent most recurrences. Acyclovir is not a cure for herpes -- the virus
remains in the body, but while taken regularly, the drug interferes with
the virus’ ability to reproduce itself.
Are
there any complications of genital herpes during pregnancy?
A pregnant woman who
develops a first episode of genital herpes can pass the virus to her fetus
and may be at higher risk for premature delivery. Newborns rarely become
infected with herpes; however, half of those who become infected either
die or suffer neurologic damage. With early detection and therapy, many
serious complications can be lessened. The newborn's chances of infection
depend on whether the mother is having a recurrent or a first outbreak. If
the mother is having her first outbreak at the time of a vaginal birth,
the baby's risk of infection is approximately one in three. If the
outbreak is a recurrence, the baby's risk is very low. Because of the
danger of infection to the baby, however, the physician will perform a
cesarean section if herpes lesions are detected in or near the birth canal
during labor. Some physicians also perform a viral culture at the time of
delivery to detect shedding in women known to have had genital herpes
outbreaks in the past. A baby born with herpes can develop encephalitis
(inflammation of the brain), severe rashes, and eye problems. Acyclovir
can greatly improve the outcome for babies with neonatal herpes,
particularly if they receive immediate treatment.
from
The Office On Women's Health - US Department of Health and Human Services
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