Genital herpes is a type of the herpes simplex virus (HSV), which enters the body through small breaks in the skin or mucous membranes. HSV is most often contracted through vaginal or anal intercourse, kissing or oral sex, and it usually affects the mouth and genital areas. However, any skin-to-skin contact can cause infection.
There are two main types of the herpes simplex virus. HSV-1 (oral herpes), the most common type that often occurs in children, is transmitted by contact with infected saliva and usually infects the lips, mouth and face in the form of sores or lesions such as cold sores (fever blisters). It can also infect the eye, especially the conjunctiva and cornea, and in some cases lead to infection of the lining of the brain (meningoencephalitis). Due to it being so common among children, a large number of adults (ranging from 30 to 90 percent) will have created anitbodies against it.
The second main type, HSV-2, is usually transmitted sexually. Up to 30 percent of adults in the U.S. have antibodies against type 2.
Cross-infections between HSV-1 and HSV-2 can occur from oral-genital contact. In other words, a person infected with HSV-1 can transmit herpes to another’s genitals, and vice versa.
A third, although much less common, type of herpes simplex called herpetic whitlow is an infection of the finger, usually affecting health care providers from exposure to saliva from people with oral herpes.
A pregnant woman with genital herpes can also infect her fetus and transmit the herpes virus to her child during vaginal delivery. According to the University of Maryland Medical Center, 60 to 80 percent of HSV infections in newborns occur with mothers who have no visible symptoms or history of genital herpes.
Genital herpes signs and symptoms vary from one individual to another; however, as many as 90% of those infected with genital herpes fail to recognize the symptoms or have no symptoms at all, thus making it a common, widespread, highly infectious disease. Being most prevalent among the poor, the less educated, cocaine users, and people with multiple sex partners, HSV affects at least 45 million Americans, with an estimated one million new infections every year.
Genital Herpes Signs and Symptoms
The initial symptoms of genital herpes are a tingling sensation, pain and itching to the affected areas, beginning most often within three days to two weeks after exposure to the virus. After several days, groups of red bump-like sores or blisters – typically 1 to 3 millimeters in size – might appear, which then rupture. Ruptured ulcers can ooze or bleed and can cause pain and tenderness in the genital area, as well as pain during urination. Scabs then form on the ulcers and they go away without scarring.
For women, genital herpes sores can erupt in the external genitalia, buttocks, anus or cervix. Internal ulcers can cause discomfort and vaginal discharge, but cannot be seen except during a gynecological examination. In men, sores can appear on the penis, scrotum, buttocks, anus or thighs. In some cases, they can surface inside the urethra as well. Symptoms may last for up to four weeks for some.
The first genital herpes outbreak is usually the most severe and most painful, and may last longer than later recurrences. About 40 percent of men and 70 percent of women develop additional symptoms during an initial outbreak, most commonly being flu-like symptoms such as headaches, muscle aches, fever, and swollen or tender lymph nodes in the groin area. Two-thirds of those infected will have recurrences, of which one-third will experience three or more episodes per year. For some people with HSV, outbreaks can continue for as long as 40 years.
A note of caution: Infected persons are most contagious when symptoms are present. Therefore, extra precaution is necessary during outbreaks or when any symptoms are experienced to avoid infecting others.
The Mayo Clinic: Genital herpes https://www.mayoclinic.com/health/genital-herpes/DS00179
University of Maryland Medical Center: Herpes simplex – Highlights https://www.umm.edu/patiented/articles/herpes_simplex_000052.htm
University of Maryland Medical Center: Herpes simplex – Overview https://www.umm.edu/ency/article/001324.htm
eMedicine Health: Genital Herpes https://www.emedicinehealth.com/genital_herpes/article_em.htm#Genital%20Herpes%20Overview