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Herpes is a sexually transmitted infection caused by one of two serotypes: Herpes Simplex Virus-1 and Herpes Simplex Virus-2. According to the Centers for Disease Control (CDC), approximately 50 million adolescents and adults are infected with HSV- type 2 (HSV-2) in the United States, causing both painful and painless, recurrent infections. Studies show that HSV-2 infection is more common in women than men. HSV-1 is responsible for painful blisters around the mouth and lips; however, this serotype may be transmitted to the genital tract during oral sex as well.
Both HSV-1 and HSV-2 are spread during sexual contact with
an infected person via vaginal, oral or penile secretions.
Studies show many people unknowingly spread the virus because
they have a mild or unrecognized infection. Once infected
with the virus, most people are unaware of their infection,
however, some people experience painful symptoms. Typical
symptoms experienced are painful blisters in and around the
vaginal opening for women and on the penis for men. The first
episode may also produce a mild fever and flu-like symptoms
with swollen glands in the groin. These symptoms are usually
appearing within two weeks after the initial infection and
heal within two to four weeks of the outbreak. It is important
to stress, however, that most people infected with HSV-2 never
have sores or symptoms.
Symtoms
Symptoms that may be caused by HSV-2 infection, but may go unrecognized, include tingling, itching, or burning in or around the vagina, vulva, anus, penis, or scrotum or burning with urination. One may also experience pain in the leg or buttocks or burning on the side of the leg or foot. Clear discharge from the vagina or penis may be present as well. It is important to seek medical attention for appropriate and timely treatment if you are experiencing some of these symptoms.
Diagnosis
Diagnosis of genital herpes is largely done by visual inspection. HSV ulcerations are typical and easily diagnosed if they are examined by a trained healthcare provider such as a physician, nurse practitioner, physician assistant, or certified nurse midwife. For patients without typical blisters, blood testing (serologic) is available but costly. New tests available are able to distinguish HSV-1 from HSV-2 infection, however, according to the CDC, almost all HSV-2 infections are sexually acquired, but the presence of HSV-1 antibody does not distinguish infections acquired from genital or oral contact. Routine screening for HSV utilizing blood tests is not routinely done.
Treatment
Treatment at this time includes antiviral medication that must be prescribed by a physician, nurse practitioner, physician assistant or certified nurse midwife. These medications do not eradicate the infection or affect the risk of transmission or severity of recurrences. It is important to discuss transmission of this virus with your healthcare provider as well as strategies to reduce transmission. At this time, abstinence is the only proven method of prevention of transmission. Latex condoms, when used correctly can reduce the risk of transmission, but do not eliminate the risk. If your partner has signs of genital herpes, avoid direct skin contact with affected areas, including sores in and around the mouth. Contact your healthcare provider for more information on prevention of transmission of HSV.
In November of 2002, the National Institute of Allergy and
Infectious Diseases and the National Institutes of Health
launched a herpes vaccine trial in women. The study will determine
the vaccine's ability to prevent genital herpes in women.
Volunteers for the study are vaccinated at the start of the
trial, at one month and six months after the first injection.
The participants will be monitored for 20 months to determine
if the vaccine prevents HSV infection or disease. Data is
expected to be released sometime in 2005-2006. Women between
the ages 18-30 who wish to be evaluated for possible inclusion
in the trial should visit http://www.niaid.nih.gov/dmid/stds/herpevac/.
The trial is being conducted in 18 sites throughout the United
States.
More information about Herpes Simplex Virus can be found at the following:
Division of STD Prevention (DSTD):
www.cdc.gov/std/
National Herpes Hotline: 919-361-8488
National Herpes Resourse Center:
www.ashastd.org/hrc
American Social Health Association:
www.ashastd.org
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