Genital Herpes (HSV-2)

Description
This highly contagious infection is typically spread through intercourse with a person infected with sores, and can be passed through oral or anal sex as well. It can also be spread when sores are not readily visible. It is a very common disease and causes blisters or groups of small ulcers on and around the genitals. As many as 80-90% of those infected have no symptoms and don’t know they are carriers.

Genital herpes are caused by the herpes simplex virus-2 (HSV-2) and in some cases, by HSV-1, the virus responsible for cold sores. One out of every 4-5 people has genital herpes, making it one of the most common sexually transmitted diseases. More women than men are infected with it.

Symptoms
There are typically no signs or symptoms, but if there are, they tend to crop up within 3-7 days of transmission. During a first attack, skin on or near the sex organ becomes inflamed and may itch. Blisters tend to group together and can be painless in some cases, to very tender and painful in others.

Typically sores open, scab over, then heal. Other symptoms upon first outbreak include:
• fever
• muscle aches
• headaches
• burning when urinating
• vaginal discharge
• swollen lymph glands in the groin area

Things that can trigger a subsequent infection include:
• stress
• physical illness
• surgery
• vigorous sex
• poor diet
• menstruation

In future outbreaks, symptoms tend to be much more mild. One sign that a flare-up is coming is pain in the area of the infection prior to the appearance of any blisters or ulcers.

Tests
Accurate testing is critical in the case of genital herpes, and is typically diagnosed via a swab of one of the sores, studied under a microscope. If sores are not visible, it can be difficult to diagnose.

Blood tests can detect HSV antibodies without symptoms, but false-negatives are possible in these cases, particularly if infection was a recent occurrence. (It takes a few weeks for antibodies to show up in the blood). Conversely, false-positives are also possible, so if risk for the virus is low, re-testing is recommended.

Internal check of the cervix in women or urethra in men can be done, as can a direct fluorescent antibody test which allows antibodies stuck to the virus, to glow when viewed under a special kind of microscope.

Outcomes
An outbreak can last for several weeks. The first flare-up is typically the worst with subsequent recurrences being much less severe. After each outbreak, the virus retreats to the nervous system where it lies dormant until it is triggered by an outside factor. It typically lives in an infected person forever. Future outbreaks can appear within weeks or months of the first, and on average recur about four times a year.

There is no cure for genital herpes, but there are anti-virus medicines that may help aid in faster recovery. Over the counter painkillers can bring relief from the symptoms. If outbreaks are more frequent than four times a year, a prescribed anti-viral (Famvir, Valtrex and Zovirax are popular) can suppress frequency.