Genital Herpes Overview

Genital herpes is one of the most common STDs. In recent years, the incidence has increased by approximately 30% compared to the 70’s, affecting mainly teenagers. Genital herpes is more common in women than in men. Genital herpes is a highly contagious infection that is usually transmitted through sexual contact with an infected person who has ulcerative lesions, but it can be transmitted through oral or anal intercourse. It can also be transmitted even if the ulcerations are not visible.

Genital herpes can also be transmitted from the mother to the infant during passage through the pelvic canal, if the mother has an active infection.

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The infection with genital herpes is caused by the herpes simplex virus. There are two strains of the virus – herpes simplex type I and herpes simplex type II. Herpes simplex type I, has a predilection for the oral cavity or nasal passages, while herpes simplex type II is more common in the genital area. During oral sex the herpes simplex type I can be transmitted to the genital region or the herpes simplex type II virus in the mouth.

In the first phase of genital herpes the virus enters the skin or genital mucosa cells. It then infects the sensory terminations of a neuron at that level and moves along the nervous trajectory of the neuron to the body of the neuron, where it shall reside for the entire lifespan of the person infected, where it cannot be attacked nor destroyed by the immune system of the host.

In the periods when the immune system is weakened during menstruation, due to stress, fever, sunstroke, or local trauma, the virus descends on the nerves up to the level where the primary infection took place. The herpes simplex virus transmission is done by coming into contact with the infected area during the moments of the eruption (herpetic spikes).

Although transmission between partners is more common during symptomatic episodes, the virus can also be transmitted out of these episodes. The virus cannot pass the placental barrier, but there is a risk of transmission of the infection from mother to fetus during passage through the birth canal through contact with infected lesions located in the genital area.

Any child with chlamydiosis requires a consultation done by a senior medical specialist to determine the exact cause of the ailment, and also to investigate a possible sexual abuse.

Genital Herpes Symptoms

Initially there is a stinging sensation in a localized point, then after a short time, this place will appear as a reddish area that will be covered with small blisters, sometimes 2-3 in number, sometimes a little more, with blisters that are filled with a transparent liquid. This liquid is highly infectious. Blisters are very painful and shortly after the blisters break, they dry out and get covered by crusts. Most people infected with genital herpes are asymptomatic or have minor symptoms and signs. The signs and symptoms that may appear immediately after contracting the virus are:

  • Enlarged lymph nodes
  • Headache
  • Fever
  • Dysuria (burning sensation during urination)
  • Myalgia (muscle pain)

After this, the virus retreats into the nervous system, where it remains dormant, until certain triggers occur that reactivate it. Typically, subsequent appearances of the lesions manifest several weeks or even months after the first outbreak. In most cases, they are less severe and shorter than the first episode. Although the virus remains in the body indefinitely, the number of active episodes tends to decrease after a number of years, as the body slowly begins to tolerate the infection with every occurring infectious spike.

If case of the first infection, these events are accompanied by painful urination (if the blisters are located in the genital area), burning sensation at the eruption site, headache, back pain, malaise (a general sensation of feeling ill). Women may experience watery vaginal discharges, and in males, urethral discharges.

The first appearance of herpes can spread over a period of several weeks. In case of the first infection, the period between the first outbreak and the disappearance of the blisters can stretch over a period of 3-4 weeks. In the event of relapses the symptoms get milder, the number of blisters decreases, and the period between the eruptions until the disappearance of the ulcerations is even more reduced, lasting no more than 10 days.

Genital Herpes Treatment

There is currently no treatment that can eradicate the infection with herpes simplex virus 2, but doctors can prescribe antiviral medicines, oral medication or ointments that can speed up the healing of the lesions. Pain medication purchased without a prescription can be effective in terms of discomfort or injuries. If reactivation is frequent, the doctor may recommend antiviral medications (such as acyclovir, famciclovir, valacyclovir) administered over long periods of time to try to suppress reactivation. No treatment can cure the infection with HSV 2. The virus can stay in the human body indefinitely, once a person is infected. The virus is dormant in the nerve cells stuck until triggers reactivate it. Symptomatic episodes, which include painful blisters, can be controlled.

Genital herpes in pregnant women and children

Genital herpes reactivation episodes during pregnancy are associated with miscarriage, stillbirth, and premature infants. Herpes infection of the newborn cause severe brain damage and blindness. However, women with genital herpes can give birth to healthy children.


Some of the methods of preventing HSV-2 infection include:

  • Avoid sexual contact with a person with genital herpes;
  • Use of condoms during sex (safe sex);
  • Use of condoms should be made associated with a spermicide containing nonoxinol-9;
  • Limiting the number of sexual partners;
  • Following a treatment with antiviral drugs (such as acyclovir) by a person with genital herpes can reduce the risk of transmission of the infection, but does not eliminate it completely;
  • By concomitant use of antiviral drugs and the measures listed above, the risk of transmission is also low.

Already fears have come true in countries such as Australia, France, Norway, Sweden and the UK, as some sexually transmitted disease can no longer be treated with current antibiotic classes.

Genital Herpes Testing

Tests for HSV are sampled mostly out of lesions in the genital area. In some instances, however, the test may be performed using samples from other types of tissues such as bone marrow, blood, urine, or even tears. To check if the lesions are signs of an infection caused by HSV, a variety of other tests can be performed, such as:

  • Viral culture is the best way to identify a possible infection with genital herpes. This is done as follows: fluid is taken from the lesions and placed in a culture dish. Viral culture often fails to detect the virus even though it is present (false-negative);
  • Test for antigen detection: the cells are harvested from a recently appeared injury and is investigated under the microscope. This test identifies antigens on the surface of the cells infected with the herpes virus.
  • Polymerase chain reaction (PCR): This test is performed using cells from an injury, blood or other fluids. PCR identified the genetic material of the virus. This test can identify the type of virus causing the infection. PCR is not typically performed using a sample taken from the lesions, but using a fluid is more efficient.
  • Test to identify the antibodies: tests performed on a blood sample can detect antibodies produced by the immune system to fight off the herpes infection. Tests for antibodies are performed occasionally and are not as conclusive as a viral culture in identifying the cause of an injury. The tests for identifying the antibodies cannot distinguish whether the herpes simplex infection is currently active or has been active in the past, making it very difficult to adopt an efficient course of treatment . Because antibodies gradually develop after the first infection, the test result may be negative, even if the infection is still very much present.

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