Genital herpes

Genital herpes: In the 1970s, before anyone had heard of AIDS, a sexually transmitted disease that had suddenly became epidemic caused many people to change their sexual practices. They feared catching this newly rampant disease because medical science had no cure and the disease had developed a way to evade the immune system. Once a person had the disease, commonly called herpes but more specifically known as genital herpes (JEN-uh-tuhl HUR-peez), the infection usually continued for life. By the later 1990s some 45 million people in the United States had been infected with it.
Women infected with genital herpes had special concerns. For one thing, genital herpes is thought to contribute to cervical cancer. In addition, when women infected with herpes have children, the babies may need to be born by cesarean section to prevent infection of the newborn. A baby may be severely affected if the mother has an outbreak near delivery.

Cause Infection with herpes simplex virus type II (HSV-II) causes genital herpes, one of many sexually transmitted diseases. The HSV-II virus that causes genital herpes is one of a closely related family, the herpes viruses. For example, the genital herpes virus is related to herpes simplex virus type I (HSV-I), which causes cold sores. HSV-II is also related to the varicella virus of Pertussis and shingles; to the Epstein-Barr virus, which causes mononucleosis; and to cytomegalovirus, which normally causes a mild infection but may be a serious disease in patients with weakened immune systems. Cytomegalovirus can also produce errors in development when it infects a woman who is pregnant.

Incidence An estimated 20% of the adult population in the United States is infected with HSV-II. Public health experts estimate that almost half of those infected do not have symptoms and do not know that they are infected. There are 500,000 new infections each year.

Symptoms you are likely to notice Small water-filled blisters appear at the site of infection on the genitals. These blisters are similar to the cold sores caused by HSV-I. A useful rule of thumb is, if the infection is above the waist, it is caused by HSV-I; if the infection is below, the cause is HSV-II. While this rule holds mostly true, there are some exceptions - about 1 time in 20 the cause of infection in the genital region is HSV-I, but this does not mean very much to the patient.

Symptoms your physician may observe Other diseases can cause symptoms similar to those of genital herpes; only a physician can accurately diagnose HSV-II infection. It is important to see a physician when the first symptoms appear so that an accurate diagnosis can be made.

Treatment options Genital herpes cannot be cured, but medication can help the pain and itching that may accompany the blisters. A physician can also suggest things to do to reduce discomfort, such as applying ice packs, wearing loose clothing, and keeping the genitals dry.
Antiviral medications, such as acyclovir, may be prescribed. Such a medication can reduce the frequency of occurrence of symptoms and reduce the intensity when symptoms do recur.

Stages and progress Infection occurs when a person who is not infected has sex with a person who is infected with HSV-II. The virus is transmitted when there is contact with the mucous membranes of the penis, vagina, mouth, or anus.
A few days to a few weeks after infection, blisters filled with water form at the site of infection. Blisters may also form on the groin and buttocks. The area may itch and be painful. Pus fills the blisters and they break open, forming raw, red sores. The sores heal in several weeks. The newly infected person may also have headaches, swollen glands near the point of infection, fever, vaginal discharge, general fatigue, and muscle soreness. When an episode of infection runs its course, the virus retreats to nerve cells near the base of the spine and becomes dormant.
The first episode of HSV-II is usually the worst. During this initial infection the immune system produces antibodies that help fight future outbreaks. Some individuals have only a single episode during which blisters appear. But most people infected with HSV-II have repeated outbreaks, sometimes as many as 6 to 12 a year. Usually the outbreaks become less frequent and less severe over time. It is during these outbreaks that the infected person is most likely to transmit HSV-II to a sexual partner. Between outbreaks an infected person is less likely to pass on the infection.
The cause of the outbreaks is uncertain, but stress, fever, sunburn, menstruation, and some medications may act as a trigger. Many people with herpes can recognize physical signals heralding an outbreak. This helps them prepare for the occurrence.
During an outbreak personal hygiene is very important. HSV-II is so infectious that touching an open  herpes sore, then touching another part of the body, can spread the virus. It is important to avoid scratching the blisters. Scratching can spread the infection as well and leave the blistered area open to other infections. Personal items, such as towels, washcloths, and clothing, should not be shared during this period.

Prevention and risk factors The best approach to HSV-II is avoidance. Do not have sex with anyone who has sores on his or her genitals. This is fairly easy to observe with men, but with women the sores may be deep in the vagina and not visible. Using a condom can help, but this is not foolproof since the herpes blisters may occur beyond the areas protected by a condom.
Trust and good communication between partners allows open discussion about sexual matters. If one partner has herpes, good communication helps the couple come to an agreement to abstain from sex during herpes outbreaks. Abstinence during outbreaks is important even if both partners are infected.