Herpes Type 1 Genital Transmission

Risk For Genital Herpes

According to the US Centers for Disease Control and Prevention , about 1 in 6 Americans ages 14 to 49 years have genital herpes. While HSV-2 remains the main cause of genital herpes, HSV-1 has significantly increased as a cause, most likely because of oral-genital sex. Except for people in monogamous relationships with uninfected partners, everyone who is sexually active is at risk for genital herpes.

Risk factors for genital herpes include:

• History of an STD
• First sexual intercourse at an early age
• High number of sexual partners
• Low socioeconomic status

Women are more susceptible to HSV-2 infection because herpes is more easily transmitted from men to women than from women to men. About 1 in 5 women, compared to 1 in 9 men, have genital herpes. African-American women are at particularly high risk.

People with compromised immune systems, such as those who have HIV, are at very high risk for genital herpes. These people are also at risk for more severe complications from herpes. Drugs that suppress the immune system, and organ transplantation, can also weaken the immune system and increase the risk for contracting genital herpes.

Why You Should Go To A Sexual Health Clinic

You can see a GP, but they’ll probably refer you to a sexual health clinic if they think you might have genital herpes.

Sexual health clinics treat problems with the genitals and urine system.

Many sexual health clinics offer a walk-in service, where you do not need an appointment.

They’ll often get test results quicker than GP practices and you do not have to pay a prescription fee for treatment.

Black And Hispanic Communities And Genital Herpes

Black Americans and Hispanic Americans have higher rates of STDs generally when compared with white Americans. This isnt because of ethnicity or race instead, social conditions such as poverty, lack of access to healthcare, and fear of discrimination from doctors and other healthcare providers all play part in the disparity.

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Genital Herpes Treatment In Pregnancy

You may be offered antiviral treatment:

• to treat outbreaks in pregnancy
• from 36 weeks to reduce the chance of an outbreak during birth
• from diagnosis until the birth if you first get herpes after 28 weeks of pregnancy

Many women with genital herpes have a vaginal delivery. You may be offered a caesarean, depending on your circumstances.

Can I Catch Herpes Simplex Off Towels Cups Or Anything

No, you will not catch it off anything. The virus is caught from the skin, not from objects. It is a delicate virus and dies quickly when away from the skin where the sore is. There is more about transmission in our Transmission leaflet available to members. This statement is taken from the guidelines for doctors produced by the British Association for Sexual Health and HIV.

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How Will My Healthcare Provider Know If I Have Genital Herpes

Your healthcare provider may diagnose genital herpes by simply looking at any sores that are present. Providers can also take a sample from the sore and test it. If sores are not present, a blood test may be used to look for HSV antibodies.

Have an honest and open talk with your healthcare provider about herpes testing and other STDs.

Please note: A herpes blood test can help determine if you have herpes infection. It cannot tell you who gave you the infection or when you got the infection.

Is There A Cure Or Treatment For Herpes

There is no cure for herpes. Antiviral medications can, however, prevent or shorten outbreaks during the period of time the person takes the medication.11 In addition, daily suppressive therapy for herpes can reduce the likelihood of transmission to partners.11

There is currently no commercially available vaccine that is protective against genital herpes infection. Candidate vaccines are in clinical trials.

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Transmission Of Herpes Simplex Virus Type

Doctors can detect HSV-1 physically because its appearance is prominent. Moreover, medicals experts dont generally recommend the PCR test to diagnose it. However, if the doctor is uncertain, then specific lab PCR tests or culture tests can diagnose the virus. HSV culture tests require a sample from the patient. After certain growth and testing, specific cells can differentiate between HSV-1 and HSV-2. However, sensitivity is low in culture tests, and a more appropriate approach is sensitive PCR testing as it gives more accurate results.

The Herpes Simplex Virus is transmitted by oral contact with the virus in sores, saliva or surfaces around the mouth. The examples of oral contact can be through sharing of drinks, kissing and many other common practices. HSV-1 can also be transmitted to the genital area through oral contact with genitals, leading to genital herpes. Pregnant women with genital herpes should consult their doctor since there is a possible risk of transmitting the infection to the infant.

How Do You Get Genital Herpes

Genital herpes is a sexually transmitted infection that causes blisters or sores on the skin on or around the genitals. Genital herpes is caused by the herpes simplex virus type 1 and type 2. Once you have been infected with herpes simplex virus, it stays in your body forever.

You cant catch genital herpes by sharing cups, towels or from toilet seats. You can still share a bed, kiss or cuddle your partner and not risk infecting them with herpes.

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What Is Neonatal Herpes

Neonatal herpes can be a very serious infection. Babies generally contract the virus from their birthing parent during childbirth even if the parent doesnt have active lesions. They may also get HSV-1 if an adult with an active cold sore kisses them. Breastfeeding babies can also get HSV-1 from the breast if there are lesions present. But babies cant get herpes from breast milk, so its safe to pump and feed.

Herpes simplex can be more dangerous for young babies because they dont have a fully developed immune system. But most babies with neonatal herpes can recover fully with treatment.

The dangers of neonatal herpes are much higher if the infection spreads to the babys organs. If youre pregnant and have herpes, speak with your healthcare provider about how to lower the risk of passing the infection to your baby.

How Can I Best Learn To Cope With Herpes Simplex

Some people feel distressed or embarrassed about their herpes simplex infection. Its important to understand that the herpes virus is common. For most people, herpes doesnt significantly interfere with daily life.

To cope with negative feelings, you may consider:

• Connecting with others through support groups or online forums.
• Sharing your feelings with a trusted friend or loved one.
• Speaking with a therapist.

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How Is Genital Herpes Diagnosed

HSV nucleic acid amplification tests are the most sensitive and highly specific tests available for diagnosing herpes. However, in some settings viral culture is the only test available. The sensitivity of viral culture can be low, especially among people who have recurrent or healing lesions. Because viral shedding is intermittent, it is possible for someone to have a genital herpes infection even though it was not detected by NAAT or culture. 11

Type-specific virologic tests can be used for diagnosing genital herpes when a person has recurrent symptoms or lesion without a confirmatory NAAT, culture result, or has a partner with genital herpes. Both virologic tests and type-specific serologic tests should be available in clinical settings serving patients with, or at risk for, sexually transmitted infections. 11

Given performance limitations with commercially available type-specific serologic tests , a confirmatory test with a second method should be performed before test interpretation. If confirmatory tests are unavailable, patients should be counseled about the limitations of available testing before serologic testing. Healthcare providers should also be aware that false-positive results occur. In instances of suspected recent acquisition, serologic testing within 12 weeks after acquisition may be associated with false negative test results. 11

Providers are strongly encouraged to look at CDCs STI Treatment Guidelines for further diagnostic considerations.

Can I Pass It On

A major concern for patients with genital herpes is fear of transmission to sexual partners. In general, transmission of HSV infections occurs by close contact with an individual who is shedding virus at a mucocutaneous surface and/or in oral or genital secretions. Infection occurs by inoculation of susceptible mucosal surfaces or through breaches in skin that are invisible to the naked eye. Since HSV is readily inactivated at room temperature and by drying, transmission by means other than direct contact is rare.

Research into transmission of genital herpes has focussed virtually exclusively on HSV-2 infection in heterosexual people. Limited indirect evidence on shedding patterns suggests that the advice we should be giving to patients about risk of transmission following a diagnosis of genital HSV-1 may differ substantially. Similarly, some information is available on HSV shedding frequency and patterns in a small study of 30 HIV negative gay men, but not on absolute transmission rates within gay partnerships.

Table 3

Summary of recent large prospective studies of herpes simplex virus transmission

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Fact #: Most People Who Have The Virus Dont Know It

Most people with herpes do not know they have it. This is regardless whether the HSV-1 virus infected the mouth or the genitals. The reason for this is the herpes-1 virus is quite sneaky. For one, it can be transmitted even when the virus is inactive and no sores are present. Furthermore, the virus can wake up and cause no symptoms. Therefore, a person is still at risk of catching or transmitting the infection from kissing, oral sex, or skin-to-skin contact.

If Both Partners Have Herpes Can They Re

When you and your partner have the same herpes simplex virus you will not reinfect each other even on a different part of the body, you will not catch it back yourself on a different part of your body.

If you have caught a genital infection from a partners genitals, they will not catch the virus back on their face.

If you have caught a genital infection from a partners facial cold sores, they will not catch the virus back on their genitals.

And also:

If you have caught it on your face from your partners genitals, then they will not catch it on their face if they do oral sex on you.

If you have caught it on your face from your partners facial cold sores, then they will not catch it on their genitals if you do oral sex on them.

Read more about protecting a partner from genital herpes in the transmission leaflet, free to members. The information is posted or sent by email.

A two-page summary is available.

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Suppressive Therapy For Recurrent Hsv

Suppressive therapy reduces frequency of genital herpes recurrences by 70%80% among patients who have frequent recurrences . Persons receiving such therapy often report having experienced no symptomatic outbreaks. Suppressive therapy also is effective for patients with less frequent recurrences. Long-term safety and efficacy have been documented among patients receiving daily acyclovir, valacyclovir, and famciclovir . Quality of life is improved for many patients with frequent recurrences who receive suppressive therapy rather than episodic treatment . Providers should discuss with patients on an annual basis whether they want to continue suppressive therapy because frequency of genital HSV-2 recurrence diminishes over time for many persons. However, neither treatment discontinuation nor laboratory monitoring is necessary because adverse events and development of HSV antiviral resistance related to long-term antiviral use are uncommon.

Valacyclovir 500 mg orally 2 times/day for 3 daysOR

Valacyclovir 1 gm orally once daily for 5 days

*Acyclovir 400 mg orally 3 times/day is also effective, but are not recommended because of frequency of dosing.

How Can I Prevent Genital Herpes

If you are sexually active, you can do the following things to lower your chances of getting genital herpes:

• Being in a long-term mutually monogamous relationship with a partner who does not have herpes.
• Using condoms the right way every time you have sex.

Be aware that not all herpes sores occur in areas that a condom can cover. Also, the skin can release the virus from areas that do not have a visible herpes sore. For these reasons, condoms may not fully protect you from getting herpes.

If your sex partner has/have genital herpes, you can lower your risk of getting it if:

• Your partner takes an anti-herpes medicine every day. This is something your partner should discuss with his or her healthcare provider.

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Symptoms Of Genital Herpes

Most people with genital herpes have no symptoms, although they can still spread the virus.

Symptomatic genital herpes typically looks like small blisters or vesicles on the genitals or rectum. These may appear in clusters and can burst open to form weeping , scabby, and painful ulcers.

Genital herpes is a lifelong condition with periods of remission between outbreaks. The first outbreak is usually the worst, with other symptoms, like fever and body aches. After that, further outbreaks tend to have less extreme symptoms and last a shorter time.

How Can You Reduce The Transmission Of Herpes

• Using condoms or dental dams can reduce transmission. Condoms provides around 50% protection. They do not completely stop the risk of infection because the herpes can be in areas not covered by the condom.
• Using suppressive treatment reduces the risk of transmission by at least 50%.
• Using a good silicone lubricant for sex may also reduce the risk of transmission by avoiding skin trauma and micro abrasions.
• If you have a cold sore, you should not perform oral sex on a partner from the time the very first symptom appears until a week after the last symptoms of the cold sore have gone.

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Can I Pass Herpes On To My Baby During Pregnancy

During pregnancy, it is possible for the herpes virus to be passed on to the baby. However, the vast majority of women with genital herpes have normal pregnancies and deliver healthy babies.

The virus can be transmitted via:

• the placenta, when the baby is still in the womb
• during delivery or
• after the birth .

Fortunately, women who have genital herpes before falling pregnant and those infected early in pregnancy have a low risk of passing the virus on to their babies, because their body has built up antibodies to the virus. These antibodies cross the placenta to protect the baby.

What Are The Symptoms Of Herpes

Symptoms depend on the type of herpes virus you have and which part of the body it affects. Many people with HSV-1 or HSV-2 dont experience any symptoms during an outbreak. This is called asymptomatic infection. With an asymptomatic infection, you are more likely to unknowingly spread the virus to others. When HSV-1 and HSV-2 do cause symptoms, the types of illness caused by both viruses often look and feel the same. The main difference is that if you are infected with HSV-2 in the genital area, you are more likely to have a relapse, or have outbreaks, than you would be if you were infected with HSV-1.

Symptoms of oral herpes can include:

• Pain, burning, tingling, or itching on the lips or mouth.
• Cold sores on the lips or around or inside the mouth, which may initially look like shallow ulcers and then crust over. Without treatment, these sores last several days to a few weeks before clearing up on their own.

Symptoms of genital herpes can include:

• Pain, burning, tingling, or itching on or around the genitals, buttocks, or inner thighs.
• Burning sensation while urinating if the sores are near the urethra .

Studies suggest that having genital herpes may also increase your risk of contracting HIV, the virus that causes AIDS. This is because herpes causes open sores on the genitals, which make it easier for the HIV virus to enter the body.

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How Can I Reduce My Risk Of Herpes Simplex

Preventing HSV-1

You can reduce your risk of contracting HSV-1 by avoiding physical contact with someone who has a cold sore. People can still spread HSV-1 when cold sores arent present, but its less likely.

If someone has an active HSV-1 infection, avoid:

• Sharing utensils, cups, lip balms or other personal care products.
• Touching the skin near their mouth.

Preventing HSV-2

If youre sexually active, you can take these steps to protect yourself and others from the herpes virus and other STIs:

• Be monogamous with one sexual partner or limit your number of partners.
• Get tested for STIs and complete any prescribed treatment.
• Tell your sexual partners if you have genital herpes so they can get tested.
• Use condoms during intercourse and dental dams during oral sex.

Wash your hands often if you have an outbreak or are around someone with symptoms.

If your sexual partner has genital herpes, these actions can lower your risk of getting the virus:

• Dont have sex when your partner has active symptoms. Condoms may not cover all sores, so you may still get the virus.
• Make sure your partner takes antiviral medication as prescribed.
• Wait to have sex until scabs fall off active lesions.

What Are The Complications Of Genital Herpes

Genital herpes may cause painful genital ulcers that can be severe and persistent in persons with suppressed immune systems, such as HIV-infected persons. 5 Both HSV-1 and HSV-2 can also cause rare but serious complications such as aseptic meningitis . 5 Development of extragenital lesions may occur during the course of infection. 5

There are also potential complications for a pregnant woman and her newborn child. See How does herpes infection affect a pregnant woman and her baby? below for information about this.

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