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What Are The Chances Of Spreading Herpes Without An Outbreak

What Is Genital Herpes Symptoms Causes Diagnosis Treatment And Prevention

How Contagious is Herpes?

Genital herpes is a common sexually transmitted disease in the United States. More than one in every six people between ages 14 and 49 living in the United States has genital herpes.

Most people infected with herpes dont even know it. They dont know because the infection often has no symptoms, very mild symptoms, or symptoms that mimic other health or skin problems. But the infection can cause small, painful sores to form on the genitals, thighs, or buttocks. If sores do arise, they typically go away within two to three weeks, but the virus stays in the body for life.

Lots and lots of people live normal, healthy lives with herpes, with some small degree of attention to protecting their partners during outbreaks, says I. Cori Baill, MD, an obstetrician-gynecologist and an associate professor at the University of Central Florida College of Medicine in Orlando, Florida.

Genital herpes can be treated, but it can’t be cured. Fortunately, there are many steps you can take to prevent giving it to other people.

Other Impacts Of Genital Herpes

Its important to also remember that there are mental and social impacts of having an incurable STI. Many people with recurrent genital herpes symptoms may feel stigmatized or fearful of pursuing sexual relationships. But people should remember, while genital herpes is not curable, it is manageable, and the outbreaks often decrease over time.

Most people live healthy happy lives with genital herpes .

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Duration Of Genital Herpes

The first episode of genital herpes usually begins with inflammation, followed by a small group of blisters that break and weep after a few days and eventually crust over and heal. The first outbreak is usually the worst and ends within about three weeks. The CDC recommends antiviral medication for everyone having a first outbreak of genital herpes.

After the initial outbreak, outbreaks tend to last for less time and have less severe symptoms. Research has indicated that the number of symptomatic outbreaks may decrease over time.

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Herpes Is A Common Infection

Herpes is a super-common infection that stays in your body for life. More than half of Americans have oral herpes, and about 1 out of 6 Americans has genital herpes. So chances are a few people you know are living with herpes.

Theres no cure for herpes, but medication can ease your symptoms and lower your chances of giving the virus to other people. And the good news is, outbreaks usually become less frequent over time, and even though herpes can sometimes be uncomfortable and painful, its not dangerous. People with herpes have relationships, have sex, and live perfectly healthy lives.

How Do People Get Genital Herpes

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Infections are transmitted through contact with HSV in herpes lesions, mucosal surfaces, genital secretions, or oral secretions. 5 HSV-1 and HSV-2 can be shed from normal-appearing oral or genital mucosa or skin. 7,8 Generally, a person can only get HSV-2 infection during genital contact with someone who has a genital HSV-2 infection. However, receiving oral sex from a person with an oral HSV-1 infection can result in getting a genital HSV-1 infection. 4 Transmission commonly occurs from contact with an infected partner who does not have visible lesions and who may not know that he or she is infected. 7 In persons with asymptomatic HSV-2 infections, genital HSV shedding occurs on 10.2% of days, compared to 20.1% of days among those with symptomatic infections. 8

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Can You Spread Herpes Without An Outbreak

Yes. It is possible for a person to spread herpes without an outbreak. As long as the person has a herpes infection, they can spread it even if an outbreak has never occurred.

Fortunately, many people who have a herpes infection never have an outbreak. If an outbreak does occur, visible symptoms such as sores and blisters will show up in the affected area. These symptoms may become visible about two and a half weeks after exposure.

When a person has an initial outbreak, they may experience symptoms such as painful urination and muscle and joint pain.

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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Transmission Of Genital Herpes

Genital herpes is a sexually transmitted disease spread by skin-to-skin contact. The risk of infection is highest during outbreak periods when there are visible sores and lesions. However, genital herpes can also be transmitted when there are no visible symptoms. Most new cases of genital herpes infection do not cause symptoms, and many people infected with HSV-2 are unaware that they have genital herpes.

To help prevent genital herpes transmission:

  • Use a condom for sexual intercourse.
  • Use a dental dam for oral sex.
  • Limit your number of sexual partners.
  • Be aware that nonoxynol-9, the chemical spermicide used in gel and foam contraceptive products and some lubricated condoms, does not protect against STDs.

Recurrence Course Triggers And Timing

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Course of Recurrence

Most cases of herpes simplex recur. The site on the body and the type of virus influence how often it comes back. Recurrences of genital herpes are more likely with HSV-2 infection than with HSV-1 infection.

The virus usually takes the following course:

  • Prodrome. The outbreak of infection is often preceded by a prodrome, an early group of symptoms that may include itchy skin, pain, or an abnormal tingling sensation at the site of infection. Headache, enlarged lymph glands, and flu-like symptoms may occur. The prodrome, which may last from 2 hours to 2 days, stops when the blisters develop. About 25% of the time, recurrence does not go beyond the prodrome stage.
  • Outbreak. Recurrent outbreaks feature most of the same symptoms at the same sites as the primary attack, but they tend to be milder and briefer. After blisters erupt, they typically heal in 6 to 10 days. Occasionally, the symptoms may not resemble those of the primary episode, but appear as fissures and scrapes in the skin or as general inflammation around the affected area.

Triggers of Recurrence

Herpes outbreaks can be triggered by different factors. They include sunlight, wind, fever, physical injury, surgery, menstruation, suppression of the immune system, and emotional stress. Oral herpes can be triggered within about 3 days of intense dental work, particularly root canal or tooth extraction.

Timing of Recurrences

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Percentage Of Hsv Risk

  • If they avoid sexual activity during outbreaks, dont use condoms regularly, and the person with the vulva doesnt take an antiviral therapy every day, the risk of transmission is about 5% per year.

Those percentages represent what studies consider an average sex life incorporating vaginal penetration over the course of one years duration, which, of course, is highly subjective.

Unfortunately, there is no available data yet on the rate of transmission between same-sex partners.

  • Armangue, Thaís, et al. Frequency, symptoms, risk factors, and outcomes of autoimmune encephalitis after herpes simplex encephalitis: a prospective observational study and retrospective analysis. The Lancet Neurology 17.9 : 760-772.
  • Groves, Mary Jo. Genital herpes: a review. Am Fam Physician 93.11 : 928-934.
  • Jonker, Iris, et al. The association between herpes virus infections and functional somatic symptoms in a general population of adolescents. The TRAILS study. PloS one 12.10 : e0185608.
  • Verhoeven, Dirk HJ, et al. Reactivation of human herpes virus-6 after pediatric stem cell transplantation: risk factors, onset, clinical symptoms and association with severity of acute graft-versus-host disease. The Pediatric infectious disease journal 34.10 : 1118-1127.
  • Croll, Benjamin J., et al. MRI diagnosis of herpes simplex encephalitis in an elderly man with nonspecific symptoms. Radiology case reports 12.1 : 159-160.

My Partner Doesnt Have Genital Herpes So How Can I Have Caught It

Your partner could be one of the two out of three people with herpes simplex who have it so mildly they do not realise. So they could have sex when the virus is active. Mild symptoms can appear as a pimple, a little cut or an itchy bit of skin and yet these are very infectious. When people with these mild symptoms learn to recognise them, then they can avoid sex at these times. Another possibility is that your partner does not have herpes simplex and you caught it from a previous partner. It is possible to have a first outbreak many years after first catchin it.

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What Are The Differential Diagnoses

Other medical conditions could be confused with genital herpes or cold sores. The conditions are severe, and it is wise to consult with a medical expert. Herpes could be distinguished from these conditions with a lab test or medical exam.

  • Medical reactions: Medication might lead to sensitive reactions and allergies that could appear as rashes. Although medication-induced rashes do not appear in the genital area, they are common around the patient’s mouth and lips.
  • Concurrent HSV-2 or HSV-1: If the patient has either type of herpes, they could also be infected with the other. The viruses are different, and having one does not prevent or cause the other.
  • Pre-cancer or Cancer: Lesions around and in your genital area could be symptoms of cancer. The appearance of precancerous or cancerous shouldn’t have blisters that come with HSV lesions. However, your doctor should be able to tell the difference.
  • Syphilis: Syphilis is an STD that manifests in genital sores that could be confused with herpes. Your OBGYN should be capable of telling the difference through visual lesions inspection.
  • Canker sores: Usually, canker sores are red, raw, painful, and whitish in the middle. They are due to oral trauma and can appear in the mouth. While the painful sensation of cold sores and canker sores is alike, a lesion looks different.

Recurrent Episodes Of Genital Herpes

What is the risk of spreading herpes? Herpes Transmission Rates ...

Recurrences are usually less painful and shorter in duration than the first episode of genital herpes. Over time, episodes usually become less frequent and may eventually stop altogether. Infections caused by HSV1 are less likely to recur in the genital area than infections caused by HSV2.

Recurrences may be triggered by:

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What Are The Chances Of Getting Herpes From An Infected Partner

While we think of HSV-2, the virus that most commonly causes gential herpes, as spreading through contact with herpes lesions, transmissions commonly occur when there are no visible lesions or from a partner who doesnt even know that they are infected. In fact, it is estimated that over 87% of people who are infected with HSV-2 never get diagnosed.

Studies have looked at herpes transmission rates between partners. In 2004, a large study published in the New England Journal of Medicine followed 1,484 heterosexual monogamous couples for 8 months where one partner had an HSV-2 infection and the other didnt. The susceptible partner was evaluated monthly for clinical signs and symptoms of genital herpes. Of the 741 couples who were only educated on using condoms for protection , 27 became infected with the virus, including 16 of whom developed an outbreak.

The Centers for Disease Control and Prevention estimates that every year, over 775,000 people get new genital herpes infections. It tends to be more common in women, possibly because it is more easily transmitted from men to women during sex.

Other than abstaining from sexual contact, there is no proven way to completely prevent getting infected by your partner. While condoms can help reduce the chance of transmission, they dont completely eliminate the risk. However, another option to further reduce the risk of spread is daily antiviral medication. More on this next.

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What Happens If I Dont Receive Treatment

Genital herpes can cause painful genital sores and can be severe in people with suppressed immune systems.

If you touch your sores or fluids from the sores, you may transfer herpes to another body part like your eyes. Do not touch the sores or fluids to avoid spreading herpes to another part of your body. If you do touch the sores or fluids, quickly wash your hands thoroughly to help avoid spreading the infection.

If you are pregnant, there can be problems for you and your unborn fetus, or newborn baby. See Im pregnant. How could genital herpes affect my baby? for information about this.

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Is One Type Of Herpes More Easily Spread Than Another

No, not really.

Both HSV1 and HSV2 can be easily transmitted via skin-to-skin contact. HSV1 tends to prefer locations above the waist, such as the mouth, and HSV2 tends to prefer locations below the waist, such as the genitals, but both can also be easily spread to other parts of the body.

Both types are most contagious during active outbreaks when visual symptoms are present but they are also commonly spread when there are no recognizable symptoms through asymptomatic shedding.

What Is The Difference Between Genital Herpes And Genital Warts

Sexual Health – Herpes

Both genital herpes and genital warts are STIs, are spread through skin-to-skin contact, and are caused by a virus. But the viruses that cause genital herpes and genital warts are different:

  • Herpes simplex virus is the virus that causes genital herpes.
  • Human papillomavirus is the virus that causes genital warts.

There is no cure for either genital herpes or genital warts. But, different medicines can help manage the symptoms of herpes and treat the complications of HPV infections that can cause genital warts.

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Research And Statistics: Who Has Genital Herpes

Its estimated that each year, 776,000 people in the United States get new genital herpes infections. Genital herpes is most often caused by herpes simplex virus type 2 .

According to data from the National Health and Nutrition Examination Survey , the prevalence of HSV-2 was 11.9 percent during 2015 and 2016, a decline of 5.9 percentage points from the years 1999 and 2000.

HSV-2 is more common in women than in men. Its suspected that women are more likely to contract the HSV-2 infection because genital infection is more easily transmitted from men to women than from women to men during penile-vaginal sex.

How Is Herpes Simplex Diagnosed

Healthcare providers may diagnose herpes simplex based on how the sores look. Your provider may take a sample from the sore. Laboratory analysis of the sample can confirm or rule out the herpes virus.

If you dont have sores, your healthcare provider can use a blood test to check for HSV-1 and HSV-2 antibody, a marker showing youve been exposed to the virus. The blood test doesnt show an active infection . But it informs your provider whether youve been exposed to the herpes virus in the past. If this is your first infection, you may not test positive for herpes if there hasnt been enough time for your body to develop antibodies. The HSV-1and HSV-2 antibody test may be repeated in eight to 12 weeks.

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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.

Support And Advice For Genital Herpes

What does herpes look like

If you have just found out you have genital herpes, you may feel shocked and may have a lot of questions. It may help you to gather as much information as you can about herpes. This can help you to make fully informed decisions about your treatment, safe sex and preventing further recurrences. Talking to a counsellor about your concerns may also help.

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Herpes Diagnosis In A Newborn Baby

Diagnosing herpes in children is complicated. Children aren’t screened for the infection. In other words, only symptoms should alert the parent that all is not okay. It should prompt a diagnosis that could be done with a swab sample. Nevertheless, a complicated herpes infection calls for specific tests like a lumbar puncture.

Symptomatic Versus Asymptomatic Herpes Transmission

This table summarizes the chance of transmission of herpes when a person is symptomatic and when he or she is asymptomatic .

The table presents information about the overall chance of getting a herpes infection over time, with multiple contacts. Please notice that infected people pass the infection regardless of whether they are symptomatic or asymptomatic.

The percentages mentioned bellow are general estimates and may vary from person to person based on immune system strength , skin condition , and race .

Disease manifestation
10.2%

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