How Do You Get Herpes
The skin on your genitals, mouth, and eyes can be infected easily. Other areas of skin may get infected if theres a way for the herpes virus to get in, like through a cut, burn, rash, or other sores. You dont have to have sex to get herpes. Sometimes herpes can be passed in non-sexual ways, like if a parent with a cold sore gives you a peck on the lips. Most people with oral herpes got it when they were kids. A mother can pass genital herpes to a baby during vaginal childbirth, but thats pretty rare.
You can spread herpes to other parts of your body if you touch a herpes sore and then touch your mouth, genitals, or eyes without washing your hands first. You can also pass herpes to someone else this way.
Herpes is most contagious when sores are open and wet, because fluid from herpes blisters easily spreads the virus. But herpes can also shed and get passed to others when there are no sores and your skin looks totally normal.
Most people get herpes from someone who doesnt have any sores. It may live in your body for years without causing any symptoms, so its really hard to know for sure when and how you got it. Thats why so many people have herpes its a pretty sneaky infection.
Because the virus dies quickly outside the body, you cant get herpes from hugging, holding hands, coughing, sneezing, or sitting on toilet seats.
How Is Genital Herpes Spread
- Saliva from a partner with an oral herpes infection
- Genital fluids from a partner with a genital herpes infection
- Skin in the oral area of a partner with oral herpes or
- Skin in the genital area of a partner with genital herpes.
You also can get genital herpes from a sex partner who does not have a visible sore or is unaware of their infection. It is also possible to get genital herpes if you receive oral sex from a partner with oral herpes.
You will not get herpes from toilet seats, bedding, or swimming pools. You also will not get it from touching objects, such as silverware, soap, or towels.
If you have more questions about herpes, consider discussing your concerns with a healthcare provider.
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.
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Suppressive Therapy For Recurrences
To suppress outbreaks, treatment requires taking pills daily on a long-term basis. Acyclovir and famciclovir are taken twice a day for suppression. Valacyclovir is taken once a day. The doses for these antiviral drugs are reduced in people with impaired renal function.
Suppressive treatment can reduce the frequency of outbreak recurrences by 70% to 80%. It is generally recommended for people who have frequent recurrences . Because herpes recurrences often diminish over time, you should discuss annually with your provider whether you should stay with drug therapy or discontinue it.
There is some evidence that valacyclovir may help prevent herpes transmission, particularly in situations where one heterosexual partner has HSV-2 and the other partner does not. However, this drug does not completely prevent transmission. While taking any suppressive therapy for genital herpes, it is still important to regularly use latex condoms and to avoid any sexual activity during recurrences.
Ruling Out Conditions That Resemble Oral Herpes
Canker Sores
Simple canker sores are often confused with the cold sores of HSV-1. Canker sores frequently crop up singly or in groups on the inside of the mouth, or on or underneath the tongue. Their cause is unknown, and they are common in perfectly healthy people. They are usually white or grayish crater-like ulcers with a sharp edge and a red rim. They usually heal within 2 weeks without treatment.
This aphthous ulcer is located in front of and just below the bottom teeth.
Thrush
Oral candidiasis is a yeast infection that causes a whitish overgrowth in the mouth. It is most common in infants, but can appear in people of all ages, particularly people taking antibiotics or those with impaired immune systems.
Other conditions that may be confused with oral herpes include herpangina , sore throat caused by strep or other bacteria, and infectious mononucleosis.
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How Common Is Infection With Hsv
Infection with either HSV-1 or HSV-2 is remarkably common. In fact, the majority of people in the world are infected with one of the two herpes viruses.
According to the U.S. Centers for Disease Control and Prevention , more than 1 in 6 people living in the United States has genital herpes.
However, U.S. rates of infection with HSV-1 and HSV-2 declined between 1999 and 2016, according to the CDC. In 2016, among people between ages 14 and 49, the prevalence of HSV-2 was 12 percent, compared with 18 percent in 1999. This means that about 1 in 8 people in this age range had HSV-2.
HSV-1 prevalence also declined during those years, from 59 percent in 1999 to 48 percent in 2016.
Taking a global look at the numbers, in 2016, 67 percent of the people in the world who were younger than 50 had an infection caused by herpes simplex virus type 1 , says the World Health Organization . That adds up to more than 3.7 billion people.
What Is Genital Herpes
Genital herpes is a sexually transmitted disease caused by the herpes simplex viruses type 1 or type 2 .
Genital herpes infection is common in the United States. Nationwide, 16.2 percent, or about one out of six, people aged 14 to 49 years have genital HSV-2 infection. Over the past decade, the percentage of persons with genital herpes infection in the United States has remained stable.
There are two types of HSV and both can cause the symptoms of genital herpes. HSV type 1 most commonly causes sores on the lips , but it can cause genital infections as well. HSV type 2 most often causes genital sores, but it also can infect the mouth. The virus remains in certain nerve cells of the body for life, causing periodic symptoms in some people. Many people who are infected with HSV never develop any symptoms.
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How Long Do Sores From Herpes Simplex Last
If youre infected with HSV-1, commonly known as oral herpes, you may notice tingling or burning around your mouth in the days before a cold sore appears. These blisters break open and ooze fluid before forming a crust. Usually, sores last for seven to 10 days.
If youre infected with HSV-2, commonly known as genital herpes, your first outbreak may last between two to four weeks. Recurrent outbreaks usually last between three to seven days.
What Else Should I Know
Genital herpes is a lifelong condition, but there are ways to manage it. If you have genital herpes:
- Take medicines to stop outbreaks or make them less frequent and less severe.
- Help reduce the risk of spreading genital herpes to others by taking medicines, always using a condom during sex, and avoiding sex during outbreaks.
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How Genital Herpes Is Spread
You can get genital herpes if you come into contact with:
- Saliva from a partner with oral herpes
- Genital fluids from a partner with genital herpes
- Skin around the mouth or genitals of someone with a herpes infection
You can even get herpes from skin-to-skin contact with someone who has no symptoms and who may not even know they have herpes.
Support And Advice For Genital Herpes
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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Myth #: People Cannot Spread Herpes To Others Unless They Have Sores Or Blisters
Fact: People can spread herpes to others at any time, including when they do not have any symptoms.
People with herpes may experience outbreaks and remissions. During an outbreak, a person has active sores or blisters, but in remission, they may have no symptoms at all.
The virus is usually more contagious when a person has an outbreak, but it can also spread when it is in remission.
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Can I Breastfeed If I Have Genital Herpes
Yes, you can breastfeed if you have genital herpes, but not if you have a herpes sore on one of your breasts. If you have genital herpes, it is possible to spread the infection to any part of your breast, including your nipple and areola.
If you have any genital herpes sores on one or both of your breasts:
- You can keep breastfeeding as long as your baby or pumping equipment does not touch a herpes sore.
- Do not breastfeed from the breast with sores. Herpes is spread through contact with sores and can be dangerous to a newborn baby.
- Pump or hand-express your milk from the breast with sores until the sores heal. Pumping will help keep up your milk supply and prevent your breast from getting overly full and painful. You can store your milk to give to your baby in a bottle for another feeding. But if parts of your pump also touch the sore while pumping, throw the milk away.
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How Do I Know If I Have Herpes
If a person has an active herpes outbreak with visible sores, a physician or specialist such as a dermatologist can make a diagnosis based on a physical examination. If the physical symptoms alone are not enough, a doctor may take a swab of the sore and send it to a lab for analysis.
If a person does not have physical sores but is concerned, blood tests are available.
People can also take at-home herpes tests, though they should seek a consultation with a doctor to confirm a diagnosis and seek treatment.
What Percentage Of The Population Has Herpes
What percentage of the population has herpes? More than 3.7 billion people under the age of 50 about 67 percent of the global population are infected with herpes simplex virus type 1 , according to a new report from the World Health Organization.
- HSV-2 infection is more common in women than in men (almost 1 out of 9.
- HSV-2 infection is also more common in blacks than in whites
- Genital herpes is common in the United States. More than one out of every six people aged 14 to 49 years have genital herpes.
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First And Subsequent Episodes
The first genital herpes outbreak will generally be worse than the ones that follow. During a first outbreak, the appearance of lesions will often be accompanied by:
- Pain or burning with urination
- Unusual vaginal discharge
Subsequent attacks tend to be shorter and less severe. They are often preceded by genital pain or shooting pain in the legs, hip, or buttocks several hours or days before the attack.
Over time, the number of outbreaks tends to decrease and become less severe.
Is It Safe To Breastfeed If I Have Genital Herpes
Yes as long as there isnt an open lesion on your chest or breast. If you have an active outbreak while breastfeeding, its possible to spread the infection to your nipples through touch. Careful hand-washing can prevent this spread. You shouldnt nurse from a breast that has herpes sores. You can pump breast milk until the sores heal. Dont give your baby expressed breast milk if the pump comes into contact with an open sore.
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A Pregnant Woman Can Give Herpes To Their Unborn Baby
The estimated number of pregnant women infected with HSV-2 is 880,000. Most transmission to newborns occurs during vaginal delivery. If a woman had genital herpes before getting pregnant, their baby may be infected but the chance is very low — less than 1%. However, the risk of infecting the baby is much higher when a woman is newly infected late in pregnancy.
If you are pregnant and think you may be infected, tell your doctor right away. Women with genital herpes are examined carefully for any symptoms before giving birth. If sores or signs that an outbreak is coming are present at the time of delivery, the baby may be delivered by cesarean section .
Can Genital Herpes Come Back
Yes. Genital herpes symptoms can come and go, but the virus stays inside your body even after all signs of the infection have gone away. The virus becomes active from time to time, leading to an outbreak. Some people have outbreaks only once or twice. Other people may have four or five outbreaks within a year. Over time, the outbreaks usually happen less often and are less severe.
Experts do not know what causes the virus to become active. Some women say the virus comes back when they are sick, under stress, out in the sun, or during their period.
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Management Of Sex Partners
The sex partners of persons who have symptomatic genital herpes can benefit from evaluation and counseling. Symptomatic sex partners should be evaluated and treated in the same manner as patients who have symptomatic genital herpes. Asymptomatic sex partners of patients who have symptomatic genital herpes should be asked about a history of genital symptoms and offered type-specific serologic testing for HSV-2. For partners without genital herpes, no data are available on which to base a recommendation for PEP or PrEP with antiviral medications or that they would prevent acquisition, and this should not be offered to patients as a prevention strategy.
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.
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What Are The Symptoms Of Herpes Simplex
Many people with the infection never experience any herpes symptoms. If you do notice symptoms, youll experience them differently depending on whether youre having your first herpes outbreak or a repeat outbreak. Recurring symptoms are usually milder than the first outbreak. Symptoms dont last as long with later outbreaks. Some people may only have one or two outbreaks during their lifetime. Others may have as many as four or five outbreaks a year.
People who do have herpes symptoms may experience:
- Cold sores around their lips, mouth or tongue. They may look crusty or like fluid-filled blisters.
- Tingling, itching or burning.
- Pain while urinating.
What Are Genital Herpes Infections Like
The first herpes infection is usually the worst one. Genital herpes infections come back over and over again. The first time, you may have one sore or many sores. The sores are painful. Some may be hidden inside the urethra. The urethra is the tube that carries urine from your bladder. The sores make urination painful. Some people also have a fever, a sore throat, deep tiredness and body aches. These problems might last three weeks.
After the first infection, HSV sores can come back any time. They often come back when you are sick with something else and when your immune system isnt strong enough. Genital herpes might come back 4 to 6 times a year at first. After a few years, the herpes sores hurt less. They come back less often.
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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.