Herpes Simplex

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• Herpes Simplex and genital herpes.
  Genital herpes is an infection caused by the herpes simplex virus or HSV.
  There are two types of herpes simplex virus , and both can cause genital herpes.
• Herpes simplex virus type 1 most commonly infects the lips, causing sores known as fever blisters or cold sores, but it also can infect the genital area and produce sores.
• Herpes simplex virus type 2 is the usual cause of genital herpes, but it also can infect the mouth. A person who has genital herpes infection can easily pass or transmit the virus to an uninfected person during sex.
• Both herpes simplex virus 1 and 2 can produce sores (also called lesions) in and around the vaginal area, on the penis, around the anal opening, and on the buttocks or thighs. Occasionally, sores also appear on other parts of the body where the virus has entered through broken skin.

Herpes simplex virus remains in certain nerve cells of the body for life, and can produce symptoms off and on in some infected people.

• According to the U.S. Centers for Disease Control and Prevention, 45 million people in the United States ages 12 and older, or 1 out of 5 of the total adolescent and adult population, are infected with HSV-2.
• Nationwide, since the late 1970s, the number of people with genital herpes infection has increased 30 percent. The largest increase is occurring in young teens. Herpes simplex virus -2 infection is more common in three of the youngest age groups which include people aged 12 to 39 years.

Most people get genital herpes by having sex with someone who is having a herpes "outbreak." This outbreak means that herpes simplex virus is active. When active, the virus usually causes visible lesions in the genital area. The lesions shed (cast off) viruses that can infect another person. Sometimes, however, a person can have an outbreak and have no visible sores at all. People often get genital herpes by having sexual contact with others who don't know they are infected or who are having outbreaks of herpes without any sores.
A person with genital herpes also can infect a sexual partner during oral sex. The virus is spread only rarely, if at all, by touching objects such as a toilet seat or hot tub.

• What are the symptoms?
  Unfortunately, most people who have genital herpes don't know it because they never have any symptoms, or they do not recognize any symptoms they might have.
• When there are symptoms, they can be different in each person. Most often, when a person becomes infected with herpes for the first time, the symptoms will appear within 2 to 10 days. These first episodes of symptoms usually last 2 to 3 weeks.
  Early symptoms of a genital herpes outbreak include
• Itching or burning feeling in the genital or anal area
  Pain in the legs, buttocks, or genital area
  Discharge of fluid from the vagina
  Feeling of pressure in the abdomen
• Within a few days, sores appear near where the virus has entered the body, such as on the mouth, penis, or vagina. They also can occur inside the vagina and on the cervix in women, or in the urinary passage of women and men. Small red bumps appear first, develop into blisters, and then become painful open sores. Over several days, the sores become crusty and then heal without leaving a scar.

Other symptoms that may go with the first episode of genital herpes are fever, headache, muscle aches, painful or difficult urination, vaginal discharge, and swollen glands in the groin area.

Can outbreaks recur?
If you have been infected by herpes simplex virus 1 and/or 2, you will probably have symptoms or outbreaks from time to time. After the virus has finished being active, it then travels to the nerves at the end of the spine where it stays for a while. Even after the lesions are gone, the virus stays inside the nerve cells in a still and hidden state, which means that it's inactive.
In most people, the virus can become active several times a year. This is called a recurrence. But scientists do not yet know why this happens. When it becomes active again, it travels along the nerves to the skin, where it makes more viruses near the site of the very first infection. That is where new sores usually will appear.

• After the first outbreak, any future outbreaks are usually mild and last only about a week.
• An infected person may know that an outbreak is about to happen by a tingling feeling or itching in the genital area, or pain in the buttocks or down the leg.
• For some people, these early symptoms can be the most painful and annoying part of an episode. Sometimes, only the tingling and itching are present and no visible sores develop.
• At other times, blisters appear that may be very small and barely noticeable, or they may break into open sores that crust over and then disappear.

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