General symptoms for a baby born with herpes (received through a vaginal delivery) may include ulcers on the face, body, and genitals. Babies who are born with genital herpes can develop very severe complications and experience:
23. American College of Obstetricians and Gynecologists (ACOG). ACOG Practice Bulletin. Clinical management guidelines for obstetrician-gynecologists. No. 82 June 2007. Management of herpes in pregnancy. Obstet Gynecol, 2007. 109(6): 1489–98.
The annual incidence in Canada of genital herpes due to HSV-1 and HSV-2 infection is not known (for a review of HSV-1/HSV-2 prevalence and incidence studies worldwide, see Smith and Robinson 2002). As many as one in seven Canadians aged 14 to 59 may be infected with herpes simplex type 2 virus and more than 90 per cent of them may be unaware of their status, a new study suggests. In the United States, it is estimated that about 1,640,000 HSV-2 seroconversions occur yearly (730,000 men and 910,000 women, or 8.4 per 1,000 persons).
In all cases, HSV is never removed from the body by the immune system. Following a primary infection, the virus enters the nerves at the site of primary infection, migrates to the cell body of the neuron, and becomes latent in the ganglion. As a result of primary infection, the body produces antibodies to the particular type of HSV involved, preventing a subsequent infection of that type at a different site. In HSV-1-infected individuals, seroconversion after an oral infection prevents additional HSV-1 infections such as whitlow, genital herpes, and herpes of the eye. Prior HSV-1 seroconversion seems to reduce the symptoms of a later HSV-2 infection, although HSV-2 can still be contracted.
In British Columbia in 1999, the seroprevalence of HSV-2 antibody in leftover serum submitted for antenatal testing revealed a prevalence of 17%, ranging from 7% in women 15–19 years old to 28% in those 40–44 years.
A pregnant woman can pass genital herpes on to her baby. A healthcare professional will advise you about what to do if you develop genital herpes whilst you are pregnant, or if you have recurrent genital herpes and become pregnant.10
Genital herpes is a sexually transmitted infection (STI) passed on through vaginal, anal and oral sex. Treatment from a sexual health clinic can help. Symptoms clear up on their own but can come back.
Pregnant women with symptoms of genital herpes should inform their health care providers. Preventing acquisition of a new genital herpes infection is particularly important for women in late pregnancy, as this is when the risk for neonatal herpes is greatest.
Detailed fact sheets are intended for physicians and individuals with specific questions about sexually transmitted diseases. Detailed fact sheets include specific testing and treatment recommendations as well as citations so the reader can research the topic more in depth.
The aims of treatment are to limit the severity and duration of pain, shorten the duration of a shingles episode, and reduce complications. Symptomatic treatment is often needed for the complication of postherpetic neuralgia. However, a study on untreated shingles shows that, once the rash has cleared, postherpetic neuralgia is very rare in people under 50 and wears off in time; in older people the pain wore off more slowly, but even in people over 70, 85% were pain free a year after their shingles outbreak.
Neonatal herpes simplex is a HSV infection in an infant. It is a rare but serious condition, usually caused by vertical transmission of HSV-1 or -2) from mother to newborn. During immunodeficiency, herpes simplex can cause unusual lesions in the skin. One of the most striking is the appearance of clean linear erosions in skin creases, with the appearance of a knife cut. Herpetic sycosis is a recurrent or initial herpes simplex infection affecting primarily the hair follicles.:369 Eczema herpeticum is an infection with herpesvirus in patients with chronic atopic dermatitis may result in spread of herpes simples throughout the eczematous areas.:373
The virus spreads more quickly when an infected person is experiencing an outbreak. Anywhere from 30 to 95 percent of adults are seropositive for HSV-1, though they may never experience an outbreak. It’s also possible to get genital herpes from HSV-1 if someone who performed oral sex had cold sores during that time.
Many people with HSV have recurring herpes. When a person is first infected, the recurrences tend to happen more frequently. Over time, however, the remission periods get longer, and occurrence tends to become less severe.
Symptoms, if they do occur, include small painful blisters that break open to form shallow painful sores or ulcers. The sores scab and heal after 1 to 2 weeks. The first attack may be very severe with multiple blisters.
Neonatal herpes can occur when an infant is exposed to HSV in the genital tract during delivery. This is a rare condition, occurring in an estimated 10 out of every 100,000 births globally, but can lead to lasting neurologic disability or death. The risk for neonatal herpes is greatest when a mother acquires HSV infection for the first time in late pregnancy. Women who have genital herpes before they become pregnant are at very low risk of transmitting HSV to their infants.
Most people don’t experience symptoms when first infected and they can take months or years to develop. If symptoms do occur when first infected, they usually develop in four to seven days. Symptoms are normally more severe the first time than in re-occurring infections.4
It should not be confused with conditions caused by other viruses in the herpesviridae family such as herpes zoster, which is caused by varicella zoster virus. The differential diagnosis includes hand, foot and mouth disease due to similar lesions on the skin.
Herpetic lesions are contagious, and those caring for the patient must avoid contact with the exudates. Wearing gloves when in contact with mucous membranes, followed by good hand hygiene helps health care professionals prevent herpetic whitlow (finger infections).
There is no time that is completely safe to have sex and not spread herpes. If you have herpes, you must tell your sex partner. You should avoid having sex if you have any sores. Herpes can spread from one person to another very easily when sores are present.
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.
Because of the limitations of a blood test to diagnose herpes, it is recommended you discuss the implications of the test with someone who has experience with requesting them and interpreting the results in light of your particular presentation.
The most serious of these other conditions are neonatal herpes and herpetic encephalitis, both of which are relatively rare but can be deadly. The causes of herpetic encephalitis are not fully understood, but having genital herpes doesn’t seem to make you more or less likely to develop it.
“Crabs” is the common term for lice that set up shop in pubic hair. The term comes from the shape of the tiny parasites, which look very different from head or body lice. The creatures crawl from one person to another during close contact. Pubic lice can be killed with over-the-counter lotions.
Genital HSV-2 infection, on the other hand, is associated with more frequent symptomatic recurrences needing antiviral treatment, viral shedding episodes and risk of transmission. Initial oral HSV-2 infections are uncommon and almost never recur in healthy people. Oral cold sores are virtually always caused by HSV-1 infection.
Most people infected with genital herpes are not aware of their infection until their first outbreak, characterised by small red bumps, blisters or open sores on or near the genitals. There can also be a vaginal discharge, fever, headaches, muscle aches, pain during urination, as well as itching, burning or swollen glands in the genital area.
Viral shedding does occur in association with outbreaks of genital herpes and therefore sexual contact should be avoided during these times. Between outbreaks viral shedding may still occur (asymptomatic viral shedding) so, as with any new relationship, it is wise to consider using condoms to reduce the chance of transmission to sexual partners.
No drug can get rid of the herpes virus. Doctors may prescribe an antiviral, such as acyclovir, which prevents the virus from multiplying. Antiviral medications will help the outbreak clear up faster and will also help reduce the severity of symptoms.
In otherwise healthy people, genital herpes outbreaks rarely require hospital visits. If an individual is experiencing an initial episode of genital herpes and cannot be seen by a regular doctor within the first few days of the illness, it is advisable go to a hospital’s emergency department to have medical treatment started.
The good news is that there is less stigma attached to all STIs in the gay community, that safer sex practices are widely accepted, and that there is a range of sexual health services specifically aimed at gay men and women. You can find contact details for some of those services on the websites listed at the back of this booklet.
Some people may acquire genital herpes without any knowledge of it – when their partner showed no symptoms at the time and they themselves did not have any initial symptoms. They may carry the infection silently or go on to have recurrences later.
The presence of a genital ulcer would provide an entry point for the HIV virus if an HIV-negative individual with an ulcer has unprotected sexual intercourse with an HIV-infected person. Treatment of the condition causing the genital ulcer would allow the ulcer to heal and therefore reduce the chances of HIV acquisition. This review assessed whether giving treatment for diseases that present with ulcers in the genital region would reduce sexual acquisition of HIV. Three studies were identified involving 173 HIV-negative patients with genital ulcers. These studies did not provide sufficient evidence that treatment of genital ulcer diseases reduces sexual acquisition of HIV infection. However, genital ulcer diseases are public health problems in their own right and patients with these conditions should be treated appropriately; whether the treatment reduces the risk of HIV infection or not.
You don’t have to have sex to get an STD. Skin-to-skin contact is enough to spread HPV, the virus family that causes genital warts. Some types cause warts and are usually harmless, but others may lead to cervical or anal cancer. Vaccines can protect against some of the most dangerous types.
During beginning stages of a herpes outbreak, you may experience a tingling, itching or burning sensation. As the episode progresses and blisters form the itching sensation tends to stop and the blisters tend to be painful rather than itchy.
Jump up ^ Whitley RJ (2005). “Changing dynamics of varicella-zoster virus infections in the 21st century: the impact of vaccination”. J. Infect. Dis. 191 (12): 1999–2001. doi:10.1086/430328. PMID 15897983.