Is Genital Herpes Serious?
HSV-2 usually produces mild symptoms, and most people with HSV-2 infection have no recognized symptoms. However, HSV-2 can cause recurrent painful genital ulcers in many adults, and HSV-2 infection can be severe in people with suppressed immune systems. Regardless of severity of symptoms, genital herpes frequently causes psychological distress among people who know they are infected.
In addition, HSV-2 can cause potentially fatal infections in infants if the mother is shedding virus at the time of delivery. It is important that women avoid contracting herpes during pregnancy, because a first episode during pregnancy creates a greater risk of transmission to the newborn. If a woman has active genital herpes at delivery, a cesarean-section delivery is usually performed. Fortunately, infection of an infant is rare among women with HSV-2 infection.
In the United States, HSV-2 may play a major role in the heterosexual spread of HIV, the virus that causes AIDS. Herpes can make people more susceptible to HIV infection, and can make HIV-infected individuals more infectious.
What Happens When Someone Is Infected with Genital Herpes?
Most people infected with HSV-2 are not aware of their infection. However, if symptoms occur during the primary episode, they can be quite pronounced. The primary episode usually occurs within two weeks after the virus is transmitted, and lesions typically heal within two to four weeks. Other symptoms during the primary episode may include a second crop of lesions, or flu-like symptoms, including fever and swollen glands. However, some individuals with HSV-2 infection may never have lesions, or may have very mild symptoms that they don't even notice or that they mistake for insect bites or a rash.
Most people diagnosed with a primary episode of genital herpes can expect to have several symptomatic recurrences a year (average four or five); these recurrences usually are most noticeable within the first year following the first episode.
How Is Genital Herpes Diagnosed?
The signs and symptoms associated with HSV-2 can vary greatly among individuals. Health care providers can diagnose genital herpes by visual inspection, by taking a sample from the sore(s) and by testing it to see if the herpes virus is present.