The most commonly reported sexually transmitted diseases (STDs) in the United States include Gonorrhea, Herpes, Syphilis, Chlamydia, Trichomoniasis, and Human Papillomavirus (HPV). These infections are generally transmitted through blood or sexual contact with an infected person. These can create mild to severe symptoms and can also cause lifetime damages in some cases. However, early diagnosis and proper treatment can reduce the severity of the infections.
What is Herpes?
Herpes is one of the highly contagious sexually transmitted diseases (STDs) caused by the herpes simplex virus, which creates sores on the genitals and mouth. Most oral and genital herpes infections are asymptomatic. The infection is common and endemic across the world. It can create irritation and pain, but it does not usually lead to serious health issues. However, the infection can recur in certain cases without developing visible symptoms.
Types of Herpes
The two common herpes simplex viruses are:
- Herpes simplex virus type 1
- Herpes simplex virus type 2
Infection with herpes simplex virus can be caused by either herpes simplex virus type 1 (HSV-1) or herpes simplex virus type 2 (HSV-2). Herpes can also be classified as
Both oral and genital herpes don’t show noticeable symptoms or in most cases they are unrecognized but they can cause some common symptoms of painful blisters or ulcers in the area of infection.
HSV-1 is mainly spread by oral-to-oral contact, causing infection in or around the mouth, oral herpes. However, the infection can develop in or around the genitals through oral-genital contact, which is commonly called genital herpes.
HSV-2 is primarily transmitted through genital-to-genital contact with an infected person during sex, which causes blisters or sores in the genital or anal area.
What is oral herpes?
Oral herpes is a commonly spread viral infection that is caused by Herpes Simplex Virus Type 1 (HSV-1), which is mostly identified by symptoms like open sores, ulcers or blisters in or around the mouth, irritation, or burning sensation in the infected area. According to a recent study, 50-80% of US adults are infected with oral herpes.
The infection is generally spread by engaging in any intimate act with an infected person like kissing or indulging in oral sex. The infection can stay in the body of an infected person throughout his/her life without showing any evident symptom. The active form of the infection always causes an outbreak of sores and other symptoms in the affected region.
What is genital herpes?
Genital herpes is a highly contagious sexually transmitted infection that is caused by Herpes simplex virus type 1 (HSV-1) or type 2 (HSV-2). People aged 14 to 50 years are more prone to infection. Direct or indirect contact with the virus through sexual contact or sexual activity is the primary reason for the transmission.
The common symptoms of genital herpes include open sores, ulcers, or blisters in the genitals or in the anus. Itching, irritation, or burning sensation in the infected area and tiredness, body pain, or fever. The infection can stay dormant in the body throughout the life of an infected person and the symptoms may recur if untreated.
Herpes simplex virus type 1 (HSV-1)
HSV-1 is a highly transmissible viral infection, which is very common throughout the world. Most HSV-1 infections are seen in youngsters and teens and they can develop from childhood and may stay for a lifetime. Most cases of type 1 herpes are oral herpes, which is infections in or around the mouth, which are commonly called orolabial, oral-facial herpes, or oral-labial. But according to statistics, a proportion of the reported cases of HSV-1 also include genital herpes.
According to WHO reports, an estimated 3.7 billion people under the age of 50 had herpes simplex virus type 1 (oral or genital) in 2016. The highest number of cases were reported in Africa and the lowest in America.
Most genital HSV-1 infections were diagnosed in people aged 15-49 years. The estimated number of genital herpes simplex virus type 1 cases was 122 million to 192 million people in 2016, and the transmission occurred in most parts across the globe, however, America, Europe, and Western Pacific reported more cases, says WHO.
Causes of Herpes simplex virus type 1
HSV type 1 is more contagious at the time of an outbreak of symptomatic infection, specifically oral herpes. But the infection can also be transmitted when there are no evident or noticeable symptoms. The common causes for the transmission of HVS-1 are,
- Oral-to-oral contact
- Oral-genital contact without safety measures
- An infected mother to child during childbirth
The infection can be transmitted from oral to skin surfaces and it might develop zero symptoms in many cases in the initial stage, but is capable of causing high risks when there are active open sores. HSV-1 can also be transmitted from an infected mother to her child at the time of delivery, and the infection caused by this is commonly called neonatal herpes. The disease can spread through contact with the virus in mucous areas, lesions, genital or oral secretions.
Are you aware of the signs and symptoms of HSV-1?
The common symptoms of oral herpes caused by HSV-1 include,
- Painful blisters in or around the mouth
- Open sores or ulcers in or around the mouth
- Sores on the lips
- Burning sensation around the mouth
In most cases, oral herpes infection is asymptomatic and the mild symptoms caused by the infection often go unnoticed by the infected persons. Symptoms of oral infection caused by HSV-1 include blisters or open sores, commonly called ulcers in or around the mouth. It also causes sores on lips, which are commonly referred to as “cold sores”. It can also cause an itching or burning sensation around the mouth of an infected person, before the development of sores.
The blisters and sores can periodically recur after the initial stage of infection and its frequency differs from person to person.
The common symptoms of genital herpes caused by HSV-1 include,
- Blisters or ulcers in the genitals
- Sores or blisters in the anus
Genital herpes caused by herpes simplex virus type 1 can be asymptomatic or can show mild symptoms that are often unrecognized by the infected ones. The infection is characterized by one or more blisters or sores in the genital or anal region of the person. It can also cause severe recurring symptoms after the initial stage of the infection. However, HSV-1 caused genital herpes does not cause recurring effects or painful symptoms, unlike the infection caused by HSV-2 in the genitals. (Read more to know about herpes simplex virus type 2).
Possible complications caused by HSV-1
- A person who is already diagnosed with advanced HIV has high chances of developing HSV-1 infection and the frequency of recurrence is relatively high in immunocompromised people.
- In some rare cases, neonatal herpes can occur at the time of childbirth, when an infant is exposed to Herpes simplex virus type 2 in the genital tract. Since the levels of HSV are highest in the initial stage of the infection, the risk of neonatal herpes is greatest when a mother gets an HSV infection for the first time in her late pregnancy.
- The symptoms of HSV infection can cause psychological distress in infected individuals because of the social stigma and the scars they leave in a few cases, and it can also affect the quality of life and their sexual relationships.
- People who are already infected with HSV-1 have lesser chances of getting it again, but they are more likely to acquire HSV-2 genital infection.
Treatment of HSV-1
To diagnose herpes, swabs can be collected from the sores in case the person has an outbreak of sores caused by the virus. When there is no symptom of sores and blisters, the doctor might take a blood test to diagnose the infection.
Antiviral medications can reduce the severity of the infection in most cases. Along with decreasing the frequency and irritation of the symptoms, it can also help prevent the transmission of the virus. The most effective antiviral medications available for the infected people are,
- Acyclovir
- Famciclovir
- Valacyclovir
Though medications can give relief from the pain and severity of the disease, they may not cure the disease completely.
Herpes Simplex Virus Type 2 (HSV-2)
Herpes simplex virus type 2 is primarily transmitted through sex or sexual contact with an infected person. HSV-2 is the prime cause of genital herpes, however, in some cases, the genital infection can also be caused by HSV-1. HSV-2 infection is widespread across the globe and it is permanent and incurable.
An estimated population of 491 million people aged between 15 and 49 is infected with HSV-2 in 2016, according to the statistics given by WHO. It is also seen that more women are infected with HSV-2 than men. The proportion of infection in women and men was estimated to be 313 million women and 178 million men in 2016, because of the higher transmission of the virus from men to women than from women to men.
Africa and America are the two countries that have the highest rate of transmission. An estimated percentage of transmission in Africa is 44% in women and 25% in men, and 24% in women and 12% in men in America, making it the second country in the world with the highest number of HSV-2 cases.
Signs and symptoms of HSV-2
Most of the HSV-2 infections occur without any noticeable symptoms and signs which makes most of the infected persons unaware of the infection. About 10-20% of the people infected with HSV-2 report a prior diagnosis of genital herpes, which can also be caused by HSV-1. The common symptoms of the infection caused by HSV-2 include,
- One or more blisters in the genital area
- Open sores or ulcers in the genitals
- Sores or blisters in the anus
In addition to the above-mentioned symptoms of genital infection, the symptoms and signs of new genital herpes often include,
- Fever
- Body pain
- Swollen lymph nodes
- Fatigue/tiredness
- Pain and itching
Most of the mild symptoms of genital herpes go unnoticed and unrecognized. Regular testing can avoid the development of the infection and can help decrease the severity of the disease.
Transmission of HSV-2
Herpes simplex virus type 2 is mostly transmitted through sex. Genital-to-genital contact is the main reason for the spread of the infection. The contact with genital surfaces, skin, sores, or fluids of the infected person also causes the transmission of genital herpes, and the possibilities of the virus getting transmitted from the skin in the genital or anal area which looks normal without any symptoms are equally high.
Possible complications caused by HSV-2
- The ones who have the HSV-2 infection are highly prone to HIV infection. HSV-2 infection increases the risk of getting a new HIV infection by three-fold of the infected population. According to WHO, HSV-2 is one of the most common infections in people who are living with HIV, and an estimated 60-90% of HIV patients have acquired HSV-2.
- The recurring symptoms of HSV-2 infections, especially genital herpes cause psychological issues and distress in most infected persons. However, most people adjust to living with the infection throughout their life.
- In some cases, herpes simplex virus type 2 can also be spread from an infected mother to her infant at the time of delivery, which is commonly called neonatal herpes. An estimated 10 in every 100,000 childbirths report a case of HSV-2. Though the prevalence of this infection is comparatively less, it can also cause infections in the infant after the delivery.
Treatment of HSV-2
Consumption of antivirals prescribed by doctors can reduce the severity of the infection and the frequency of symptoms, but it cannot completely cure genital herpes caused by HSV-2. The most effective medications for HSV-2 infected persons include,
- Acyclovir
- Famciclovir
- Valacyclovir
Some people follow home care remedies to reduce the pain and sores in the skin. Though such treatments can decrease the symptoms and the discomfort, the infection cannot be completely cured.
Testing of herpes
An early diagnosis can help reduce the severity and frequent recurrence of the disease. For persons with noticeable symptoms like open sores or ulcers, doctors can collect swabs or it can be done in a healthcare center to diagnose the infection. In other cases where the person develops zero symptoms like sores or blisters, a blood test can be taken and used for diagnosis. Oral herpes is often tested with PCR, blood test, or biopsy.
It is advisable to consult a doctor when a person finds any mild symptoms of an STD, as persons with an STD are more likely to acquire HIV infection.
Prevention of Herpes
Persons who are diagnosed with genital herpes are advised to refrain from any sexual activity when they have active symptoms like itching in the genitals, sores or ulcers in or around genitals, or sores in the anus. HSV-1 and HSV-2 are the most contagious in the initial stage when there is an outbreak of symptoms like sores, but the infection can also spread when no symptoms are felt or found.
People with genital HSV infection should also get tested for HIV and other sexually transmitted diseases. HSV and HIV have been shown to influence each other and can also target immunocompromised persons who have an STD.
Using safety precautions like condoms and dental dams can prevent the transmission of the virus in most cases. Regular and correct usage of condoms can significantly reduce the risk of transmitting genital herpes. However, other contraceptive measures are not proven to be effective like condoms.
Avoiding sex or any sexual contact with HSV infected person or a sexually active person can also decrease the infection’s chances. A person with an active sexual life or multiple sex partners should regularly get tested for the infection and other STDs. Early testing of an STD can reduce the damage and severity of the infection.
People in underdeveloped countries should develop awareness regarding the prevalence and transmission of herpes and other STDs like gonorrhea, chlamydia, syphilis, and more. Since more cases are seen in youngsters and adolescents, awareness of STDs should be developed in teenagers.
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