Genital Herpes

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Genital Herpes

Is it Genital Herpes? Symptoms of an Initial Outbreak

Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: Jay W. Marks, MD

The initial symptoms of genital herpes include fever, itching or tingling in the genital area, vaginal discharge, and headache Genital herpes is a sexually transmitted viral infection (STD) that is relatively common worldwide. In the U.S., it is estimated to affect about 45 million people. While the hallmark of this recurring condition is the presence of raised, reddened, and usually painful bumps or blisters in the genital area, the initial outbreak of genital herpes may look and feel different than the later characteristic flare-ups.

In a person who has never been exposed to the herpes simplex virus (genital herpes is caused by herpes simplex virus type 2 or HSV-2; and, less commonly, herpes simplex virus type 1 or HSV-1), symptoms (if present) typically develop within two to 12 days, with an average time of four days. The symptoms and appearance of the initial infection (known as the primary infection) vary widely among individuals.

It is possible for someone to become infected with the herpes simplex virus and not display any symptoms at all. Other people may have a mild infection that may even go unnoticed. Still others will develop a more severe illness including the typical skin lesions.

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Genital Herpes Overview

Genital herpes is a common, highly infectious disease caused by a virus. It is transmitted from one person to another during sexual activity. Genital herpes causes blisters or groups of small ulcers (open sores) on and around the genitals in both men and women. It cannot be cured, only controlled.

Genital herpes is extremely widespread, largely because it is so contagious. Carriers can transmit the disease without having any symptoms themselves of active infection.

As many as 50 million Americans are infected with the genital herpes virus, with about one million new infections each year. As many as 80%-90% of those infected fail to recognize herpes symptoms or have no symptoms at all.

The highest rates of infection are seen among the poor, those with less education, those using cocaine, and those with many sexual partners.

Genital Herpes Causes

Genital herpes is caused by the herpes simplex virus (HSV). There are two types: HSV-1 and HSV-2. Most genital herpes infections are caused by HSV-2. HSV-1 is the usual cause of what most people call "fever blisters" in and around the mouth and can be transmitted from person to person through kissing. Less often, HSV-1 can cause genital herpes infections through oral sexual contact. The genital sores caused by either virus look the same.

Genital herpes is spread by direct contact with an infected person. Sexual intercourse and oral sex are the most common methods of spreading genital herpes. Any type of skin-to-skin contact, however, is capable of spreading herpes.

Note: People with herpes may spread the disease even if they do not realize they have an infection. Furthermore, there is strong evidence that people with herpes can transmit infection even while their disease appears to be inactive and no sores can be seen.

Many people remember having an episode of genital herpes when it occurs. But as many as 90% of those infected fail to recognize the symptoms or have no symptoms at all. It is not clear whether these people never had an initial herpes outbreak or whether they never noticed a mild infection. They are contagious and may have additional outbreaks, nonetheless.