Facts and Triggers - Genital Herpes

Genital herpes is a common disease worldwide, and it is estimated that 45 million people in the US are afflicted. Most genital herpes infection is caused by HSV-2, but HSV-1 may also infect the genital tract in both women and men (5-15%). A new (primary) infection is often asymptomatic, which means that an individual may acquire genital herpes without knowing it. The presence of specific antibodies to HSV-2 in serum indicates that a patient has been infected with the virus and studies have shown that lonely around 30% of the 20-25% of all adults that have HSV-2 antibodies have a history of genital herpes.

Once the primary infection has occurred, the virus will travel up the nerve cell and establish a dormant infection in the sacral ganglia from where it may re-emerge, sometimes causing blisters in the genital area, and sometimes just being excreted without causing symptoms (asymptomatic shedding).

Both the virus present in the blister and “shedded” virus are contagious. Transmission of HSV-2 most commonly results from a sexual contact with an asymptomatic, infected partner.
Does the virus disappear from the body when the genital lesion is healed?

No, the virus will remain dormant in the body forever.
Why do I get recurrent genital herpes and some don’t?

Little is known about this but some patients may be genetically predisposed to get genital herpes.
What triggers an outbreak of genital herpes?

Of the 20-25% of individuals that are HSV-2 antibody positive in North America, only 5-10% report clinically recurrent genital herpes. Thus, most HSV-2 infected patients will not have clinically evident recurrent infection. Approximately 1% of HSV-2 infected patients shed the virus on any given day. Studies have shown that asymptomatic shedding lasts for approximately 1.5 days. Clinically evident recurrent genital herpes is usually mild and the blisters will generally heal within a week. In some individuals, symptoms may be more pronounced and include tender lymph nodes, pain when urinating, vaginal discharge, and occasionally fever. Most patients with a history of genital herpes will recognize the outbreak prior to lesions with tingling and tenderness. Stress, menstruation, depression, sexual intercourse, and immune-suppression are some factors that may trigger recurrent infection.