HSV-2 is contracted through forms of sexual contact with a person who has HSV-2. An estimated 20 percent of sexually active adults in the United States are infected with HSV-2, according to the American Academy of Dermatology (AAD). HSV-2 infections are spread through contact with a herpes sore. In contrast, most people get HSV-1 from an infected person who is asymptomatic, or does not have sores.

HSV-2 is commonly referred to as genital herpes because it usually causes cold sores to erupt around the genitalia. In fact, genital herpes is the No. 1 cause of genital ulcers worldwide, according to the Centers for Disease Control and Prevention (CDC), and affects up to 1 in 3 adults (although most who are infected don’t even know it). (5) Both types of herpes viruses are highly contagious, and both can cause cold sores in either area of the body (or sometimes both). 


Herpes has been known for at least 2,000 years. Emperor Tiberius is said to have banned kissing in Rome for a time due to so many people having cold sores. In the 16th-century Romeo and Juliet, blisters "o'er ladies' lips" are mentioned. In the 18th century, it was so common among prostitutes that it was called "a vocational disease of women".[91] The term 'herpes simplex' appeared in Richard Boulton's A System of Rational and Practical Chirurgery in 1713, where the terms 'herpes miliaris' and 'herpes exedens' also appeared. Herpes was not found to be a virus until the 1940s.[91]
There are two types of herpes simplex virus, type 1 (HSV-1) and type 2 (HSV-2).[1] HSV-1 more commonly causes infections around the mouth while HSV-2 more commonly causes genital infections.[2] They are transmitted by direct contact with body fluids or lesions of an infected individual.[1] Transmission may still occur when symptoms are not present.[1] Genital herpes is classified as a sexually transmitted infection.[1] It may be spread to an infant during childbirth.[1] After infection, the viruses are transported along sensory nerves to the nerve cell bodies, where they reside lifelong.[2] Causes of recurrence may include: decreased immune function, stress, and sunlight exposure.[2][3] Oral and genital herpes is usually diagnosed based on the presenting symptoms.[2] The diagnosis may be confirmed by viral culture or detecting herpes DNA in fluid from blisters.[1] Testing the blood for antibodies against the virus can confirm a previous infection but will be negative in new infections.[1]
Patients with genital herpes have reported that outbreaks or episodes typically diminish through the years. Early prodromal symptoms, or warning signals, that are followed by outbreaks. These prodromal symptoms often include mild tingling or shooting pains in the legs, hips and buttocks, and can last from 2 hours to 2 days. After the prodromal symptoms occur the blisters develop into painful red spots, which then evolve into yellowish, clear fluid-filled blisters after a day or two. These blisters burst or break and leave ulcers that usually heal in about 10 days. In women, blisters can develop inside the vagina and cause painful urination.

A 2004 study in the New England Journal of Medicine found that suppressive therapy decreases the risk of HSV-2 transmission from symptomatic, infected partners to uninfected partners by 48%. So “the risk of transmission is significantly reduced, but cannot be eliminated even with suppressive therapy,” Johnston explains, and she stresses that the virus can be passed along even without signs or symptoms.

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