However, asymptomatic carriers of the HSV-2 virus are still contagious. In many infections, the first symptom people will have of their own infections is the horizontal transmission to a sexual partner or the vertical transmission of neonatal herpes to a newborn at term. Since most asymptomatic individuals are unaware of their infection, they are considered at high risk for spreading HSV.[47]
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.
There are two types of herpes simplex viruses (HSV), they are termed HSV-1 and HSV-2. These two viruses have distinctly different DNA, and both cause oral and genital lesions. However, HSV-1 causes about 80% of all oral lesions and only about 20% of genital lesions while HSV-2 causes the reverse (about 80% genital and 20% oral). Studies also suggest that in adolescents, up to 40% of genital herpes is caused by HSV-1 because of reported increased oral/genital contact (transmission by oral sex).
Doctors prescribe suppressive treatment if a person experiences more than six recurrences in a year. In some cases, a doctor my recommend that the individual takes daily antiviral treatment indefinitely. The aim here is to prevent further recurrences. Although suppressive treatment significantly reduces the risk of passing HSV to a partner, there is still a risk.
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