What is it about ?
Genital herpes is a sexually transmitted infection (STI) that is caused by the herpes simplex virus (HSV). This virus is very contagious. Once you are infected, it remains present (‘asleep’) in the body. You therefore carry the virus for life.
There are two types of HSV: HSV1 and HSV2. Over 60% of genital herpes cases are caused by HSV2 and over 30% by HSV1. Partners who do not know they are carriers of the virus (the infection can remain asymptomatic) transmit it in about half of the cases.
How to recognize it?
Primary infection or first outbreak of genital herpes
Genital herpes can be recognized by small painful blisters that appear on or in the anus, vagina, penis, or in the buttock region, about 4 to 14 days after infection. Blisters can also form inside the mouth or on the lips.
Hatching of the blisters is often preceded by a tingling and prickling sensation at the site of infection. Gradually, the skin reddens and a vesicle filled with fluid forms. This blister bursts, leaving a small ulcer on which a scab forms. A burning sensation may also be felt temporarily when you urinate.
Other general symptoms may also occur, such as fever, headache and muscle pain, swollen glands in the groin, and, in women, ulcers on the cervix. Symptoms persist for 2 to 3 weeks. The skin heals completely, without scarring.
The primary infection, which is usually the most severe, may be followed by a new flare-up (i.e., recurrence). At this point, sometimes there aren’t the slightest symptoms.
Recurrent genital herpes
80% of people who have had a first outbreak of herpes know a new one. In the event of recurrence, the vesicles are localized on one side of the genitals, in women generally only on the level of the lips. General symptoms (such as fever, headache, muscle pain, swollen glands, etc.) are rare. The new relapse can be triggered by physical or mental stress, or by your period, and lasts about 7 days.
During pregnancy, the risk of transmission of the virus to the fetus is 50% in the case of primary infection and 5% in the event of new outbreaks of herpes.
How is the diagnosis made?
Your doctor will be able to make the diagnosis based on the symptoms and physical examination. No additional examination is usually performed, except in the event of pregnancy.
If necessary, a viral culture or a DNA test can be performed. To do this, the doctor takes a sample of the virus by rubbing a cotton swab on a lesion that is preferably oozing (lesion) exudative. A normal test does not rule out infection.
Tests for antibodies in the blood demonstrate carrier status, but do not provide information on the focus of infection.
What can you do ?
Wearing a condom does not always prevent contamination. Indeed, the lesions can be present anywhere on the genitals. The only really effective measure is total abstinence in the presence of visible blisters, because this is when the risk of contamination is the highest.
What can your doctor do?
Your doctor can explain the course of the infection to you. As said before: once you have contracted the virus, it is no longer possible to get rid of it. However, there are drugs that can reduce symptoms, shorten the duration of the flare-up and reduce the risk of relapse (recurrence).
Based on a probable diagnosis of primary infection, the doctor may prescribe antiviral therapy for 5-10 days. If symptoms are severe, treatment can be given as an infusion. A new antiviral treatment can be started in the event of recurrence. If the relapses are frequent and debilitating, treatment may even need to be followed for a longer period (6 months). Note, however, that the virus can still be transmitted.
Want to know more?
- What are STIs? (video) – LoveAttitude
- Herpes – Depistage.be
- Modes of transmission of STIs – Depistage.be
- Infections (viral, bacterial, etc.) and immunity – mongeneraliste.be – SSMG – Scientific Society of General Medicine
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