The incubation period for both oral and genital herpes is 2 to 12 days. During the herpes incubation period, you may still test negative for the virus, as your body is building an immune response to the infection. There are four main types of diagnostic tests that can be used to diagnose herpes. Your doctor will determine which type of test to use based on whether an outbreak is present or not. It generally takes anywhere from 4 to 7 days for herpes symptoms to appear.
Both genital and oral herpes outbreaks have similar symptoms. The primary symptom of a herpes outbreak is sores that resemble blisters, called herpes lesions, on the mouth or genitals. Most of the symptoms that occur before an outbreak indicate that the virus is replicating.
Symptoms are usually the worst during the first herpes outbreak. According to the Centers for Disease Control and Prevention CDC , subsequent herpes outbreaks are usually not as severe, and many people become familiar with the signs and symptoms of an approaching outbreak. If you have the herpes virus and your body has produced antibodies, it can be detected on a blood test, even if you have no symptoms.
However, you can still spread the herpes virus to your sexual partners at any time, even if no sores are present. If you have herpes, you can still take care of your sexual health through open communication and safer sex. While women with genital herpes may be offered antiviral medication late in pregnancy through delivery to reduce the risk of a recurrent herpes outbreak, third trimester antiviral prophylaxis has not been shown to decrease the risk of herpes transmission to the neonate.
HSV nucleic acid amplification tests NAAT are the most sensitive and highly specific tests available for diagnosing herpes. However, in some settings viral culture is the only test available. The sensitivity of viral culture can be low, especially among people who have recurrent or healing lesions. Because viral shedding is intermittent, it is possible for someone to have a genital herpes infection even though it was not detected by NAAT or culture.
Type-specific virologic tests can be used for diagnosing genital herpes when a person has recurrent symptoms or lesion without a confirmatory NAAT, culture result, or has a partner with genital herpes.
Both virologic tests and type-specific serologic tests should be available in clinical settings serving patients with, or at risk for, sexually transmitted infections. If confirmatory tests are unavailable, patients should be counseled about the limitations of available testing before serologic testing. Healthcare providers should also be aware that false-positive results occur. In instances of suspected recent acquisition, serologic testing within 12 weeks after acquisition may be associated with false negative test results.
HSV-1 serologic testing does not distinguish between oral and genital infection, and typically should not be performed for diagnosing genital HSV-1 infection. Diagnosis of genital HSV-1 infection is confirmed by virologic tests from lesions. Patients who are at higher risk of infection e. There is no cure for herpes. Antiviral medications can, however, prevent or shorten outbreaks during the period of time the person takes the medication.
There is currently no commercially available vaccine that is protective against genital herpes infection. Candidate vaccines are in clinical trials. Correct and consistent use of latex condoms can reduce, but not eliminate, the risk of transmitting or acquiring genital herpes because herpes virus shedding can occur in areas that are not covered by a condom.
The surest way to avoid transmission of STDs, including genital herpes, is to abstain from sexual contact, or to be in a long-term mutually monogamous relationship with a partner who has been tested for STDs and is known to be uninfected. Persons with herpes should abstain from sexual activity with partners when herpes lesions or other symptoms of herpes are present.
It is important to know that even if a person does not have any symptoms, he or she can still infect sex partners. Sex partners of infected persons should be advised that they may become infected and they should use condoms to reduce the risk.
Sex partners can seek testing to determine if they are infected with HSV. Daily treatment with valacyclovir decreases the rate of HSV-2 transmission in discordant, heterosexual couples in which the source partner has a history of genital HSV-2 infection.
Counseling those with genital herpes, as well as their sex partners, is critical. It can help patients cope with the infection and prevent further spread into the community.
More information is available at www. Sexually transmitted infections among US women and men: Prevalence and incidence estimates, Centers for Disease Control and Prevention.
Accessed Jan. Klausner JD, et al. Genital herpes. New York, N. Albrecht MA. Epidemiology, clinical manifestations and diagnosis of genital herpes simplex virus infection. Longo DL, et al. Herpes simplex virus infections.
In: Harrison's Principles of Internal Medicine. Frequently asked questions. Gynecologic problems FAQ American Congress of Obstetricians and Gynecologists. Related Genital herpes Genital herpes: Can you get it from a toilet seat? If you were diagnosed with genital herpes in the last few days, you may be experiencing a number of uncomfortable or painful symptoms.
Or, perhaps the symptoms are rather mild, barely noticeable, and resemble an insect bite or a rash. First episodes usually occur within the first two weeks after the virus is transmitted. These classic lesions of genital herpes often resemble small pimples or blisters that eventually crust over and finally scab like a small cut. These lesions may take anywhere from two to four weeks to heal fully.
During this time, some people will experience a second crop of lesions, and some will experience flu-like symptoms, including fever and swollen glands, particularly in the lymph nodes near the groin.
Headache and painful urination also sometimes accompany full-blown symptoms of first episodes. Again, while first episodes can amount to a major bout with illness, the signs of herpes come in a wide variety — and in some people an initial infection produces mild symptoms or even symptoms that are ignored.
In other words, the signs go unrecognized as being caused by genital herpes. Signs and symptoms can be found on the penis and vulva, near the anus, on the thigh, on the buttocks, and virtually anywhere in the genital area. Treatment with antiviral drugs is standard during first episodes and can speed healing significantly. If you have recently made it through a first episode that consisted of full-blown symptoms, you know something about signs and symptoms already.
The good news is that the first episode is almost always the worst that HSV throws your way. Signs and symptoms of recurrent episodes when they occur tend to be milder and heal much more quickly, typically within two to twelve days.
In recurrent herpes, however, this process usually takes about half the time it does in first episodes. In addition, many people have very subtle forms of recurrent herpes that heal up in a matter of days. And lastly, herpes is capable of reactivating without producing any visible lesions This is called asymptomatic reactivation.
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