How Long After A Herpes Outbreak Are You Contagious

Basic Fact Sheet | Detailed Version

Detailed fact sheets are intended for physicians and individuals with specific questions nigh sexually transmitted diseases. Detailed fact sheets include specific testing and treatment recommendations as well equally citations so the reader can research the topic more in depth.

What is genital herpes?

Genital herpes is a sexually transmitted disease (STD) acquired by the canker simplex virus type 1 (HSV-i) or type 2 (HSV-two).

How common is genital herpes?

Genital herpes infection is common in the The states. CDC estimated that there were 572,000 new genital herpes infections in the United States in a single year.^one Nationwide, 11.nine % of persons aged fourteen to 49 years take HSV-2 infection (12.1% when adapted for age).² Notwithstanding, the prevalence of genital canker infection is higher than that considering an increasing number of genital herpes infections are caused by HSV-i. ⁱⁱⁱ Oral HSV-1 infection is typically caused in childhood; considering the prevalence of oral HSV-ane infection has declined in contempo decades, people may have get more susceptible to contracting a genital herpes infection from HSV-1. ⁴

HSV-ii infection is more mutual among women than amid men; the percentages of those infected during 2015-2016 were fifteen.9% versus viii.2% respectively, amongst xiv to 49 twelvemonth olds.ⁱⁱ This is perchance because genital infection is more hands transmitted from men to women than from women to men during penile-vaginal sex activity. ^v HSV-ii infection is more mutual among non-Hispanic blacks (34.six%) than among non-Hispanic whites (8.ane%). ⁱⁱ A previous analysis found that these disparities, exist even among persons with like numbers of lifetime sexual partners. Nearly infected persons may be unaware of their infection; in the Usa, an estimated 87.four% of 14 to 49 year olds infected with HSV-2 have never received a clinical diagnosis. ^vi

The age-adapted percentage of persons in the U.s. infected with HSV-2 decreased from eighteen.0% in 1999–2000 to 12.1% in 2015-2016. ²

How do people get genital herpes?

Infections are transmitted through contact with HSV in herpes lesions, mucosal surfaces, genital secretions, or oral secretions. ⁵ HSV-i and HSV-two can be shed from normal-appearing oral or genital mucosa or skin. ⁷ ^,8 Generally, a person tin can but get HSV-2 infection during genital contact with someone who has a genital HSV-2 infection. However, receiving oral sexual activity from a person with an oral HSV-1 infection can result in getting a genital HSV-1 infection. ⁴ Transmission commonly occurs from contact with an infected partner who does not take visible lesions and who may not know that he or she is infected. ^seven In persons with asymptomatic HSV-2 infections, genital HSV shedding occurs on ten.2% of days, compared to 20.1% of days amidst those with symptomatic infections. ⁸

What are the symptoms of genital canker?

About individuals infected with HSV are asymptomatic or accept very mild symptoms that go unnoticed or are mistaken for another skin condition. ^ix When symptoms exercise occur, herpes lesions typically announced equally i or more vesicles, or small-scale blisters, on or effectually the genitals, rectum or oral fissure. The boilerplate incubation period for an initial herpes infection is four days (range, ii to 12) after exposure. ¹⁰ The vesicles break and leave painful ulcers that may take two to iv weeks to heal after the initial herpes infection. ^5,10 Experiencing these symptoms is referred to as having a first herpes "outbreak" or episode.

Clinical manifestations of genital canker differ between the first and recurrent (i.e., subsequent) outbreaks. The kickoff outbreak of herpes is frequently associated with a longer elapsing of herpetic lesions, increased viral shedding (making HSV transmission more than probable) and systemic symptoms including fever, body aches, swollen lymph nodes, or headache. ⁵ ^,10 Recurrent outbreaks of genital herpes are mutual, and many patients who recognize recurrences have prodromal symptoms, either localized genital pain, or tingling or shooting pains in the legs, hips or buttocks, which occur hours to days before the eruption of herpetic lesions. ⁵ Symptoms of recurrent outbreaks are typically shorter in duration and less severe than the first outbreak of genital herpes. ^five Long-term studies have indicated that the number of symptomatic recurrent outbreaks may subtract over time. ^five Recurrences and subclinical shedding are much less frequent for genital HSV-i infection than for genital HSV-2 infection.⁵

What are the complications of genital herpes?

Genital herpes may cause painful genital ulcers that can be severe and persistent in persons with suppressed immune systems, such as HIV-infected persons. ⁵ Both HSV-1 and HSV-2 can also cause rare merely serious complications such as aseptic meningitis (inflammation of the linings of the encephalon). ^five Development of extragenital lesions (e.g. buttocks, groin, thigh, finger, or centre) may occur during the class of infection. ^v

Some persons who contract genital canker have concerns nigh how it will touch on their overall wellness, sexual practice life, and relationships. ^5, ¹¹ There can also be considerable embarrassment, shame, and stigma associated with a herpes diagnosis that can substantially interfere with a patient's relationships. ¹⁰ Clinicians can accost these concerns by encouraging patients to recognize that while canker is not curable, it is a manageable condition. ^v Three important steps that providers tin accept for their newly-diagnosed patients are: giving information, providing support resources, and helping define treatment and prevention options. ¹² Patients tin can be counseled that risk of genital herpes transmission can exist reduced, but not eliminated, by disclosure of infection to sexual partners, ^five avoiding sexual practice during a recurrent outbreak, ⁵ apply of suppressive antiviral therapy, ^5, ¹⁰ and consistent safe use. ⁷Since a diagnosis of genital herpes may affect perceptions virtually existing or hereafter sexual relationships, information technology is of import for patients to understand how to talk to sexual partners about STDs. One resource can be found here: www.gytnow.org/talking-to-your-partnerexternal icon

There are also potential complications for a pregnant woman and her newborn child. See "How does herpes infection affect a pregnant woman and her baby?" beneath for information about this.

What is the link between genital canker and HIV?

Genital ulcerative disease caused by herpes makes it easier to transmit and larn HIV infection sexually. There is an estimated two- to 4-fold increased hazard of acquiring HIV, if individuals with genital herpes infection are genitally exposed to HIV. ^13-xv Ulcers or breaks in the pare or mucous membranes (lining of the mouth, vagina, and rectum) from a herpes infection may compromise the protection normally provided by the pare and mucous membranes against infections, including HIV. ¹⁴ In improver, having genital herpes increases the number of CD4 cells (the target jail cell for HIV entry) in the genital mucosa. In persons with both HIV and genital herpes, local activation of HIV replication at the site of genital herpes infection can increase the risk that HIV will be transmitted during contact with the mouth, vagina, or rectum of an HIV-uninfected sex partner.^xiv

How does genital canker affect a pregnant woman and her baby?

Neonatal herpes is i of the virtually serious complications of genital herpes.^5, ¹⁶ Healthcare providers should ask all meaning women if they have a history of genital herpes.¹¹ Canker infection can be passed from mother to child during pregnancy or childbirth, or babies may be infected shortly after birth, resulting in a potentially fatal neonatal herpes infection. ¹⁷ Infants born to women who acquire genital canker close to the fourth dimension of delivery and are shedding virus at commitment are at a much college chance for developing neonatal canker, compared with women who have recurrent genital canker . ^16, ^18-20 Thus, it is important that women avert contracting herpes during pregnancy. Women should be counseled to abstain from intercourse during the third trimester with partners known to have or suspected of having genital herpes. ^five, ¹¹

While women with genital herpes may be offered antiviral medication late in pregnancy through delivery to reduce the risk of a recurrent herpes outbreak, 3rd trimester antiviral prophylaxis has not been shown to decrease the risk of herpes transmission to the neonate.^11, ^21, ²² Routine serologic HSV screening of pregnant women is not recommended. ¹¹ Nonetheless, at onset of labor, all women should undergo careful examination and questioning to evaluate for presence of prodromal symptoms or herpetic lesions. ^eleven If herpes symptoms are present a cesarean delivery is recommended to foreclose HSV transmission to the baby.^5, ^11, ²³ There are detailed guidelines for how to manage asymptomatic infants built-in to women with active genital herpes lesions.²⁴

How is genital herpes diagnosed?

HSV nucleic acid amplification tests (NAAT) are the most sensitive and highly specific tests bachelor for diagnosing canker. Still, in some settings viral civilisation is the only examination available. The sensitivity of viral civilization can be depression, especially amidst people who have recurrent or healing lesions. Because viral shedding is intermittent, it is possible for someone to take a genital herpes infection even though it was not detected by NAAT or culture. ^xi

Type-specific virologic tests can exist used for diagnosing genital herpes when a person has recurrent symptoms or lesion without a confirmatory NAAT, culture issue, 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. ^eleven

Given performance limitations with commercially available blazon-specific serologic tests (especially with depression index value results [<3]), a confirmatory test (Biokit or Western Absorb) with a second method should be performed earlier test interpretation. If confirmatory tests are unavailable, patients should exist counseled about the limitations of available testing before serologic testing. Healthcare providers should too be aware that false-positive results occur. In instances of suspected recent conquering, serologic testing within 12 weeks after acquisition may exist associated with fake negative examination results. ¹¹

HSV-1 serologic testing does non distinguish between oral and genital infection, and typically should not be performed for diagnosing genital HSV-1 infection. Diagnosis of genital HSV-one infection is confirmed by virologic tests from lesions. ¹¹

CDC does not recommend screening for HSV-i or HSV-two in the general population due to limitations of the type specific serologic testing.^eleven Several scenarios where blazon-specific serologic HSV tests may be useful include:

Patients with recurrent genital symptoms or atypical symptoms and negative HSV NAAT or civilization;
Patients with a clinical diagnosis of genital herpes just no laboratory confirmation; and
Patients who report having a partner with genital herpes. ¹¹

Patients who are at higher adventure of infection (e.g., presenting for an STI evaluation, especially those with multiple sexual practice partners), and people with HIV might demand to be assessed for a history of genital herpes symptoms, followed by serology testing in those with genital symptoms. ^xi

Providers are strongly encouraged to look at CDC's STI Treatment Guidelines for further diagnostic considerations.

Is there a cure or treatment for herpes?

There is no cure for canker. Antiviral medications tin, still, prevent or shorten outbreaks during the menses of time the person takes the medication.^xi In addition, daily suppressive therapy (i.eastward., daily use of antiviral medication) for canker tin reduce the likelihood of manual to partners.^eleven

There is currently no commercially bachelor vaccine that is protective against genital canker infection. Candidate vaccines are in clinical trials.

How can canker exist prevented?

Correct and consistent use of latex condoms can reduce, simply not eliminate, the gamble of transmitting or acquiring genital herpes considering herpes virus shedding can occur in areas that are not covered by a rubber.^25, ²⁶

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 sex 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 whatever 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 decide if they are infected with HSV.

Daily treatment with valacyclovir decreases the rate of HSV-two transmission in discordant, heterosexual couples in which the source partner has a history of genital HSV-2 infection. ²⁷ Such couples should exist encouraged to consider suppressive antiviral therapy every bit role of a strategy to forestall manual, in addition to consistent safe utilise and avoidance of sexual practice during recurrences.

Counseling those with genital herpes, as well as their sex partners, is disquisitional. It can help patients cope with the infection and prevent farther spread into the community. The STI Treatment Guidelines includes messaging broken down by canker type. ¹¹

National Network of STD Clinical Prevention Training Centers, STD Clinical Consultation Network external icon

Health intendance providers with STD consultation requests tin contact the STD Clinical Consultation Network (STDCCN). This service is provided by the National Network of STD Clinical Prevention Grooming Centers and operates 5 days a week. STDCCN is convenient, simple, and free to health care providers and clinicians. More information is available at www.stdccn.orgexternal icon.

Where tin can I get more information?

Division of STD Prevention (DSTDP)
Centers for Disease Control and Prevention

Personal health inquiries and information about STDs:

CDC-INFO Contact Heart
1-800-CDC-INFO (1-800-232-4636)
TTY: (888) 232-6348
Contact CDC-INFO

Resources:

CDC National Prevention Information Network (NPIN)
P.O. Box 6003
Rockville, MD 20849-6003
i-800-458-5231
1-888-282-7681 Fax
1-800-243-7012 TTY
Electronic mail: npin-info@cdc.gov

American Sexual Health Clan (ASHA)external icon
P. O. Box 13827
Research Triangle Park, NC 27709-3827
1-800-783-9877

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