herpes symptoms : How is genital herpes diagnosed and treated?

During the initial outbreak, cultures of the blisters are positive for the herpes virus in only about 80% of patients. This means that in 20% of women with an actual herpes outbreak, a negative culture result might incorrectly lead them to believe that they do not have the herpes virus. In other words, a negative test result from a blister is not as helpful as a positive test result, because the test may come false negative if the blister isn't sampled in the early fluid-filled stage. However, if a sample of a fluid-filled blister (in the early stage before it dries up and crusts) tests positive for herpes, the test result is very reliable. After the initial outbreak, subsequent outbreaks tend to be sporadic. They can occur weekly, or even years apart. Some women only have the initial outbreak and never have a recurrence. In women who do have recurrences, culturing the blister fluid detects the herpes virus in only 50% of the cultures. There are herpes blood tests that are used only for research purposes. The reason the blood tests are limited to research is that they only indicate that someone is a "carrier" of the virus and do not mean he or she actually will get an attack of genital herpes that can be spread from person to person. This is the reason why it's best to go right to the blister and sample it, since what really needs to be known is whether a blister is filled with infectious herpes virus or not.

Genital herpes has received a great deal of publicity in recent years. It is believed that 60% of sexually active adults carry the herpes virus. Part of the reason for the continued high infection rate is that most women infected with the herpes virus do not know that they are infected, because they have few or no symptoms. The typical symptoms of itching, blisters, and painful ulcers are not always present. In many women, there are "atypical" outbreaks where the only symptom may be mild itching or minimal discomfort. Often, the longer the woman has had the virus, the fewer the symptoms they have with their outbreaks. Additionally, the virus can shed from the cervix into the vagina in women who are not experiencing any symptoms.

Although there is no known cure for herpes, there are treatments for the outbreaks. There are oral medications, such as acyclovir (Zovirax), famciclovir (Famvir), or valacyclovir (Valtrex) and ointments that can be used to help lessen the pain associated with the outbreak and even shorten the length of the eruption. Recently medication has also been approved to decrease (but not totally prevent) the risk of transmission to uninfected sexual partners of people with genital herpes. Herpes can be spread from one part of the body to another during an outbreak. Therefore, it is important not to touch the eyes or mouth after touching the blisters or ulcers. Thorough hand washing is a must during outbreaks. Clothing that comes in contact with ulcers should not be shared with others. Couples that want to minimize the risk of transmission should always use condoms if a partner is infected with the herpes virus. Unfortunately, even when an infected partner isn't currently having an outbreak, herpes can be spread. Couples may also want to consider avoiding all sexual contact, including kissing, during an outbreak of herpes. Since an active genital herpes outbreak (blisters) during labor and delivery can be harmful to the infant, pregnant women who suspect that they have genital herpes should tell their doctor. Women who have herpes and are pregnant can have a vaginal delivery as long as they are not experiencing symptoms or actually having an outbreak while in labor.

©1996-2006 MedicineNet, Inc. All rights reserved.