HSV-2
recurring outbreaks
will generally occur
in the genital region.
Herpes type 2 is
believed to be a
painful and dangerous
infection that affects
people with an “overly
active sex life.
This couldn't be
more false. Genital
Herpes can infect
anyone who has sex,
even if only once.
An estimated 25%
of adults from varying
backgrounds, income
levels and ethnic
groups have Herpes
type 2 causing genital
herpes. Herpes type
2 is often so mild
that an estimated
two thirds of those
infected don't even
realize they have
it. Herpes type
2 rarely causes
complications and
more rarely spreads
to other parts of
the body. Herpes
type 2 is the most
common cause of
neonatal herpes
(herpes in the newly
born baby), a rare
but often dangerous
and potentially
fatal condition
that affects newborns.
Herpes type 2 oral
infections are very
rare and in those
few known cases,
recurring outbreaks
are extremely rare.
HSV-2 is associated
with genital infection
(herpes
genitalis or genital
herpes).
This happens
in three stages
- Prodromal symptoms
- Sore appears
- Lesion begins
to heal, usually
without scarring
In men, the lesions
may occur on the
shaft of the penis,
in the genital region,
on the inner thigh,
buttocks, or anus.
In women,
lesions may
occur on or near
the pubis, labia,
clitoris, vulva,
buttocks, or anus.
This may require
a very careful examination;
for example, during
delivery, examination
by use of a flashlight
may be necessary.
The appearance
of herpes lesions
and the experience
of outbreaks in
these areas vary
tremendously among
individuals. Herpes
lesions on/near
the genitals may
look like cold
sores. An outbreak
may look like a
paper cut, or chafing,
or appear to be
a yeast infection.
Symptoms
of a genital outbreak
may include aches
and pains in the
area, discharge
from the penis or
vagina, and discomfort
when urinating.
Initial outbreaks
are usually more
severe than subsequent
ones, and generally
also involve flu-like
symptoms and swollen
glands for a week
or so. Subsequent
outbreaks tend to
be periodic or episodic,
typically occur
four to five times
a year, and can
be triggered by
stress, illness,
fatigue, menstruation,
and other changes.
The virus sequesters
in the nerve ganglia
that serve the infected
dermatome during
non-eruptive periods,
where it cannot
be conventionally
eliminated by the
body's immune system.
Women are more
susceptible to acquiring
genital HSV-2 than
men. On an annual
basis, without the
use of anti-viral
preparations or
condoms, the transmission
risk from infected
male to female is
approximately 8-10%.
This is believed
to be due to the
increased exposure
of mucosal tissue
to potential infection
sites. Transmission
risk from infected
female to male is
approximately 4-5%
annually. Suppressive
antiviral therapy
reduces these risks
by 50%. Anti-viral
preparations also
help prevent the
development of symptomatic
HSV
in infection scenarios
by about 50%, meaning
the infected partner
will be seropositive
but symptom free.
Condom use also
reduces the transmission
risk by 50%. Condom
use is much more
effective at preventing
male to female transmission
than vice-versa.
The effects of combining
antiviral and condom
use is roughly additive,
thus resulting in
approximately a
75% combined reduction
in annual transmission
risk. It is important
to note that these
figures reflect
experiences with
subjects having
frequently recurring
genital herpes,
subjects with low
recurrence rates
and those with no
clinical manifestations
were excluded from
these studies.
Effects of
Herpes Simplex VirusType
2 (HSV 2)
The HSV-2 herpes
virus is more virulent,
affects the lower
half of the body,
and tends to remain
dormant in the sacral
ganglia. It can
also produce aseptic
meningitis and neuralgias
along the genitocrural,
sciatic and obturator
nerves due to radiculomyelopathy.
The pain radiates
from the hip downwards
and forwards to
the upper thighs
and groins. Herpetic
Whitlow or nailbed
infection, meningitis,
encephalitis, Hepatitis,
etc. are rarely
seen manifestations
of the virus and
tend to occur only
in the immunocompromised
individuals. Eventually
the patient can
succumb to these
pathologies.
