Genital herpes spreads by touching skin with sores or blisters. It may also spread during sexual intercourse without a condom or dental dam. It can also spread by saliva or mucous from the mouth during oral sex.
Herpes can also be passed on through indirect contact, such as sharing eating utensils with an infected person. It can even be spread to a baby during delivery if the mother has active herpes.
Herpes Simplex Virus 1 (HSV-1)
Herpes is one of the most common infections worldwide. It can cause recurrent painful blisters and ulcers in the mouth or genital region. Viruses that cause herpes are classified as types 1 and 2. The type 1 virus (HSV-1) spreads mostly through kissing, which can lead to oral herpes or fever blisters, or by sharing utensils or drinks with an infected person. It can also spread through sexual activity to cause genital herpes. The type 2 virus (HSV-2) is generally contracted through anal or vaginal sex, although it can also be transmitted by oral sex.
Once a person is infected with herpes, the virus remains in the body. The virus lies dormant in nerve cells until something triggers it to become active again. The herpes virus causes painful sores around the mouth, genital area, or rectum. Other symptoms may include fever, swollen glands, and flu-like symptoms. Outbreaks tend to last a few days to a week. Symptoms are more likely to be spread during an outbreak or when sores are present.
HSV-2 is more often spread through anal or vaginal contact than oral sex. It is rare for genital herpes to be transmitted through direct contact between two people without visible sores. However, it can be spread when areas of skin with herpes come in contact with mucous membranes that line these regions.
Herpes Simplex Virus 2 (HSV-2)
HSV-2 is transmitted through skin-to-skin contact with genital herpes sores. It’s possible to get HSV-2 through oral sex, but it’s not very common. It’s also possible to spread herpes when an infected person has no visible sores (this is called asymptomatic shedding). People with herpes can also spread it through kissing, sharing toothbrushes and utensils, and sharing saliva or other body fluids like urine. Infected women may also pass herpes to their babies during childbirth.
Symptoms of herpes can range from mild to severe. During an outbreak, people may develop sores in or around their mouth, genital area, or anal canal. The sores can ooze and itch and can be very painful. The virus can also cause fever, swollen lymph nodes, and headaches. It’s possible to have repeated herpes outbreaks over time (called recurrences). Medicines can decrease how long symptoms last and how painful they are, but they cannot cure herpes.
It’s possible to limit herpes transmission by avoiding contact with sores, using condoms during sexual activity, and not kissing. Those who have herpes can take antiviral medicines to help reduce the number of outbreaks they have and how painful they are. These drugs can be taken daily or just during an outbreak. It’s important to talk to a doctor about the right dose for each person.
Herpes Simplex Virus 3 (HSV-3)
HSV-2 can be spread in many ways other than sexual activity, including through direct contact of areas of the body affected by herpes sores (such as the genital area or anal area) and through skin-to-skin contact without ejaculation. It can also be passed from a person with herpes to another person through oral sex (giving or receiving), when the virus enters the nervous system via the mouth and reaches the genital area. It can also be transmitted through contact with a person’s saliva and through sharing objects such as eating utensils, towels or razors that are infected with herpes.
Hsv-2 can also be transmitted to a newborn baby during delivery, which is called neonatal herpes. Newborns infected with herpes are more likely to have serious developmental or physical problems and a higher risk of death. Herpes can also cause infections of the internal organs or in the nervous system, which can be life-threatening for a newborn.
Some people with herpes have no symptoms or only mild ones. The virus can remain in the body and not cause any outbreaks for months or even years. In some cases, the virus can reactivate and lead to an outbreak of genital herpes. Symptoms include painful sores, blisters that break open and ooze, and swollen lymph nodes near the infection. Taking antiviral medicines, such as acyclovir, famciclovir and valacyclovir, can decrease the length and severity of outbreaks and help prevent them from occurring.
Herpes Simplex Virus 4 (HSV-4)
HSV-2 is transmitted through direct contact of areas on the skin with herpes that have no visible sores. It can also be spread through the mucous membranes of the vagina, anus and mouth. The virus infects and reproduces on the epithelial cells of these areas, and is then shed into the surrounding area. Once the herpes virus reaches the mucous membrane, it usually lays dormant in the genital or anal area or in the mouth for months or even years before the first outbreak.
It is possible to get genital herpes through oral or anal sex, and it can be passed through unprotected intercourse with any partner (CDC, 2022). You can also pass the herpes virus to others by sharing towels, bathing products, bed linens, silverware, faucet handles and eating utensils that may have come into contact with an infected person’s bodily fluids or open sores.
Herpes can also be passed from mother to baby during childbirth (neonatal herpes), which is very dangerous for the infant. In rare cases, herpes can cause more severe and widespread infections in immunocompromised people such as those with advanced HIV infection (CDC, 2021). Daily treatment with valacyclovir decreases the risk of transmitting herpes to partners in discordant heterosexual relationships where one or both of the individuals have genital herpes. Consistent use of condoms in sexual activity and foreplay is the most effective method of reducing herpes transmission.