Journal of the American Medical Association (02/09/00) Vol.
Genital herpes is caused by the herpes simplex viruses (HSV)
and is one of the three most prevalent sexually transmitted
diseases (STDs) in the United States. The disease affects
people chiefly between the ages of 15 and 40. One problem
related to the high number of HSV infections is that the
symptoms are unrecognized and mild infections often do not
attract medical attention. Most symptoms include painless
ulcers, dysuria, or discharge from the genitals. Many
infected people do not get lesions and are unaware of the
infection, and thus are at risk of unknowingly transmitting
the disease. Neonatal herpes is the most serious problem
associated with the infection, but the mother can be treated.
Genital ulcers also increase HIV transmission, and HSV
infection has been implicated in HIV transmission. The
Centers for Disease Control and Prevention's advisory panel
has recommended type-specific testing for HSV, and better
serologic tests are now available. Clinicians can use viral
culture to detect HSV when diagnosing genital ulcer disease.
Patients should also be counseled to avoid HSV transmission
during sex by using condoms.