Signs of Herpes: Often Ambiguous and Often Absent

Genital herpes, caused by herpes simplex virus 2, ranks as one of the most prominent STDs in the country. The CDC estimates over 50 million American are infected with genital herpes. Sexually active women are almost twice as likely to be infected as their male counterparts. About every one in five sexually active women is infected with genital herpes, whereas one in nine males have the virus.

Herpes is a widely common virus, but of those infected, an overwhelming 90 percent are unaware they are positive with genital herpes. This discrepancy can be attributed to fact that signs of herpes are not always evident following infection making it more difficult for those at risk to protect themselves. Also, since signs of herpes can be similar to symptoms of other known STDs, the only way to truly identify herpes infection is to undergo STD testing.

Common Signs of Herpes

The majority of people infected with the herpes simplex virus will never display symptoms at all. For others, signs of herpes can be so indiscriminant that they’re mistaken for harmless skin irritation, jock itch, or mild allergic reaction. A more disruptive and noticeable herpes outbreak, however, can produce painful, blistering genital sores that generally take several weeks to heal. Accompanying these sores may be the presence of flu-like symptoms, including fever, swollen glands, and fatigue. While the frequency and severity of outbreaks produced by the herpes simplex virus will generally diminish over time without medical intervention, treating herpes patients with antiviral drugs and suppressive therapy can also help control outbreaks.

Genital Sores Don’t Always Mean Herpes

Though genital sores are recognized as one of the telltale signs of herpes, the herpes simplex virus is not the only STD known to produce vaginal or penile sores. The following infections can often be mistaken for herpes disease:

• Syphilis: More common among men who have sex with other men (MSM), syphilis can produce genital sores in those infected. These sores will generally be small, firm, round, and painless, and will usually appear at the original site of infection.
• HPV: HPV can produce painless genital warts which usually appear in cauliflower-like clusters. These warts are generally benign but can be removed by a doctor. These warts are often mistaken for genital herpes sores.  Genital warts may indicate a more serious HPV infection in women so it is important to see a gynecologist when such symptoms are present.
• Chancroid: While Chancroid is less common in the US than other parts of the world, this highly contagious STD can cause genital sores or lesions. Sore are often painful, open raised sores that can resemble herpes.

Testing for Herpes

The only way to effectively identify herpes is to undergo STD testing. As signs of herpes can be similar to other STDs, testing is necessary for a proper diagnosis. The most accurate form of herpes testing is by an IgG antibody test. A blood test can identify specific IgG herpes antibodies even when symptoms are not present.  Furthermore, this test can determine whether the infection is caused by herpes simplex virus 1 (oral herpes) or herpes simplex virus 2 (genital herpes).

Following a positive diagnosis, herpes is treated with antiviral medication. Treatment for the herpes simplex virus, however, differs significantly from that used to target other STDs like syphilis and HIV, which is why the CDC strongly encourages annual herpes screenings for those who are sexually active. According to the CDC, the number of genital herpes infections has remained stable over the past decade. While stable is more encouraging than increasing herpes rates, one million new genital herpes infections each year is far from ideal.