The herpes viruses that cause genital herpes outbreaks, herpes simplex 1 and herpes simplex 2, are members of the herpesvirus family--which is also responsible for chickenpox, shingles and the Epstein-Barr virus that causes mono. To understand why it's difficult, if not impossible, to predict how long HSV-1 and HSV-2 can lay dormant, it's important to understand the nature of these viruses. Once HSV enters the body--usually through a vulnerable part of the skin, such as the mouth or the genital area--it travels to certain nerve ganglia, where it "sleeps" until something triggers it into action. It then travels down the neural pathways to the initial site of infection, and an outbreak usually occurs--although not always. Most people acquire HSV-2 through genital-to-genital contact, but around 10 per cent of genital herpes cases are the result of HSV-1, which is passed to an uninfected partner orally by a partner with oral herpes caused by HSV-1.
Some people can have HSV for months or even years without experiencing an outbreak, while others note an outbreak almost immediately after acquiring HSV. The Mayo Clinic notes that it's possible for someone who experiences an initial outbreak to go 40 years before they have another.
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When HSV Wakes Up
Centers for Disease Control statistics indicate that up to 90 per cent of people infected with herpes don't even know it because they experience very mild symptoms of herpes, or sometimes none. However, if someone has an initial outbreak, this most often occurs within two weeks of acquiring HSV from a sexual partner. Initial genital outbreaks, typically accompanied by full-body symptoms such as a headache, aching joints and swollen glands--similar to those noted during a case of the flu--last between two and four weeks. The CDC states that most people who note initial outbreaks can expect to experience around five or six subsequent outbreaks during the rest of the year, although these will be shorter and less severe. People who live with herpes may notice certain triggers that precede subsequent outbreaks, such as stress, excessive fatigue or illness.
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Even when the virus is triggered, some people may note no physical symptoms at all, according to the American Social Health Association. Often, the physical presentation of genital herpes may be so innocuous, it goes undetected, or lesions are written off as something else--a yeast infection, insect bite or a reaction to spermicide or condoms. However, even in absence of lesions, when HSV "wakes up," it results in asymptomatic shedding of the virus, during which time an infected person can pass the virus onto uninfected partners through small cracks in the skin. Genital herpes symptoms can also go undetected because many people who acquire HSV-2 through sexual intercourse already have the HSV-1 that causes oral herpes, also known as fever blisters and cold sores. Once infected with HSV-1, the body begins to produce antibodies to fend off other types of HSV.
Mayo Clinic experts have determined that around 70 per cent of all cases of genital herpes were acquired when an infected partner showed no physical signs or symptoms, but when HSV was actively shedding. Herpes has medical treatments, but no cure. Because this is a highly-contagious sexually transmitted disease, the Mayo Clinic advocates regular and correct use of Latex condoms. Sexually-active individuals who are infected with HSV-1 or HSV-2 that cause genital herpes are encouraged to use prescription oral antiviral medications on a daily basis to suppress herpes outbreaks.
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