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About 40% of men and 70% of women develop other symptoms during initial outbreaks of genital herpes, such as flu-like discomfort, headache, muscle aches, fever, and swollen glands.
On average, people have about four recurrences during the first year, although this varies widely. Oral herpes (herpes labialis) is most often caused by herpes simplex virus 1 (HSV-1) but can also be caused by herpes simplex virus 1 (HSV-2). The blisters eventually rupture as painful open sores, develop a yellowish membrane before healing, and disappear within 3 - 14 days. Rarely, the infection may be accompanied by difficulty in swallowing, chills, muscle pain, or hearing loss.
It is not completely known what triggers renewed infection, but several different factors may be involved.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.
Sexually Transmitted Infections Toward effective prevention, diagnosis and treatment Building awareness In Canada and around the world, the trend is clear: sexually transmitted infections (STIs) are on the rise. Sexually Transmitted Infections Toward effective prevention, diagnosis and treatment Informing your partner Critical to prevent further spread of STIs and prevent complications. Sexually Transmitted Infections Toward effective prevention, diagnosis and treatment Precautions It is recommended that infected individuals and their sexual partner(s) abstain from sexual activity until: treatment is complete (for treatable STIs) symptoms have subsided the infection is cured (for curable STIs, confirmed through follow-up testing, as appropriate). Chlamydia Bacterial An often-asymptomatic infection That can lead to reproductive complications What is it? Gonorrhea Bacterial An often-asymptomatic infection That can lead to reproductive complications What is it? Syphilis Bacterial A staged STI once considered rare in Canada, but now on the rise What is it? Syphilis Bacterial Secondary syphilis A person may develop a range of symptoms from two to 24 weeks after exposure, most commonly: A general feeling of being unwell A rash anywhere on the body but classically on the palms of the hands or soles of the feet Patchy hair loss Flat, smooth warts in the genital area (not the same as those caused by HPV) Early latent syphilis Is generally asymptomatic, but for the first year after infection lesions or rashes of primary or secondary syphilis can recur and the infection can be transmitted. Syphilis Bacterial Considerations and possible complications Syphilis increases the risk of transmitting or becoming infected with HIV Response to treatment must be monitored over time to ensure effectiveness, especially in HIV-infected individuals In individuals with HIV co-infection, symptoms may be modified. Genital Herpes Viral A very common viral infection that can cause genital and anal sores What is it? Hepatitis B Viral Considerations and possible complications All sexual and household contacts of people with hepatitis B should be advised to be vaccinated to prevent infection Chronic hepatitis B can lead to severe liver damage including cirrhosis (scarring of the liver) and cancer Individuals who develop chronic hepatitis B infection require liver-function monitoring and may benefit from treatment with interferon or an anti-viral medication Babies born to mothers with hepatitis B are at a high risk of becoming chronic carriers. HIV (Human Immunodeficiency Virus) Viral A virus that attacks the body’s immune system, leaving infected individuals unable to ward off other illnesses What is it?
HPV (Human Papillomavirus) Viral A very common viral infection that can cause anogenital warts and cervical cancer What is it?
For patients with symptoms, the first outbreak usually occurs in or around the genital area 1 - 2 weeks after sexual exposure to the virus.
It usually affects the lips and, in some primary attacks, the mucous membranes in the mouth. If the primary (initial) oral infection causes symptoms, they can be very painful, particularly in small children.
In adolescents, the primary infection is more apt to appear in the upper part of the throat and cause soreness.

The outbreak of infection is often preceded by a prodrome, an early group of symptoms that may include itching skin, pain, or an abnormal tingling sensation at the site of infection. Recurrent outbreaks of herpes simplex virus (HSV) feature most of the same symptoms at the same sites as the primary attack, but they tend to be milder and briefer. These include sunlight, wind, fever, physical injury, surgery, menstruation, suppression of the immune system, and emotional stress.
For most people, outbreaks recur with more frequency during the first year after an initial attack. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Current and previous partner(s) are to be made aware so they can seek medical attention, and treatment if needed. In the case of viral STIs, a health care provider can offer safer-sex and risk-reduction tips to prevent transmission.
The most common bacterial sexually transmitted infection Greatest number of infections found in people 15 to 24 years old Can affect the cervix and urethra, and occasionally the rectum, throat, and eye How is chlamydia transmitted? The second most common bacterial STI Two-thirds of reported cases in Canada are in men Most common in individuals 15 to 29 years Can affect the cervix, urethra, rectum, throat, and occasionally the eyes Often occurs as a co-infection with chlamydia How is gonorrhea transmitted?
An infection sometimes called the great imitator because symptoms mirror those of some common medical conditions Progresses in stages Infectious in the first year after contraction How is syphilis transmitted? Primary syphilis Three days to three months after exposure, infected individuals develop a small painless sore called a chancre.
A longer course of treatment and closer follow-up post-treatment may be required Untreated syphilis may lead to tertiary syphilis, which can damage: The cardiovascular system (heart and blood vessels) The neurological system Other major organs of the body Complications of tertiary syphilis may lead to death. Through direct vaginal, oral or anal sexual contact with an infected partner By receiving oral sex from a partner with a history of cold sores Through asymptomatic shedding (transmission of the virus when there are no symptoms or lesions) From an infected woman to her infant during pregnancy or birth Less commonly through fomite transmission—contact with contaminated objects such as towels Condoms have limited effectiveness at preventing infection as they do not cover the entire genital area.
A virus that affects the liver A virus found in blood and body fluids including the vaginal secretions, semen, breast milk and saliva of infected individuals Most infected people (90%) naturally produce antibodies to fight the disease, but some develop chronic hepatitis B; they carry the virus all their lives and are infectious for life Chronic infection can significantly damage the liver Most common in developing countries How is hepatitis B transmitted? Virus that destroys cells critical to a person’s immune system, robbing the body of its ability to fight other infections and illnesses. Two to four weeks after exposure, some infected individuals may experience mild flu-like symptoms that last a few weeks then disappear.
Partner notification is important; infected individuals should seek guidance from their healthcare providers. One of the most common sexually transmitted infections There are over 100 types of HPV; 40 can cause anogenital infection It is estimated that 75% of the adult population will have at least one HPV infection during their lifetime Low-risk HPV types cause anogenital warts and other benign lesions High-risk HPV types are associated with cancer (mainly of the cervix) Vaccination is available to prevent certain types of HPV Most HPV infections clear on their own within one to two years How is HPV transmitted?
Many individuals infected with low-risk types have no symptoms (do not develop visible warts or lesions) In some people, anogenital warts develop within one to eight months on the vulva, cervix, penis, scrotum, anus or in the urethra. 75% of women develop vaginal candidiasis at least once in their lifetime Candida can also affect the mouth, esophagus, skin or blood. The first signs are a tingling sensation in the affected areas (such as genitalia, buttocks, and thighs) and groups of small red bumps that develop into blisters. The virus sheds for a much shorter period of time (about 3 days) compared to in an initial outbreak of 3 weeks.
There are some differences in frequency of recurrence depending on whether HSV-2 or HSV-1 causes genital herpes.

A herpes infection may occur on the cheeks or in the nose, but facial herpes is very uncommon. Oral herpes can be provoked within about 3 days of intense dental work, particularly root canal or tooth extraction. During that period, the body mounts an immune response to HSV, and in most healthy people recurring infections tend to become progressively less severe and less frequent.
With the right information, individuals can make informed choices and better protect themselves and their partners. Support is available A health care provider can contact your partner(s) if you feel uncomfortable doing it yourself. Condoms are important to reduce the risk of transmission, even if other methods of birth control are being used to prevent pregnancy.
Gonorrhea can be spread through unprotected oral, vaginal or anal sex with an infected partner Penetration and ejaculation are not required for transmission.
Atypical signs and symptoms (without lesions) Genital pain, urethritis, aseptic meningitis or cervicitis. Through anal, vaginal or oral sex with an infected person Through exposure to infected blood or blood products (e.g. The prodrome, which may last as short as 2 hours or as long as 2 days, stops when the blisters develop.
Occasionally, the symptoms may not resemble those of the primary episode but appear as fissures and scrapes in the skin or as general inflammation around the affected area.
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This is done confidentially, meaning the patient’s name is never revealed to notified partners. It can be passed from an infected mother to her infant during birth, causing an eye infection.
Once the immune system is weakened, the following may develop: Frequent fever or sweats Joint or muscle pain Persistent skin rashes Swollen glands Sore throat Fatigue or lack of energy Headaches Rapid, unexplained weight loss Nausea, vomiting, or diarrhea A blood test to check for HIV antibodies is the only way to detect HIV infection.
In fact, studies indicate that 10 - 25% of people infected with HSV-2 are unaware that they have genital herpes. The chancre is painless and can be missed easily; while it heals on its own without treatment, the infection remains. Even if infected people have mild or no symptoms, they can still transmit the herpes virus.
Any duplication or distribution of the information contained herein is strictly prohibited. Individuals who suspect they may have been infected should be encouraged to seek medical attention immediately, rather than waiting for the onset of visible symptoms. Anyone at high risk who tests negative initially should retest three months later for certainty.

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