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Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Most individuals infected with HSV-1 or HSV-2 experience either no symptoms or have very mild symptoms that go unnoticed or are mistaken for another skin condition.  Because of this, most people infected with HSV-2 are not aware of their infection.
Repeat outbreaks of genital herpes are common, in particular during the first year of infection. Genital herpes can cause painful genital sores in many adults and can be severe in people with suppressed immune systems.  If a person with genital herpes touches their sores or the fluids from the sores, they may transfer herpes to another part of the body. Some people who contract genital herpes have concerns about how it will impact their overall health, sex life, and relationships. There is no cure for herpes, but there are antiviral medications that can shorten and prevent outbreaks of sores as long as the person continues the medication. If you have herpes for the first time, visit your local clinic or doctor for a prescription of anti-viral tablets, works by preventing HSV from multiplying. You should visit your GP if you have been diagnosed with genital herpes before and are experiencing a recurrent outbreak.
If the symptoms are mild, your GP may suggest things you can do at home to help ease your symptoms without the need for treatment.
If your symptoms are more severe, you may be prescribed antiviral tablets (aciclovir), which you will need to take five times a day for five days.
If you have fewer than six recurrent outbreaks of genital herpes in a year, your GP may prescribe a five-day course of aciclovir each time you experience tingling or numbness before symptoms begin.
If you have more than six recurrent outbreaks of genital herpes in a year, or if your symptoms are particularly severe and causing you distress, you may need to take aciclovir every day as part of a long-term treatment plan. It is important to note that while suppressive treatment can reduce the risk of passing HSV on to your partner, it cannot prevent it altogether.
If you are experiencing recurrent outbreaks of genital herpes you should also consider being tested for HIV. This may be a sign of a weakened immune system (the body’s natural defence against infection and illness), which may indicate you have HIV. The surest way to avoid transmission of sexually transmitted diseases, including genital herpes, is to abstain from sexual contact, or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected. Persons with herpes should abstain from sexual activity with partners when sores or other symptoms of herpes are present.
If you suspect you might have contracted a STD, you can do  a self-test quiz, the STD Quiz.
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04-30 049 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Cheyenne, Wyoming THE ISSUES 1. It is mostly contagious in the incubation period of chickenpox which can last from 7 to 23 days. This infection is usually caused by the herpes simplex virus-2 (HSV-2) or the herpes simplex virus-1 (HSV-1), the virus usually responsible for cold sores. There is no cure for herpes, but there is treatment that can lessen symptoms and decrease the likelihood of passing it on to someone else. When symptoms do occur, they typically appear as one or more blisters on or around the genitals, rectum or mouth.
Symptoms of repeat outbreaks are typically shorter in duration and less severe than the first outbreak of genital herpes. It is best to talk to a health care provider about those concerns, but it also is important to recognize that while herpes is not curable, it is a manageable condition. However, it does not clear the virus from your body completely and does not have any effect once you stop taking it. Apply an ice pack wrapped in a flannel, or cold, wet, tea bags on the sores to help soothe pain and speed up the healing process. Apply petroleum jelly, such as Vaseline, or an anaesthetic (painkilling) cream, such as 5% lidocaine, to any blisters or ulcers to reduce the pain when you pass urine.
In this instance, it is likely you will need to take aciclovir twice a day for six to 12 months. It is important to know that even if a person does not have any symptoms, he or she can still infect sex partners. HSV-1 can also cause genital herpes. Herpes simplex virus 2 (HSV-2) is the most common cause of genital herpes, but it can also cause oral herpes. Although the infection can stay in the body indefinitely, the number of outbreaks tends to decrease over a period of years.
Since a genital herpes diagnosis may affect perceptions about existing or future sexual relationships, it is important to understand how to talk to sexual partners about STDs.
You will need to take a course of anti-viral tablets (for example aciclovir) for at least five days, or longer if you still have new blisters and open sores forming on your genital area when your treatment begins. This will help prevent blisters or ulcers from becoming infected and may encourage them to heal quicker. Sex partners of infected persons should be advised that they may become infected and they should use condoms to reduce the risk.
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Trends in HSV Types and Genital Herpes Genital herpes can be caused by either HSV-2 or HSV-1.
Experiencing these symptoms is sometimes referred to as having an “outbreak.” The first time someone has an outbreak they may also experience flu-like symptoms such as fever, body aches and swollen glands. Passing urine while sitting in a bath or while pouring water over your genitals may also help. Our goal as a team is to develop as softball players and build character within ourselves as well as represent our communities as responsible and classy individuals. In recent years, HSV-1 has become a significant cause in developed countries, including the United States.
REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD Stephen F.
Sylvester, Counsel INTRODUCTION The veteran served on active duty from October 1980 to October 1983. This case comes before the Board of Veterans’ Appeals (Board) on appeal of December 2002 and June 2003 decisions by the Department of Veterans Affairs (VA) Regional Office (RO) in Cheyenne, Wyoming, and a July 2004 decision by the VARO in Denver, Colorado. The risk of infection is highest during outbreak periods when there are visible sores and lesions.
Even though shingles virus is not considered to be a fully contagious disease, people with weak immune system, small children. Finally, for reasons which will become apparent, the appeal as to the issue of service connection for gonorrhea is being REMANDED to the RO via the Appeals Management Center (AMC) in Washington, D.C. Symptoms When genital herpes symptoms do appear, they are usually worse during the first outbreak than during recurring attacks.
FINDING OF FACT Genital herpes is not shown to have been present in service, or for many years thereafter, nor is it the result of any incident or incidents of the veteran’s period of active military service. CONCLUSION OF LAW Genital herpes was not incurred in or aggravated by active military service.
Herpes, Pregnancy, and Newborn Infants Herpes can pose serious risks for a pregnant woman and her baby.
The risk is greatest for mothers with a first-time infection, because the virus can be transmitted to the infant during childbirth. Guidelines from the American Academy of Pediatrics recommend using specific diagnostic tests for women in labor to determine the risk of transmission.
Babies born to mothers infected with genital herpes are treated with the antiviral drug acyclovir, which can help suppress the virus. REASONS AND BASES FOR FINDING AND CONCLUSION The Veterans Claims Assistance Act of 2000 (VCAA) Pub. Fixed ksthere was a kaposi sarcoma ks hhv words Sarcoma ks hhv during the timingthe slower. They include human herpes virus 8 (the cause of Kaposi sarcoma) and varicella-zoster virus (also known as herpes zoster, the virus responsible for shingles and chickenpox).
The word "herpes" comes from the Greek word "herpein," meaning "to creep." This refers to the unique characteristic pattern of all herpes viruses to creep along local nerve pathways to the nerve clusters at the end, where they remain in an inactive (dormant) state for variable periods of time. HSV-1 can also cause genital herpes, which is a sexually transmitted disease (STD). Herpes simplex virus 2 (HSV-2) is the usual cause of genital herpes, but it can also cause oral herpes. The notice requirements of the VCAA require VA to notify a veteran of any evidence that is necessary to substantiate his claim, as well as the evidence VA will attempt to obtain and which evidence he is responsible for providing. Until recently, the general rule was to assume that HSV-1 caused oral herpes and HSV-2 caused genital herpes.
It is now clear, however, that either type of herpes virus can be found in the genital or oral areas (or other sites). In fact, HSV-1 is now responsible for more than half of all new cases of genital herpes in developed countries. The Disease ProcessHerpes is transmitted through close skin-to-skin contact.
To infect people, the herpes simplex viruses (both HSV-1 and HSV-2) must get into the body through tiny injuries in the skin or through a mucous membrane, such as inside the mouth or on the genital or anal areas. The risk for infection is highest with direct contact of blisters or sores during an outbreak.
But the infection can also develop from contact with an infected partner who does not have visible sores or other symptoms. Once the virus has contact with the mucous membranes or skin wounds, it enters the nuclei of skin tissue cells and begins to replicate.
The virus is then transported from the nerve endings of the skin to clusters of nerve cells (ganglia) where it remains inactive (latent) for some period of time. Such notice must be provided to a claimant before the initial unfavorable decision on a claim for VA benefits by the agency of original jurisdiction (in this case, the RO). However, at some point, the virus wakes up and travels along nerve pathways to the surface the skin where it begins to multiply again. During this time, the virus can infect other people if it is passed along in body fluids or secretions.


Viral shedding may be accompanied by noticeable symptoms (outbreak) but it can also occur without causing symptoms (asymptomatic shedding).
In either case, a person is infectious during periods of viral shedding. Symptoms may appear as multiple small red bumps or patches that develop blisters.
However, the VCAA notice requirements may be satisfied if any errors in the timing or content of such notice are not prejudicial to the claimant. Certain triggers can wake up the virus from its dormant state and cause it to become active again.
In the present case, in correspondence of September 2002, the RO provided notice to the veteran regarding what information and evidence was needed to substantiate his claim for service connection, as well as what information and evidence should be submitted by him, what information and evidence would be obtained by VA, and the need for the veteran to advise VA of or submit any further evidence in his possession pertaining to his claim.
The record also reflects that VA has made reasonable efforts to obtain relevant records adequately identified by the veteran. In general, recurrent episodes of herpes cause less severe symptoms than the primary outbreak.
Specifically, the information and evidence that have been associated with the claims file includes the veteran’s service medical and personnel records, as well as VA and private inpatient and outpatient treatment records and evaluation reports. There is no indication that there is additional evidence to obtain, there is no additional notice that should be provided, and there has been a complete review of all the evidence without prejudice to the appellant. HSV-1 is the most prevalent form of herpes simplex virus, and infection is most likely to occur during preschool years. As such, there is no indication that there is any prejudice to the appellant by the order of events in this case.
People can get HSV-2 through genital contact or HSV-1 through mouth-to-genital contact with an infected partner. Any error in the sequence of events or content of the notice is not shown to have had any effect on the case, or to have caused injury to the claimant. Thus, any such error is harmless and does not prohibit consideration of this matter on the merits.
People with active symptoms of genital herpes are at very high risk for transmitting the infection.
Unfortunately, most cases of genital herpes infections occur when the virus is shedding but producing no symptoms. Most people either have no symptoms or do not recognize them when they appear. In the past, genital herpes was mostly caused by HSV-2, but HSV-1 genital infection is increasing.
There is also evidence that children today are less likely to get cold sores and become exposed to HSV-1 during childhood. Although the Board has an obligation to provide adequate reasons and bases supporting this decision, there is no requirement that the evidence submitted by the appellant or obtained on his behalf be discussed in detail.
Rather, the Board’s analysis below will focus specifically on what evidence is needed to substantiate each claim, and what the evidence in the claims file shows, or fails to show, with respect to each claim. Centers for Disease Control and Prevention (CDC), about 1 in 6 Americans ages 14 to 49 years have genital herpes.
While HSV-2 remains the main cause of genital herpes, HSV-1 has significantly increased as a cause, most likely because of oral-genital sex. African-American women are at particularly high risk. People with compromised immune systems, such as those who have HIV, are at very high risk for genital herpes.
The veteran in this case seeks service connection for genital herpes, or the residuals thereof. Drugs that suppress the immune system, and organ transplantation, can also weaken the immune system and increase the risk for contracting genital herpes.
In that regard, service connection may be established for disability resulting from disease or injury incurred in or aggravated by active military service. It is almost impossible to defend against the transmission of oral herpes, because it can be transmitted by very casual contact, including kissing. Still, you can help reduce the risk of transmitting oral herpes by not sharing objects that touch the mouth, such as eating and drinking utensils, toothbrushes, and towels.
Service connection may also be granted for any disease diagnosed after discharge, when all of the evidence establishes that the disease was incurred in service. It is best to refrain from any type of sex (vaginal, anal, or oral) during periods of active outbreak. However, herpes can also be transmitted when symptoms are not present (asymptomatic shedding).
Only water-based lubricants (K-Y Jelly, Astroglide, AquaLube, and glycerin) should be used. In the present case, service medical records are negative for history, complaints, or abnormal findings indicative of the presence of genital herpes.
Moreover, there is no indication that, at any time during the veteran’s period of active military service, or at service separation, he suffered from or received treatment for genital herpes. In point of fact, the earliest clinical indication of the presence of genital herpes is revealed by VA outpatient treatment records dated in November and December 2002, almost 20 years following the veteran’s discharge from service, at which time it was determined that chronic suppressive therapy in the form of acyclovir should be initiated for herpes genitalis. Significantly, at no time was it noted that the veteran’s herpetic lesions had their origin during his period of active military service. In reaching this determination, the Board has given due consideration to the request of the veteran’s accredited representative that the veteran be afforded a VA medical examination prior to a final adjudication of his claim. However, given the fact that there exists no evidence of genital herpes in service, or for many years following the veteran’s discharge, the Board is of the opinion that such an examination would serve no useful purpose.
It is very unlikely to transmit or contract genital herpes from a toilet seat or bath towel. Studies suggest that male circumcision may help reduce the risk of HSV-2, as well as human papillomavirus (HPV) and HIV infections. REMAND In addition to the above, the veteran in this case seeks service connection for gonorrhea, or the residuals thereof. In pertinent part, it is argued that the veteran’s claimed gonorrhea had its origin during his period of active military service. However, herpes can cause significant and widespread complications in people who don't have a fully functioning immune system. In that regard, the Board notes that, while in correspondence of September 2002, the veteran was provided VCAA-complying notice with regard to the issue of service connection for genital herpes, he has yet to be provided notice with regard to the issue of service connection for gonorrhea. Such notice is necessary prior to a final adjudication of the veteran’s claim for service connection for gonorrhea. The CDC recommends that all people diagnosed with herpes simplex virus 2 (HSV-2) get tested for HIV. Most people with HIV are co-infected with HSV-2 and are particularly vulnerable to its complications. The RO should review the veteran’s claims file, and ensure that all notification and development action required by the Veterans Claims Assistance Act of 2000 (VCAA) is complete with regard to the issue of service connection for gonorrhea, or residuals thereof. HSV-2 infection increases HIV levels in the genital tract, which makes it easier for the HIV virus to be spread to sexual partners. Herpes and PregnancyPregnant women who have genital herpes due to either HSV-2 or HSV-1 have an increased risk for miscarriage, premature labor, inhibited fetal growth, or transmission of the herpes infection to the infant in the uterus or at the time of delivery. Herpes in newborn babies (herpes neonatalis) can be a very serious condition. Fortunately, neonatal herpes is rare.
Although about 25 to 30% of pregnant women have genital herpes, less than 0.1% of babies are born with neonatal herpes. The baby is at greatest risk during a vaginal delivery, especially if the mother has an asymptomatic infection that was first introduced late in the pregnancy. Any pertinent VA or other inpatient or outpatient treatment records, subsequent to April 2004, the date of the most recent evidence of record, should then be obtained and incorporated in the claims folder.
The risk for transmission also increases if infants with infected mothers are born prematurely, there is invasive monitoring, or instruments are used during vaginal delivery. Transmission can occur if the amniotic membrane of an infected woman ruptures prematurely, or as the infant passes through an infected birth canal. The RO should then review the veteran’s claim for service connection for gonorrhea, or the residuals thereof. This risk is increased if the woman is having or has recently had an active herpes outbreak in the genital area. Very rarely, the virus is transmitted across the placenta, a form of the infection known as congenital herpes.
Should the benefit sought on appeal remain denied, the veteran and his representative should be provided with a Supplemental Statement of the Case (SSOC) and appropriate period of time should be allowed for response.
Also rarely, newborns may contract herpes during the first weeks of life from being kissed by someone with a herpes cold sore. Infants may get congenital herpes from a mother with an active herpes infection at the time of birth. Aggressive treatment with antiviral medication is required. Most infected pregnant women do not have a history of symptoms, so herpes infection is often not suspected or detected at the time of delivery.
Fortunately, if a woman does have genital lesions, rapid diagnostic blood tests can quickly determine her chances of transmitting the virus to her baby during delivery. The appellant has the right to submit additional evidence and argument on the matter or matters the Board has remanded. Some women with new or recurrent herpes may also be prescribed antiviral medication during pregnancy. A woman with herpes can usually safely breastfeed her baby, as long as she does not have a lesion on her breast or nipple. Neonatal herpes can spread to the brain and central nervous system, causing encephalitis and meningitis. Herpes can also spread to internal organs, such as the liver and lungs. Infants infected with herpes are treated with acyclovir, an antiviral drug. They usually receive several weeks of intravenous acyclovir treatment, followed by several months of oral acyclovir.
It is important to treat babies quickly, before the infection spreads to the brain and other organs.
Fortunately, rapid diagnostic tests and treatment with acyclovir have significantly improved survival rates and reduced complication rates. Nearly all who recover have some impairment, ranging from very mild neurological changes to paralysis. Like encephalitis, meningitis symptoms include headache, fever, stiff neck, vomiting, and sensitivity to light.
Fortunately, herpes meningitis usually resolves after about a week without complications, although symptoms can recur. Herpes Eye ComplicationsOcular herpes is a recurrent infection that affects the eyes. Herpes Skin ComplicationsEczema Herpeticum: A rare form of herpes infection called eczema herpeticum, also known as Kaposi varicelliform eruption, can affect people with skin disorders and those with a weakened immune system.


In children, this is often caused by thumb sucking or finger sucking while they have a cold sore. It can also occur in adult health care workers, such as dentists, because of increased exposure to the herpes virus.
The use of latex or polyurethane gloves prevents herpes whitlow in health care workers. SymptomsHerpes symptoms vary depending on whether the outbreak is initial or recurrent.
The primary outbreak is usually worse than recurrent outbreaks, with more severe and prolonged symptoms. In fact, studies indicate that 10 to 25% of people infected with HSV-2 are unaware that they have genital herpes. The first signs are a tingling sensation in the affected areas (genitalia, buttocks, and thighs) and groups of small red bumps that develop into blisters. The sores may sometimes itch, but itching decreases as they heal. 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, and fever. Some women may have difficulty urinating and may, occasionally, require a urinary catheter. The virus sheds for a much shorter period of time (about 3 days) compared to an initial outbreak of 3 weeks. Women may have only minor itching, and the symptoms may be even milder in men. On average, people have about four recurrences during the first year, although this varies widely. There are some differences in frequency of recurrence depending on whether HSV-2 or HSV-1 caused genital herpes. HSV-2 genital infection is more likely to cause recurrences than HSV-1. Symptoms of Oral Herpes Oral herpes (herpes labialis) is most often caused by HSV-1, but it can also be caused by HSV-2. It usually affects the lips and, in some primary attacks, the mucus membranes in the mouth.
The sores last 10 to 14 days and can be very uncomfortable. Blisters that may be preceded or accompanied by sore throat, fever, swollen glands, and painful swallowing. Recurrent Oral Herpes Infection: A recurrent oral herpes infection is much milder than the primary outbreak.
It usually manifests as a single sore, commonly called a cold sore or fever blister (because it may arise during a bout of cold or flu).
The sore usually shows up on the outer edge of the lips and rarely affects the gums or throat.
Recurrences of genital herpes are more likely with HSV-2 infection than with HSV-1 infection. 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. They 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.
The good news is that in most healthy people, recurring infections tend to become progressively less frequent, and less severe, over time. However, other conditions can resemble herpes, and doctors cannot base a herpes diagnosis on visual inspection alone.
These tests include: Virologic tests (viral culture of the lesion) Serologic tests (blood tests that detect antibodies) The CDC recommends that both virologic and serologic tests be used for diagnosing genital herpes. People diagnosed with genital herpes should also be tested for other sexually transmitted diseases. At this time, experts do not recommend screening for HSV-1 or HSV-2 in the general population. Genital herpes can be caused by either HSV-1 or HSV-2. It is important to determine which virus is involved, as the type of herpes infection influences prognosis and treatment recommendations. Recurrences of genital herpes, and viral shedding without overt symptoms, are much less frequent with HSV-1 infection than with HSV-2. False-negative (testing negative when herpes infection is actually present) or false-positive (testing positive when herpes infection is not actually present) results can occur. Your health care provider may recommend that you have a test repeated. Virologic TestsViral culture tests are made by taking a fluid sample, or culture, from the lesions as early as possible, ideally within the first 48 hours of the outbreak. PCR tests are much faster and more accurate than viral cultures, and the CDC recommends PCR for detecting herpes in spinal fluid when diagnosing herpes encephalitis. PCR can make many copies of the virus' DNA, so that even small amounts of DNA in the sample can be detected. However, many labs now use PCR for herpes testing because it is highly accurate. An older type of virologic testing, the Tzanck smear test, uses scrapings from herpes lesions. The scrapings are stained and examined under a microscope for the presence of giant cells with many nuclei or distinctive particles that carry the virus (called inclusion bodies).
The Tzanck test is not reliable for providing a conclusive diagnosis of herpes infection and is not recommended by the CDC. Serologic TestsSerologic (blood) tests can identify antibodies that are specific for either HSV-1 or HSV-2.
When the herpes virus infects you, your body's immune system produces specific antibodies to fight off the infection. If a blood test detects antibodies to herpes, it is evidence that you have been infected with the virus, even if the virus is in a non-active (dormant) state. The presence of antibodies to herpes also indicates that you are a carrier of the virus and might transmit it to others. Serologic tests can be especially useful for people who do not have active symptoms, but who have other risk factors for herpes (such as other STDs, multiple sex partners, or a monogamous partner who has genital herpes). Although glycoprotein (gG) type-specific tests have been available for many years, many of the older nontype-specific tests that cannot distinguish HSV-1 from HSV-2 are still on the market. Canker sores frequently crop up singly or in groups on the inside of the mouth, or on or underneath the tongue.
They usually heal within 2 weeks without treatment. Canker sores (Aphthous ulcers) are very common. The drugs are used initially to treat a first attack of herpes, and then afterward to either treat recurrent outbreaks (episodic therapy) or reduce frequency of recurrences (suppressive therapy).
Drugs can, however, reduce the severity of symptoms, improve healing times, and prevent recurrences.
If people experience very severe disease or complications, they need to be hospitalized and receive an antiviral drug intravenously. Your health care provider will prescribe one of the three antiviral medications, which you will take for 7 to 10 days. You should begin the medication as soon as you notice any signs or symptoms of herpes, preferably during the prodrome stage that precedes the outbreak of lesions.
If taken during prodrome, episodic therapy may help prevent an outbreak from occurring or reduce its severity. Valacyclovir is taken once a day. Suppressive treatment can reduce the frequency of outbreak recurrences by 70 to 80%.
It is generally recommended for people who have frequent recurrences (6 or more outbreaks per year). Because herpes recurrences often diminish over time, you should discuss annually with your health care provider whether you should stay with drug therapy or discontinue it. While taking any suppressive therapy for genital herpes, it is still important to regularly use latex condoms and to avoid any sexual activity during recurrences. A new form of acyclovir (Sitavig) is administered orally as an adhesive tablet; it is applied to the gum region of the mouth, where it dissolves during the course of the day. In addition, acyclovir is available in topical form, as is the related drug penciclovir (Denavir). Topical TreatmentsThese ointments or creams can help shorten healing time and duration of symptoms. However, none are truly effective at eliminating outbreaks. Penciclovir (Denavir) heals HSV-1 sores on average about half a day faster than without treatment, stops viral shedding, and reduces the duration of pain. Ideally, you should apply the cream within the first hour of symptoms, although the medication can still help if applied later.
Apply the cream 5 times a day, beginning at the first sign of tingling or pain. Over-the-counter topical ointments may provide modest relief.
They include Anbesol gel, Blistex lip ointment, Camphophenique, Herpecin-L, Viractin, and Zilactin. Some contain a topical anesthetic such as benzocaine, tetracaine, or phenol. Lip balm that contains sunblock, or sunscreen applied around the lips may help prevent sun-triggered outbreaks.
Herbs and SupplementsGenerally, manufacturers of herbal remedies and dietary supplements do not need FDA approval to sell their products. Just like a drug, herbs and supplements can affect the body's chemistry, and therefore have the potential to produce side effects that may be harmful. There have been several reported cases of serious and even lethal side effects from herbal products. Always check with your provider before using any herbal remedies or dietary supplements. Many herbal and dietary supplement products claim to help fight herpes infection by boosting the immune system. There has been little research on these products, and little evidence to show that they really work.
Epidemiology, clinical presentation, and antibody response to primary infection with herpes simplex virus type 1 and type 2 in young women. Seroprevalence of herpes simplex virus type 2 among persons aged 14 - 49 years -- United States, 2005-2008. Guidance on management of asymptomatic neonates born to women with active genital herpes lesions.
Epub 2013 Jan 28. Martin ET, Krantz E, Gottlieb SL, Magaret AS, Langenberg A, Stanberry L, et al.
Genital shedding of herpes simplex virus among symptomatic and asymptomatic persons with HSV-2 infection.



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