1.Q: Is genital herpes a sexually transmitted disease? A: Genital herpes is mainly caused by herpes simplex virus HSV-II. The disease is clearly defined as one of the sexually transmitted diseases, both domestically and abroad. In foreign countries, the incidence of genital herpes ranks third in STD incidence after gonorrhea and syphilis, and takes the first place among STDs caused by viruses. In China, genital herpes is also showing a rising trend year by year. 2. Q: What is herpes simplex virus? What is the typology? A: Herpes simplex virus (HSV) is an NDA virus with a diameter of about 120-150 microns, consisting of three concentric structures in the order of envelope, body and capsid. Humans are the only natural hosts of herpes simplex virus, with up to 80-90% of the population infected and 10% asymptomatic. Herpes simplex virus is particularly sensitive to ether and lipid solvents. It can survive for months at low temperatures and can be destroyed in 30 minutes at 50°C in humid heat and 90°C in dry conditions. Herpes simplex virus can be divided into two types, HSV-Ⅰ and HSV-Ⅱ, depending on antigenicity. HSV-Ⅰ is mainly transmitted through close contact with the respiratory tract, skin and mucous membranes, and infects skin mucous membranes and organs above the waist, such as causing inflammation and herpes in the mucous membranes of the mouth and lips, nasal vestibule, conjunctiva, and pharynx. Herpes occurring around the mouth and orifice is 99% caused by HSV-Ⅰ infection. HSV-Ⅱ mainly exists in the cervix, vagina, vulvar skin of women and penis and urethra of men, and is the culprit of genital inflammation and herpes. According to statistics, there is also a crossover between the infection sites of these 2 types of viruses. 90% of the pathogens of genital herpes are type II herpes viruses, and only 10% are HSV-Ⅰ. 3.Q: How is herpes simplex virus transmitted? A: Herpes simplex virus is mainly transmitted through direct close contact and sexual contact, HSV exists in the herpes fluid, oral and nasal secretions and feces of the infected person, among which herpes type II virus is mainly found in the cervix, vagina, vulva skin of women and penis and urethra of men. 4.Q: How is genital herpes transmitted? A: Genital herpes is transmitted from symptomatic patients and asymptomatic infections. Asymptomatic infections and atypical patients are the main source of infection for the disease. Most people with genital herpes contract the disease during sexual contact with sexual partners who are often unaware that they have genital herpes. It is highly contagious when symptomatic, while asymptomatic infections and the asymptomatic phase of recurrent patients can also be contagious. Genital herpes is transmitted through sexual contact and mother-to-child and mother-to-fetus transmission. Sexual contact transmission is the main route of transmission and includes genital intercourse, oral sex and anal sex. Vertical transmission refers to mother-to-infant and mother-to-fetus transmission, including intrauterine infection and infection through the birth canal. Herpes simplex virus is present in the cervix, vagina, urethra, vulva and anus of female patients and in the penis, urethra, anus and semen of male patients. When the mucous membrane of the skin of the sexual organs is rubbed during sexual intercourse, virus particles can enter the skin mucous membrane cells through tiny fissures that cannot be detected by the naked eye, and the virus replicates and multiplies within the cells and destroys them, thus damaging the skin mucous membrane. Barrier contraception such as condoms can greatly reduce the risk of transmission of genital herpes (especially asymptomatic genital herpes), but infection can occur during sexual intercourse with skin lesions, even if condoms are used. Herpes simplex virus vaccination is the best way to prevent genital herpes, but the herpes simplex virus vaccine is currently only in clinical trials in a few countries, including the United States. Therefore, as with other STDs, being clean and eliminating multiple partners is a fundamental measure to prevent genital herpes. 5. Q: What is an asymptomatic HSV infected person? Is it necessary to have symptoms to be infected? A: Not every infected person will show discomfort or clinical manifestations after HSV infection, only 10-20% of patients have symptoms, and the virus is still active in patients without symptoms, so more than 70% of HSV transmission is caused by asymptomatic patients. This is the reason why HSV transmission is increasing year by year and is difficult to control. According to foreign studies 45% of HSV-infected patients never realize they are HSV patients. Therefore, even patients with no clinical symptoms may infect people. 6.Q: What is the incubation period of herpes simplex? A: HSV invades mucous membranes or broken skin, and after an incubation period of about 1~26 days (average 5~7 days), it produces erythema, papules and blistering damage at the invasion site. The incubation period of individual patients can be several months. 7. Q: Will herpes simplex virus infection in pregnant women affect the fetus? A: The fetus may be infected through the placenta during pregnancy and through the birth canal during delivery. Occult infection is common, with only 10-20% of first-time infections showing symptoms. Initial HSV infection in pregnant women is more likely to affect the fetus or newborn than recurrent pregnancies, mainly because recurrent pregnancies already have antibodies to the virus in their bodies. Intrauterine herpes infection in the fetus can lead to miscarriage, preterm delivery, stillbirth and birth defects. Pregnant women infected with the virus deliver newborns through the birth canal, causing neonatal herpes, resulting in neonatal encephalitis with a high mortality rate (70-80%) and survivors mostly suffering from central nervous system sequelae. 8.Q: Why is genital herpes easy to recur? A: Herpes simplex infection produces neutralizing antibodies and complement binding antibodies in the body after 1-3 weeks, and the residual virus may transfer to the peripheral nerves along the nerve axis into the trigeminal ganglion (herpes virus type I) or sacral ganglion (herpes virus type II), while incubating for a long time and entering a quiescent state. When some triggering factors such as anxiety, trauma, cold, trauma, infection, drug allergy, high fever, menstruation, pregnancy, etc. disrupt the body’s physiological balance, specific transcriptase required for virus proliferation appears in the nerve cells, activating the virus and causing recurrence. humoral antibodies do not stop herpes virus recurrence, and weakened cellular immunity has a significant impact on recurrence. the recurrence rate of genital herpes in HSV-1 infection is much higher than that in The recurrence rate of genital herpes with HSV-2 infection is much lower than that of genital herpes with HSV-2 infection. 9. Q: What are the manifestations of HSV infection? A: HSV-I is mainly transmitted through close contact with the respiratory tract, skin and mucous membranes, and infects the skin mucous membranes and organs above the waist. Such as causing inflammation and herpes in the mucous membrane of the mouth and lips, nasal vestibule, conjunctiva, pharynx, herpes around the mouth and mouth, 99% is caused by herpes virus type I infection. It is also known as “fire” in China. In men, HSV-II is found on the glans, coronal sulcus, urethra, penis, scrotum, thighs and buttocks. In women, it is more common in the labia, mons pubis, clitoris, perianal area or vagina. In about 90% of patients, the virus may also invade the cervix, presenting with increased vaginal discharge or lower abdominal pain, and may be complicated by cervicitis and uterine inflammation. Most patients of both sexes have bilateral enlarged inguinal lymph nodes. In later stages, when the inflammation spreads to the urethra and bladder, there may be difficulty in urination, painful urination, frequent urination, and in severe cases, urinary retention. In addition, there may be other symptoms present at the same time, such as fever, general malaise, headache, cervical tonicity, meningitis, and sacral neurological insufficiency. The disease is more common in women than in men, and the symptoms are more severe than in men. 10.Q: What are the typical manifestations of genital herpes? A: When first infected with the genital herpes virus, the incubation period is usually about 2-10 days from the time of contact to the onset of the disease. The site first has a burning sensation, and soon 3-10 red papules occur in clusters on the basis of erythema, accompanied by itching, and the papules soon become small blisters, which turn into pustules after 3-5 days and form large vesicles and ulcers after breaking down, with self-conscious pain, and finally crusting and healing. The entire course of the disease can last about 20 days. Between 50% and 70% of patients with genital herpes do not show any symptoms. Among patients with genital herpes, male homosexuals can develop anorectal infection with rectal herpes virus type II, which is second only to gonococcal anorectitis in men. The clinical manifestations are severe anorectal pain, constipation, pus discharge and urgency, and blisters and ulcers in the anus. 11.Q: What is the significance of herpes simplex virus typing test? A: Herpes simplex has a high infection rate, latent infection and transmission increasing year by year and difficult to control the epidemic trend. For pregnant women and perinatal women: detection of herpes simplex can prevent the birth of unhealthy and mentally retarded children; reduce the incidence of neonatal herpes; and provide a reference for the choice of caesarean section. For sexually active people: testing can reduce sexual contact infections. Testing of immunocompromised populations may prevent hepatitis and pediatric encephalitis in immunocompetent children and reduce mortality from acute episodes of herpes simplex in patients using immunosuppressive drugs. Because of the cross-infection that can occur between HSV-I and HSV-II and the differences in the severity of disease and illness that each causes, it is increasingly important to provide clinical typing for diagnosis. Treatment options and prognosis differ for different types of herpes virus infections. Approximately 90% of people with first genital herpes HSV-II infection will experience a recurrence within 12 months (average of 4 recurrences), whereas only 50% of people with first HSV-Ⅰ infection experience a similar recurrence (average of less than 1 recurrence). recurrence rates for HSV-II infection are highly variable, with most recurrences occurring 5-9 times per year, usually within 1-6 months after the primary herpes has subsided.