context: . Genital herpes is a highly contagious infection usually spread through intercourse with a person with infected sores. But it also can be passed through oral or anal sex. And although less likely, it still can be spread by viral shedding even if no sores are visible. Genital herpes can also be transmitted (spread) to a newborn during birth if the mother has an active infection. Usually, this infection is caused by the herpes simplex virus-2 ( HSV-2), although herpes simplex virus-1 ( HSV-1), the virus responsible for cold sores, is increasingly the cause of the disease. It can be spread by an infected partner who does not have any sores and may not know he or she has the disease. At least 45 million American adults and adolescents have genital herpes -- that's one out of every four to five people, making it one of the most common sexually transmitted diseases. Since the late 1970s, the number of Americans with genital herpes infection has increased 30%, mostly in teens and young adults. Genital herpes is more common in women than in men. Most people infected with genital herpes have very minimal or no signs or symptoms of their disease. The first attack of herpes usually follows this course: Skin on or near the sex organ becomes inflamed. Skin may burn, itch, or be painful. A small cluster of blister-like sores appear on the skin near the sex organs. Sores open, scab over, and then heal. Symptoms that may also be present when the virus first appears include: Swollen glands Fever Headache Burning when passing urine Muscle aches The first outbreak of herpes can last for several weeks. After the outbreak, the virus retreats to the nervous system, where it remains inactive until something triggers it to become active again. Typically, another outbreak can appear weeks or months after the first, but it almost always is less severe and shorter than the first episode. Although the infection can stay in the body indefinitely, the number of outbreaks tends to decrease over a period of years. It depends on the person. Some commonly reported triggers include: Stress Illness Surgery Vigorous sex Diet Monthly period Your doctor can diagnose genital herpes by visual inspection if the outbreak is typical and by examining a sample from the sore(s). But HSV infections can be difficult to diagnose between outbreaks. Your doctor may check for ulcers internally -- on the cervix in women and the urethra in men. Blood tests that detect HSV-1 or HSV-2 antibodies may be helpful, although the results are not always easy to interpret. There is no cure for genital herpes, but your doctor can prescribe anti-viral drugs that may help the sores heal faster. Over-the-counter painkillers may help with the discomfort. If recurrences of your genital herpes are frequent, your doctor may prescribe an antiviral medication [such as acyclovir ( Zovirax), famciclovir, ( Famvir), and valacyclovir ( Valtrex)], and to take on a regular basis to help suppress the outbreaks. Outbreaks of genital herpes during pregnancy have been associated with miscarriage, stillbirth, prematurity, and herpes infection that can cause severe brain injury and possible blindness in the baby. In most cases, women with herpes give birth to healthy babies. If you have herpes and plan to have children, talk to your doctor. To prevent getting genital herpes: Do not have sex with someone who has an open sore on his or her sex organs. Always use a condom during sex. Limit your number of sex partners. Taking antiviral medications can reduce the risk of a person with genital herpes from spreading the disease, but that doesn't eliminate the risk. Be sure to practice the measures listed above to decrease risk. There is no cure for herpes. Once a person has the virus, it remains in the body. The virus lies inactive in the nerve cells until something triggers it to become active again. These herpes "outbreaks," which can include the painful herpes sores, can be controlled with medication. Many people who find out that they have herpes feel depressed knowing that they will always have the virus and can give it to others. But you are not alone. If you have herpes, you should learn all that you can about the condition. Information will help you to manage the infection and feel better about yourself. It also helps to talk about your illness with a trusted friend. If you have herpes, you can still have sex if you or your partner use a condom and you tell your partner about the illness. You also can still have children.