Infection usually spreads from person to person as a result of intercourse or oral sex during this acute phase, but the virus can spread even when no sign of the disease is present. It is also possible to be infected through towels and toilet seats. Many people infected with the virus have never had an outbreak yet can still pass it on to their sexual partners, and newborns can be infected during birth. Herpes promotes the spread of HIV by giving it direct access to the bloodstream. Changes in sexual practices, primarily the increased prevalence of oral sex, have caused a crossover between the two strains of herpes virus, and now HSV I is found in the genital area and HSV II is found around the mouth.
Symptoms vary from person to person.
An outbreak usually begins with an itching inflammation and progresses to tiny blisters that leak fluid and crust over within three weeks. Most infected individuals have outbreaks only once or twice a year with minor pain and itching, but others have recurrent incidents of painful ulcers. Additional symptoms include swollen lymph nodes, painful urination, and urethral or vaginal discharge. Stress appears to be a factor in the number and severity of episodes. Studies show that as many as one-half of all infected persons will have no symptoms whatsoever.