Genital warts (Human Papillomavirus [HPV])
What are genital warts (HPV)?
Genital warts are caused by the human papillomavirus (HPV) and are the most common sexually-transmitted infection (STI). There are more than 100 types of HPV. A diagnosis may be made based on the typical clinical presentation. However, many people infected with HPV do not have noticeable symptoms and do not know they are infected. Some types of HPV are associated with cervical dysplasia (abnormal cell growth) and cancer. However, these types of HPV do not cause genital warts.
Signs and symptoms
- Single or multiple soft, fleshy, painless growths/bumps anywhere on or around the genitalia. They can be small or large, raised or flat.
- HPV may also infect the mouth and throat, although this is rare.
- Generally symptoms are minor or not present at all.
Incubation period
Variable
Contagious period and spread
Genital warts are transmitted through sexual contact: oral, anal, and vaginal. Once a person is infected, they may spread the infection to others throughout their life.
Public health reporting requirements
- Cases of genital warts or HPV infections are not reportable to public health.
- The possibility of sexual abuse must be considered when infections occur in prepubescent children and must be reported to appropriate authorities.
Control of spread
- People with infection should be examined by a health care provider and should seek medical care if symptoms persist or recur. Parental consent is not required for minors to be examined and treated.
- Sexual activity should be avoided if a person has signs and symptoms.
- People with infection should abstain from sex or use condoms to prevent future infections.
Vaccination
Routine child/adolescent recommendations:
- The HPV vaccination series is routinely recommended at age 11 and 12 years, but can be started as early as 9 years. The vaccine is given in two or three doses depending on the age vaccinations is initiated. It is important to get all recommended doses to get the best protection.
- There are more than 100 types of HPV. The available vaccine protects against the nine HPV types that cause most HPV cancers and genital warts.
- HPV vaccination prevents new HPV infections but does not treat existing HPV infections or diseases.
- HPV vaccine works best when given before any exposure to HPV.
Colorado school-required vaccines:
- There is no school vaccine requirement for HPV vaccine.
Routine adult/other recommendations:
- HPV vaccination is recommended through age 26.
- Most adults aged 27 and older do not need the HPV vaccine.
- Adults aged 27-45 may receive the HPV vaccination based on shared-clinical decision making with their health care provider.
Treatment
There is no treatment for HPV, but visible genital warts can be physically removed by a health care provider. Wart removal does not eradicate HPV. However, it will decrease the amount of virus shedding that may limit transmission. Removal regimens include cryotherapy, electrodessication, electrocautery, or other topical treatments.
Exclusion
No exclusions or environmental interventions are necessary. STIs require close intimate physical contact for transmission, virtually always of a sexual nature.
Role of teachers, caregivers, and family
- Encourage routine vaccination.
- General education about sexual health and STI prevention is recommended.
- Infections in prepubescent children and other high-risk individuals must be reported to appropriate authorities to address the possibility of sexual abuse.