Herpes Simplex

Herpes

Herpes simplex is the name of a virus, and there are two types: herpes simplex 1 (HSV-1) and herpes simplex 2 (HSV-2). Herpes simplex is more commonly known as herpes.

HSV-1 generally causes most sores around the mouth, lips, and nose (also called cold sores or fever sores), although infections with HSV-2 are becoming more common. HSV-2 typically causes most cases of genital herpes, although these can also be caused by HSV-1.

What causes herpes simplex infections?

Herpes simplex is a virus that is a type of infecting organism that can only replicate inside the cells of a living host. Experts believe herpes simplex has been around since before the existence of man and estimate that around 67% of the population under the age of 50 is already infected with HSV-1.

Herpes infections are passed on by direct contact with secretions or sores on the skin. HSV-1 is usually spread through kissing or by sharing objects such as toothbrushes or eating utensils.

Generally, HSV-2 is spread by sexual contact; however, both HSV-1 and HSV-2 infections can be spread even if a person is currently not having any symptoms; however, this is infrequent as the amount of virus shed by inactive lesions is 100 to 1000 times less than active lesions.

HSV-1 can also be acquired through a minor break to the skin, for example, a health care worker may develop herpetic whitlow which is when the virus enters the cuticle of the fingernails.

Genital herpes can also be passed onto a baby during birth if the mother is infected during pregnancy. This is called birth-acquired herpes.

In people who already have the virus, it can be reactivated by the following conditions:

  • General illness
  • Surgery
  • Dental work to the mouth
  • Trauma to the affected area, such as sexual activity
  • Immunosuppression
  • Menstruation
  • Stress.

What are the symptoms of herpes simplex infection?

Symptoms that occur when the HSV-1 virus first enters your body can be significantly different from subsequent infections. The initial infection most commonly happens during childhood and usually causes inflammation of the roof of the mouth, inner cheeks, and gums, which swell and bleed easily. Other symptoms may include a high fever, excessive dribbling, and whitish-yellowish ulcers in the mouth or on the tongue.

Reactivation of the virus causes cold sores (also called fever blisters) to develop. Symptoms may include:

  • Tingling in an area followed by the appearance of a fluid-filled blister on the lips or bottom edge of the nose
  • This blister pops to form a cluster of fluid-filled pockets
  • Sometimes a sore throat, fever, or swollen lymph nodes in the neck.

HSV-2 infections are usually transmitted sexually and are more common after puberty. HSV-2 infections most commonly cause genital herpes. Genital herpes is one of the most common sexually transmitted infections in the United States. Many people don’t know they have it as symptoms may be mild and go unnoticed. Symptoms may include painful vesicles, ulcers, redness and swelling in the area that lasts for 2 to 3 weeks, if untreated. Fever and swollen lymph nodes in the pelvic area may also occur.

  • In males, these may affect the tip, foreskin, and shaft of the penis. Infection around the anus may also occur although this is more common in men who have sex with men.
  • In females, the vulva and inside the vagina are usually infected which may make it difficult or painful to pass urine. The cervix may also become infected and ulcerated.

Birth-acquired herpes (congenital herpes)

This is a serious infection that can be life-threatening. Symptoms usually develop shortly after birth and cause a skin infection, or a system-wide infection called systemic herpes. This can affect a baby’s brain and breathing and cause seizures.

How is herpes simplex infection treated?

Antiviral agents are used to treat herpes simplex infections.

Herpes infections of the mouth may be mild and require no treatment, although the topical application of antivirals may shorten the duration of symptoms if started early enough.

More severe herpes infections or genital herpes require treatment with an oral antiviral agent.

Treatment does not cure the person of the virus but may reduce the number of outbreaks.