Primary Infection: This is the first stage wherein the contagion reproduces upon entering from the mucous membrane or skin. Typical symptom is the appearance of oral lesions which may not be present initially resulting in an asymptotic infection. In this case due to lack of symptoms one will be unaware of the presence of an infection. The sores usually takes 21 days to form and become visible, then the blisters will persist up to 10 days before beginning to heal.
Human herpes virus 3 (HHV3) is also called varicella-zoster virus. HHV3 causes chickenpox. It can also cause a recurrent virus infection of the skin, which is called herpes zoster or shingles. Shingles occurs when dormant varicella-zoster virus from an initial bout of chickenpox becomes reactivated. Like its close relative, HHV1, herpes zoster likes to infect skin cells and nerve cells. This virus may also recur along nerve fibre pathways, causing multiple sores where nerve fibres end on skin cells. Because an entire group of nerve cells is often affected, shingles is generally much more severe than a recurrence of herpes simplex. The lesions generally appear in a band-like or belt-like pattern occurring on one side of the body and are often accompanied by itching, tingling, or even severe pain. Healing usually occurs in 2 to 4 weeks, and scars may remain. Postherpetic neuralgia is a complication of shingles where the pain associated with the infection can persist for months and even years. Most people who experience shingles once do not experience it again.

An important source of support is the National Herpes Resource Center which arose from the work of the American Sexual Health Association (ASHA).[113] The ASHA was created in 1914 to in response to the increase in sexually transmitted diseases that had spread during World War I.[114] During the 1970s, there was an increase in sexually transmitted diseases. One of the diseases that increased dramatically was genital herpes. In response, ASHA created the National Herpes Resource Center in 1979. The HRC was designed to meet the growing need for education and awareness about the virus. One of the projects of The Herpes Resource Center (HRC) was to create a network of local support (HELP) groups. The goal of these HELP groups was to provide a safe, confidential environment where participants can get accurate information and share experiences, fears, and feelings with others who are concerned about herpes.[115][116]
The most effective method of avoiding genital infections is by avoiding vaginal, oral, and anal sex.[1] Condom use decreases the risk.[1] Daily antiviral medication taken by someone who has the infection can also reduce spread.[1] There is no available vaccine[1] and once infected, there is no cure.[1] Paracetamol (acetaminophen) and topical lidocaine may be used to help with the symptoms.[2] Treatments with antiviral medication such as aciclovir or valaciclovir can lessen the severity of symptomatic episodes.[1][2]
Prescription antiviral medications are also commonly used to reduce the duration, severity, and incidence of outbreak. These medications include (but are not limited to) valacyclovir, acyclovir, and famciclovir. Remember that these medications will not cure HSV-1 or HSV-2. Instead, they will help reduce the amount of time the outbreak is present, and help control the severity of symptoms.
If you think you have or have been exposed to herpes you should see your primary care provider for follow up, screening, and possible treatment. Many providers today will not test unless you have symptoms of an outbreak, as often tests come back as false positive and the CDC has concluded that false positives cause psychological trauma to those tested. There is much debate on if you should test without symptoms or not, others say it is unethical to not be aware of your current STD status and risk infecting other people.
Although the cause is unknown, outbreaks are often associated with periods of weakened immune systems, skin wounds, menstruation, fever, nerve damage, tissue damage from surgery, or exposure to extreme climate situations. A genital herpes outbreak or episode occurs when the HSV-1 or HSV-2 virus is reactivated from its dormant stage. Genital herpes is an incurable disease, and once you contract it, you may experience outbreaks throughout your lifetime. Those who are experiencing their first herpes episode of genital herpes can expect to have several (typically four or five) outbreaks within a year. Over time these recurrences usually decrease in frequency and severity. The first outbreak of herpes is often the longest outbreak experienced. After that, short and inconsistent episodes can be managed and treated with antiviral medication.
In all cases, HSV is never removed from the body by the immune system. Following a primary infection, the virus enters the nerves at the site of primary infection, migrates to the cell body of the neuron, and becomes latent in the ganglion.[14] As a result of primary infection, the body produces antibodies to the particular type of HSV involved, preventing a subsequent infection of that type at a different site. In HSV-1-infected individuals, seroconversion after an oral infection prevents additional HSV-1 infections such as whitlow, genital herpes, and herpes of the eye. Prior HSV-1 seroconversion seems to reduce the symptoms of a later HSV-2 infection, although HSV-2 can still be contracted.

Although herpes treatment is helpful, there is no cure. However, in most cases, outbreaks become fewer, less painful, and weaker over the course of a few years. If you have herpes, you can take certain medications to help manage the infection. Using herpes treatments is usually very effective in speeding up the healing of sores and preventing them from returning frequently.
In order to diagnose herpes, a health care provider can swab an area of visibly active herpes infection or, if symptoms aren’t active, a blood test can be given that measures the number of herpes antibodies present in the body. The antibodies don’t indicate herpes itself, but rather show the immune system’s response to the presence of the virus in the body. It’s important to note that sometimes a swab can give false negative results since herpes lesions need to be large enough to yield enough detectable virus and if the outbreak is already healing it also may not be detected in a swab. (6)
Oral herpes is a viral infection mainly of the mouth area and lips caused by a specific type of the herpes simplex virus. Oral herpes is also termed HSV-1, type 1 herpes simplex virus, or herpes labialis. The virus causes painful sores on the upper and lower lips, gums, tongue, roof of the mouth, inside the cheeks or nose, and sometimes on the face, chin, and neck. Infrequently, it may cause genital lesions. It also can cause symptoms such as swollen lymph nodes, fever, and muscle aches. People commonly refer to the infection as "cold sores."
Signs and symptoms of dehydration usually warrant going to a hospital's emergency department. Infants, especially under 6 weeks of age or if the infant appears to slow urine output or decrease fluid intake, should be evaluated by their pediatrician or in an emergency center if oral sores appear. Individuals with immune suppression (for example, patients undergoing chemotherapy, HIV patients, or cancer patients) should contact their doctors if they suspect a HSV-1 infection.
Varicella-zoster is transmitted though the mucosa of the respiratory system, specifically the upper respiratory tract, or the conjunctiva of the eye. Initial replication takes place in the regional lymph nodes, and then the virus spreads and replication begins in the liver and spleen. The virus is then transported to the skin where the rash develops. The incubation period of varicella is about 10 to 21 days.
If abstinence is not possible, using a sexual barrier (such as a condom or dental dam) can reduce the likelihood of transmission, although there is still a risk that these methods will not be sufficient to prevent the spread of the virus. It’s also a good idea to keep a visual reminder of your infection at hand to avoid any accidental food or beverage sharing.
What is herpes gladiatorum? Herpes gladiatorum is a virus similar to that which causes the common cold. It is spread through skin-to-skin contact. The symptoms vary between people, but they include a fever and skin sores. If the virus affects the eyes, it can be dangerous. Find out about the symptoms, risks, treatment, and prevention options. Read now
Herpes virus type 3 is also known as varicella-zoster virus which causes chicken pox. This virus can also lead to a recurrent infection called herpes zoster or shingles. It occurs when the virus becomes reactivated after causing chicken pox and infects the skin. So if you have had chicken pox as a child, you may get shingles afterwards. Shingles and chicken pox cause blisters anywhere on the body. They are contagious and can be spread by direct contact with fluid from the blisters.
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Traditionally, it was assumed that HSV-1 strictly caused oral sores and blisters, whereas HSV-2 caused genital and/or rectal sores and blisters. However, the virus- or perhaps just our understanding of the virus itself- has evolved in such a way that doctors now recognize that either HSV-1 or HSV-2 can cause genital and/or rectal sores, albeit with HSV-2 causing the majority of sores in the genital or rectal areas.
Herpes virus type 5 is also known as cytomegalovirus. It is the major cause of mononucleosis. Mononucleosis causes symptoms similar to infectious mononucleosis. It is spread via blood transfusion, breast-feeding, organ transplants, and sexual contact. The virus causes diarrhea, or severe vision problems and even leads to AIDS. People with weakened immune systems are more susceptible to these diseases.
In infants for whom the condition is quickly diagnosed and controlled by antiviral medication, prognosis is good. However, in untreated and undiagnosed infants, the virus can attack the body’s organs systems, causing serious and potentially life-threatening complications, including seizures and Encephalitis, which can cause brain and/or spinal damage.
Herpetic whitlow and herpes gladiatorum Herpes whitlow is a painful infection that typically affects the fingers or thumbs. On occasion, infection occurs on the toes or on the nail cuticle. Individuals who participate in contact sports such as wrestling, rugby, and football (soccer), sometimes acquire a condition caused by HSV-1 known as herpes gladiatorum, scrumpox, wrestler's herpes, or mat herpes, which presents as skin ulceration on the face, ears, and neck. Symptoms include fever, headache, sore throat, and swollen glands. It occasionally affects the eyes or eyelids.
To reduce the chance of acquiring HSV-1, avoid touching saliva, skin, or mucous membranes of people who have HSV-1 lesions. Prevention of genital HSV may be accomplished by latex condoms, but protection is never 100%. Spermicides do not protect against HSV. Some clinicians recommend using dental dams (small latex squares) during oral sex, but like condoms, they are not 100% protective.

The frequency and severity of recurrent outbreaks vary greatly between people. Some individuals' outbreaks can be quite debilitating, with large, painful lesions persisting for several weeks, while others experience only minor itching or burning for a few days. Some evidence indicates genetics play a role in the frequency of cold sore outbreaks. An area of human chromosome 21 that includes six genes has been linked to frequent oral herpes outbreaks. An immunity to the virus is built over time. Most infected individuals experience fewer outbreaks and outbreak symptoms often become less severe. After several years, some people become perpetually asymptomatic and no longer experience outbreaks, though they may still be contagious to others. Immunocompromised individuals may experience longer, more frequent, and more severe episodes. Antiviral medication has been proven to shorten the frequency and duration of outbreaks.[79] Outbreaks may occur at the original site of the infection or in proximity to nerve endings that reach out from the infected ganglia. In the case of a genital infection, sores can appear at the original site of infection or near the base of the spine, the buttocks, or the back of the thighs. HSV-2-infected individuals are at higher risk for acquiring HIV when practicing unprotected sex with HIV-positive persons, in particular during an outbreak with active lesions.[80]
Herpes of the mouth is a viral infection. The virus HSV-1 may be transmitted by droplet spread – direct contact with saliva or even respiratory droplets. These droplets must make contact with broken skin or the mucous membranes in order to infect a person. The method of spread can involve kissing an infected person or even through touch. It can also be spread through the use of contaminated kitchen utensils. Sexual contact accounts for a small number of cases of HSV-1. Nevertheless it is a consideration when genital lesions are present. HSV-2 on the other hand is usually transmitted through sexual contact.

Condoms offer moderate protection against HSV-2 in both men and women, with consistent condom users having a 30%-lower risk of HSV-2 acquisition compared with those who never use condoms.[49] A female condom can provide greater protection than the male condom, as it covers the labia.[50] The virus cannot pass through a synthetic condom, but a male condom's effectiveness is limited[51] because herpes ulcers may appear on areas not covered by it. Neither type of condom prevents contact with the scrotum, anus, buttocks, or upper thighs, areas that may come in contact with ulcers or genital secretions during sexual activity. Protection against herpes simplex depends on the site of the ulcer; therefore, if ulcers appear on areas not covered by condoms, abstaining from sexual activity until the ulcers are fully healed is one way to limit risk of transmission.[52] The risk is not eliminated, however, as viral shedding capable of transmitting infection may still occur while the infected partner is asymptomatic.[53] The use of condoms or dental dams also limits the transmission of herpes from the genitals of one partner to the mouth of the other (or vice versa) during oral sex. When one partner has a herpes simplex infection and the other does not, the use of antiviral medication, such as valaciclovir, in conjunction with a condom, further decreases the chances of transmission to the uninfected partner.[14] Topical microbicides that contain chemicals that directly inactivate the virus and block viral entry are being investigated.[14]

At the other end of the spectrum, there is a possibility of a herpetic flare up taking a sinister turn and leading to herpetic encephalitis. It is estimated to affect at least 1 in 500,000 individuals per year. The mechanism of this is not fully understood, but it is believed that the infection occurs through direct transmission of the virus via nerves from other parts of the body to the brain. In such cases, a person may complain of fever, headache, and lethargy, followed by confusion or delirium. In some cases, some people even develop seizures. This requires immediate medical attention and treatment.
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