Introduction

Herpes simplex virus (HSV) type I /II are two of the eight strains of the herpes virus family. Both HSV-I and HSV-II can be extremely widespread and contagious. Roughly 80% of oral herpes cases are caused by HSV-I, while the remaining 20% are caused by HSV-II. It has been documented that 75-80% of Americans carry at least one herpes simplex virus (type I or II). Most people get HSV-I as a child that was contracted through skin-to-skin contact with an adult who carries the virus. An adult does not have to have visible sores to spread the virus. A person typically contracts HSV-II through sexual contact where about 20% of sexually active adults in the United States carry HSV-II and may not even be aware of it.

Causes

The herpes simplex virus spreads from direct person-to-person contact. It is possible to contract the herpes simplex virus from touching a herpes sore; however, most people contract herpes simplex from an infected person who does not have visible sores; known as, “asymptomatic viral shedding.” Someone with HSV-I may spread the virus through: kissing, touching the infected person’s skin, as well as sharing objects such as silverware, lip balm, or razors. Most individuals contract genital herpes from HSV-II through sex. If someone has a cold sore and performs oral sex, HSV-I may spread to the genitals causing herpes sores to develop. Factors that may trigger the virus into a lytic phase are: surgery, illness, sun exposure, menstrual periods, and even stress.  Mothers can give the herpes virus to their baby during childbirth. If the baby is born during the mother’s first episode of genital herpes, the baby can have serious medical complications.

Symptoms

Once a person becomes infected with the herpes virus, it never leaves the body. After the first outbreak, the virus moves from the skin cells to nerve cells where it will remain dormant in the nerve cells. Many people who contract the herpes simplex virus may never see or feel anything. If the virus does become active again (lytic phase) it can elicit one or more of the following symptoms: tingling, itching, or burning sores; flu-like symptoms; incontinence; and eye infections (herpes keratitis). In oral herpes, commonly observed symptoms may present as blisters on the lips, around the mouth, and at times on the face or tongue. Although these are the most common places to find oral herpes, the sores can appear anywhere on the skin. Genital herpes typically presents as sores on the penis, vagina, buttocks, or anus. Like oral herpes, these sores can appear anywhere on the skin.

Diagnosis

During an outbreak, we can diagnose herpes simplex by looking at the sores. To confirm if you have herpes simplex, we may take a swab from a sore and send it to the laboratory for analysis. When sores are not present, other medical tests, such as blood tests, may detect the herpes simplex virus.

Treatment

There is no cure for herpes simplex but sores may clear without treatment. Many people choose to treat herpes simplex because treatment can relieve symptoms as well as shorten the duration of an outbreak. Most people are treated with some sort of antiviral medication; for example, an antiviral cream or ointment may relieve the burning, itching, or tingling. Valacyclovir, Acyclovir, and Famciclovir are three examples of prescription antiviral medications approved for the treatment of both types of herpes simplex. Taken daily, these medications may lessen the severity and frequency of outbreaks and have also been indicated to prevent infected people from spreading the virus.