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Show full transcript for What is Herpes video

In this lesson, we're going to look at herpes, including some shocking statistics, the two types of herpes, how it's transmitted, how it's diagnosed, treatment options, and how to prevent herpes.

The herpes infection is caused by the herpes simplex virus (HSV). There are two categories or types of herpes – herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2).

Herpes simplex virus type 1 refers mainly to oral herpes, which appears mostly as cold sores. Herpes simplex virus type 2 refers to genital herpes.

Herpes Simplex Virus Type 1 (HSV-1) Oral Herpes

HSV-1 is highly contagious and is a larger problem around the world than most would think. Most HSV-1 infections are acquired during childhood and infection is lifelong. Also, most HSV-1 infections are oral herpes (rather than genital) that occur in and around the mouth.

The incidence rates of HSV-1 are profound. In 2012, there were an estimated 3.7 billion people worldwide under 50 years of age with the infection. The highest area of prevalence was in Africa, at around 87 percent of the population. The lowest area of prevalence was in the Americas, at between 40 and 50 percent.

In 2012, there were 140 million people between the ages of 15 and 49 with the genital version of HSV-1 and prevalence once again varied by region. Most genital HSV-1 infections occurred in the Americas, Europe, and the Western Pacific region, where it continues to be acquired well into adulthood.

In other regions, like Africa, most HSV-1 infections are acquired in childhood, well before the age that most begin having sexual contact.

Herpes Simplex Virus Type 1 (HSV-1) Oral Herpes – How is it Transmitted?

This infection is mostly transmitted by mouth to mouth contact via sores, saliva, and surfaces in and around the mouth. The other mode of transmission is oral to genital contact, which is the cause of genital type 1 herpes.

Pro Tip #1: HSV-1 can be transmitted from oral or skin surfaces that appear normal and healthy, as in an absence of signs and symptoms. However, it's equally important to know that the greatest risk of becoming infected is when there is the presence of obvious and active sores.

Individuals who already have HSV-1 oral herpes are unlikely to also be infected with HSV-1 genital herpes. In rare circumstances, an infection can be transmitted from mother to baby during birth.

The incubation period for HSV-1 oral herpes is between 2 and 12 days.

Herpes Simplex Virus Type 1 (HSV-1) Oral Herpes – Signs and Symptoms

There are often no signs and symptoms of HSV-1 oral herpes. However, if there are, those symptoms include:

  • Tingling, itching, and burning sensation around the mouth prior to sores appearing
  • Painful blisters and open sores in and around the mouth, such as cold sores
  • Clusters or groups of painful blisters that ooze clear, yellowish fluid that will crust over

This type of infection comes and goes, and the frequency of recurrences varies from person to person.

Oral symptoms, in particular, can result in intense pain at the onset of infection, making eating and drinking difficult. Symptoms can appear on lips, gums, the front of the tongue, inside the cheeks, in the throat, and on the roof of the mouth. Gums can become mildly swollen and red and may bleed.

Symptoms aren't limited to the oral areas and can extend down the chin and neck. Lymph nodes in the neck are often swollen and painful. For people in their teens or 20s, sore throats with swollen sores and a grayish coating on the tonsils are also common symptoms.

Pro Tip #2: Herpes is highly communicable (easily transmitted to others). The secretion of the virus in saliva can occur for up to seven weeks after recovery from stomatitis – inflammation of mouth and lips. And people with primary genital lesions are infectious for 7-10 days.

Herpes Simplex Virus Type 2 (HSV-2) Genital Herpes

HSV-2 is also widespread around the world and is almost exclusively sexually transmitted and the main cause of genital herpes, though as you've just learned the HSV-1 virus can also cause genital herpes.

Infection with HSV-2 is also lifelong and incurable.

The incidence rates of HSV-2 are just slightly less shocking than HSV-1. Annually, 776,000 people in the U.S. get a new HSV-2 herpes infection. Slightly more than 15 percent of people ages 14 to 49 have an HSV-2 infection.

HSV-2 is more common for women than men (20.3 percent vs. 10.6 percent) as genital infection is more easily transmitted from men to women.

Herpes Simplex Virus Type 2 (HSV-2) Genital Herpes – How is it Transmitted?

This type of herpes is mainly transmitted during sex through contact with genital surfaces, skin, sores, or fluids of someone infected with the virus.

HSV-2 can be transmitted from skin in or around the genitals and anal area that appears normal and symptom-free. And in rare circumstances, it can be passed from mother to baby during birth.

The incubation period for HSV-2 genital herpes is between 2 and 12 days.

Herpes Simplex Virus Type 2 (HSV-2) Genital Herpes – Signs and Symptoms

Like HSV-1, HSV-2 can also be present without any symptoms at all or just mild symptoms that go unnoticed or are mistaken for something else. When symptoms are present, they include:

  • One or more small blisters on or around the genitals, rectum, or mouth
  • Fever
  • Body aches
  • Swollen lymph nodes
  • Headache

Pro Tip #3: The first outbreak usually includes longer-lasting symptoms (like sores or lesions) and a greater chance of transmitting the infection to others.

Symptoms of recurrent outbreaks also include:

  • Localized genital pain and tingling
  • Shooting pain in the legs, hips, and buttocks

Recurrent symptoms can occur hours or days before the eruption of lesions, which are typically shorter in duration and less severe than the first outbreak.

How is Herpes Diagnosed?

HSV-1 (Oral Herpes)

HSV-1 diagnosis is done through an Immunosorbent Assay (ELISA) test. This is a blood test that looks for antibodies to the HSV-1 virus in the blood. This is a highly sensitive test and will only detect the presence of HSV-1 antibodies.

HSV-2 (Genital Herpes)

HSV-2 diagnosis is done using a Polymerase Chain Reaction (PCR) test. This test produces rapid and accurate results and is increasingly being used. A viral culture requires a sample from a lesion and if viral growth is found, a procedure will differentiate the HSV-1 virus from the HSV-2 virus.

Pro Tip #4: With the shocking statistics presented in this lesson, you may be inclined to be tested immediately. However, the CDC does not recommend screening for the general population.

Having said that, there are several scenarios where HSV tests may be recommended and these include:

  • People with recurrent genital symptoms
  • People with a clinical diagnosis of genital herpes even though lab tests have not been done to confirm an infection
  • People who have a sex partner with herpes
  • People who have another STD or have multiple sex partners
  • People who have HIV

What are the Treatment Options for Herpes?

As already mentioned, there is no cure for either type of herpes. However, antiviral medications can prevent or shorten outbreaks for those who are infected. Also, antiviral medications can reduce the chance of spreading the disease to others.

At this time, there is no commercially available vaccine to protect against either herpes virus.

What are the Prevention Techniques for Herpes?

Herpes prevention looks like a recipe for becoming a Buddhist monk and includes:

For HSV-1 (Oral Herpes)

  • Avoid oral contact with others and sharing objects that come in contact with saliva
  • Abstain from oral sex to avoid the transmission of herpes to the genitals of all sex partners

For HSV-2 (Genital Herpes)

  • Abstain from sexual contact
  • Be in a long-term, mutually monogamous relationship with sex partners who have been tested and shown to be uninfected