There are 2 types of herpes simplex virus – I and II. Herpes Simplex Virus Type I usually causes cold sores, while Type II causes a sexually transmitted genital ulcer disease.
Oral herpes begins 2 to 20 days after contact with an infected person. Small painful blisters form on a red base, then burst leaving shallow ulcers, which scab over. In general, a first episode can last between 7 to10 days. However, the virus that causes the infection moves to the nerve cells where it enters a resting state. Recurrences vary among individuals but usually occur close to the area of the first episode and are preceded by a tingling, burning or itching sensation. Some people will have outbreaks once a month, while others will not have any. Most people get type I infections from family members and close friends during childhood.
Genital herpes usually presents with sores on the buttocks or genital region 2 to 20 days after sexual contact with an infected individual. Like oral herpes, the virus rests in the nerves and can recur after the primary episode resolves. In both oral and genital herpes, it is possible that individuals with mild primary disease are unaware of their infection and, may unknowingly transmit it to others. In addition, some people never get herpes lesions but are infected and can still shed the virus (this is known as asymptomatic viral shedding). As a result, it is important to note that it can be very difficult to identify the source of a new infection and avoid making unsubstantiated accusations.
To avoid transmitting the herpes viruses, it is necessary to avoid contact with active lesions or areas in which tingling, burning or itching occurs in a previously infected area. The herpes virus can be transmitted not only to others, but also to uninfected body parts. For those with genital herpes, condoms may help reduce the risk of transmission, but do not fully protect, as there may be virus on non-covered areas.
Herpes virus outbreaks are generally annoying, but pose little threat to overall health. However, infections can be very dangerous if they involve the eye or if they occur in pregnant women, AIDs patients, people with cancer, organ transplant recipients and those with major illnesses.
Swabs and blood tests may be done to confirm the diagnosis of herpes in certain cases. Anti-viral therapy can be given as needed to treat outbreaks as they occur or as a daily dose for suppression.