Herpes or Herpes Simplex Virus (HSV) is a viral infection with 2 forms: HSV-1 and HSV-2. These infections can result in oral cold sores, genital cold sores, or both. The World Health Organisation estimates that 3.7 billion people under 50 have HSV-1 globally, while 491 million people aged 15-49 have HSV-2. Herpes is one of the most common infections worldwide, with around 65% of people in the age range 15-49 infected with HSV-1 and 11% of people in the age range 15-49 infected with HSV-2.
HSV-1 is usually contracted through oral-to-oral contact but can sometimes be acquired after oral-genital contact, in or around the genital area. HSV-2 is exclusively contracted during sex and is a sexually transmitted disease.
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What are the symptoms of HSV-1?
Individuals contracting HSV-1 usually are asymptomatic until they develop their first cold sore. Adults are less likely to develop symptoms after primary infection compared to children. The usual symptoms to look out for are sore throat, swollen glands, painful sore in and around the mouth. Along with these symptoms, individuals might also have flu-like symptoms such as fever, nausea, and headaches.
Individuals with HSV-1 usually only experience cold sores and no other symptoms. Cold sores are small, sore blisters that form around the mouth, usually the bottom lip. It can last from 7 to 10 days and regularly clear up on their own without any medical treatment. There is a precursor to developing cold sores. Individuals might notice a tingling, itching sensation around the mouth.
HSV-1 can lay dormant for years, and individuals might not realize they have contracted Herpes until their first cold sore outbreak. Events like stress, being unwell, and having a period can trigger a cold sore outbreak.
After contracting HSV-2, individuals might not experience any symptoms initially. During an outbreak, individuals can expect to find small, painful blisters around the genitals, rectum, cervix, thighs, and or buttocks. These blisters can burst, leaving open sores, but they will not leave scars. Individuals could also experience pain during urination and flu-like symptoms. Some women might even notice unusual vaginal discharge.
These symptoms usually last three weeks, and the sore should scab and heal on its own. However, these outbreaks do not occur in isolation. After experiencing one outbreak, individuals can expect more outbreaks in the future.
The outbreaks tend to be less severe and unpleasant over time.
However, there are non-sexual ways to contract Herpes. Some examples are kissing, birth, and sometimes but less likely, indirect contact. Let us cover sexually transmitted Herpes first.
Transmission can occur from female-to-male or from male-to-female. As long as one sexual partner has an active HSV-2 infection and is partaking in unprotected sex, there is a high chance of transmitting it. The cold sores contain high amounts of the virus and hence increases the chances of spread significantly. HSV-2 can also be spread without an active infection (without any symptoms), but the chances are lower.
Even though HSV-2 spreads through sexual contact, you can spread HSV-1 from the mouth to the genital region with oral sex. It is impossible to eliminate the risk of spreading HSV-1 or HSV-2, but there is a way to reduce the transmission factor.
Using condoms is very important. It is the only form of contraception that can offer protection from sexually transmitted diseases. Condoms do not entirely remove the risk of transmission, but it does make a significant difference. A study showed that using a condom reduces the risk of transmission of HSV-2 from female to male by 65% and male to female by 96%.
Antiviral medications also stop the spread of the herpes infection within the body. This, in turn, reduces the risk of viral shedding. A study conducted concluded that taking valacyclovir antiviral therapy makes a person 48% less likely to transmit the infection to their partner.
Kissing is one of the most common ways of spreading HSV-1. HSV-1, as we know, results in oral cold sores, and by swapping saliva with someone else, there is a risk of transmitting the virus to another person.
During an active infection, Herpes is present in the saliva of the mouth and on the lips. So all it can take is a kiss for HSV-1 to spread from one infected person to another. Just like HSV-2, it is possible to spread Herpes even without an active infection.
Birth is another avenue in which Herpes can spread. If a woman has an active genital herpes infection during labor and delivery, there is a possibility of passing the Herpes from mother to child through the birth canal.
A herpes infection in an infant is a serious health risk to the child and can result in other grave conditions such as the central nervous system's disease. In some cases, an infant herpes infection can be fatal. To minimize this risk, doctors advise mothers to have a cesarean section as this does not involve the child from coming into contact with the mother's genitalia. The statistics for herpes acquisition through birth is rare, and out of every 100,000 birth globally, only ten newborn babies are infected with Herpes through birth.
This method of spread is very improbable and is not 100% confirmed through literature. For example, the herpes virus can be spread through sharing a wet towel, utensil, or other items. However, the literature is skeptical as there is debate on whether the virus can live outside the human body. Hypothetically, if the use of straw or utensil is quick, the virus could pass through the shared saliva.
The reality is that Herpes is one of the most common infections in the world and many people have some form of Herpes, either HSV-1 or HVS-2.