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 age range 15-49 infected with HSV-1 and 11% of people in age range 15-49 infected with HSV-2.
HSV-1 is usually contracted through oral-to-oral contact but can sometimes be transmitted after oral-genital contact. HSV-2 is exclusively contracted during sex and is a sexually transmitted disease.
Individuals contracting HSV-1 are usuallly asymptomatic until they develop their first cold sore, and most often experience cold sores and no other symptoms. 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, and a painful sore in or around the mouth. Along with these symptoms, individuals might also have flu-like symptoms such as fever, nausea, and headaches.
Cold sores are small, sore blisters that form around the mouth, usually the bottom lip. They can last from 7 to 10 days and normally clear up without any medical treatment. Individuals might notice a tingling, itching sensation around the mouth as a precursor to developing a cold sore.
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, illness, and menstruation can trigger a cold sore outbreak.
After contracting HSV-2, individuals may 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 may also experience pain during urination and flu-like symptoms. Some women might even notice unusual vaginal discharge.
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.
Outbreaks tend to be less severe and unpleasant over time.
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 transmission. The cold sores contain high amounts of virus and hence increase the chances of spread significantly. HSV-2 can also be spread without an active infection (without any symptoms), but the chances are lower.
It is impossible to eliminate the risk of spreading HSV-1 or HSV-2, but there is a way to reduce the risk of transmission.
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 do 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 can stop herpes virus replication 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 saliva. 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 disease. In some cases, an infant herpes infection can be fatal. To minimize this risk, doctors advise mothers to have a cesarean section to prevent the child from coming into contact with the birth canal. Herpes acquisition through birth is rare affecting 1 in 10,000 births globally.
This method of spread is very improbable and has not been 100% confirmed through literature. For example, it is thought that herpes virus can be spread through sharing a wet towel, utensil, or other items, however, there is debate on whether the virus can survive outside the human body.
Regardless, 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.