A herpes infection is caused by the herpes simplex virus (HSV). It has 2 main types, including HSV-1 and HSV-2. While HSV-1 can cause oral herpes, HSV-2 can be responsible for genital herpes. Oral herpes is also known as cold sores or fever blisters. It mainly occurs on the lips, around the mouth. Genital herpes is usually referred to as herpes. It mostly affects the genitals and anal area. Genital herpes is considered to be a sexually transmitted disease. It’s extremely contagious and can be spread through sexual intercourse.
During these periods, it is especially important to abstain from kissing and any form of physical contact with the blistering area, saliva, or sexual discharge. If you are infected, be sure to wash your hands after touching an infected area on either the oral or genital regions. Herpes medications can also help reduce your risk of transmitting the virus to another individual.
Once a person is infected, there are no symptoms for anywhere between 2 days to 2 weeks. This is known as the incubation period and is the time during which the virus multiplies profusely. The first symptoms that are seen are the small fluid-filled blisters known as vesicles. This arises as the virus starts destroying cells at the site and causes intense localized inflammation. These small vesicles or sometimes the larger bullae may either burst resulting in ulcer or heal completely with no scarring. The virus may also travel from the site of infection and “hides” by the sensory dorsal root. Here it remains latent until is it is reactivated.

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.


Human herpes virus 6 (HHV6) is a recently observed agent found in the blood cells of a few patients with a variety of diseases. It causes roseola (a viral disease causing high fever and a skin rash in small children) and a variety of other illnesses associated with fever in that age group. This infection accounts for many of the cases of convulsions associated with fever in infancy (febrile seizures).


Herpes, whether on the mouth or genitals, is caused by a family of over 70 related viruses. These viral infections cause small, fluid-filled blisters to develop on the skin and mucous membranes. There are actually eight different types of herpes simplex viruses that both children and adults can acquire, but two are by far the most common: HSV-1 and HSV-2.


Human herpes virus 2 (HHV2) is also called herpes simplex virus 2 (HSV2). It typically causes genital herpes, a sexually transmitted infection. However, it can also cause cold sores in the facial area. Like HHV1, the HHV2 infection is contagious and is spread by skin-to-skin contact. The main route of transmission is through sexual contact, as the virus does not survive very long outside the body.
OK, so the majority of people have it. Just this year, the World Health Organization released a study that estimates two thirds of people in the world (67%) have the HSV-1 strain of the herpes simplex virus — that’s approximately 3.7 billion people worldwide. While HSV-1 typically refers to oral herpes infections, it also includes some genital infections. The new report estimates that half of the HSV-1 infections in people between the ages of 15–49 are actually genital infections transmitted via oral-to-genital contact. The Center For Disease Control (CDC) estimates that 1 in 6 people have genital herpes.
If abstinence is not possible, using a sexual barrier (such as a condom or dental dam) can reduce the likelihood of transmission, although there is still a risk that these methods will not be sufficient to prevent the spread of the virus. It’s also a good idea to keep a visual reminder of your infection at hand to avoid any accidental food or beverage sharing.
^ Nasser M, Fedorowicz Z, Khoshnevisan MH, Shahiri Tabarestani M (October 2008). "Acyclovir for treating primary herpetic gingivostomatitis". The Cochrane Database of Systematic Reviews (4): CD006700. doi:10.1002/14651858.CD006700.pub2. PMID 18843726. (Retracted, see doi:10.1002/14651858.cd006700.pub3. If this is an intentional citation to a retracted paper, please replace {{Retracted}} with {{Retracted|intentional=yes}}.)
“Herpes is caused by sexual intimacy and contact with a person who is actively shedding the herpes virus,” says Cullins. If you have HSV-1, that shedding could happen through the mouth or a cold sore, which means that the virus can be transmitted through kissing, or just sharing a drink. If you have herpes that affects the genitals, it can be transmitted from sharing sex toys, grinding, or even mutual masturbation — any activity where the virus can be transmitted from one person to another through skin-to-skin or mucosal contact.
“Someone having HSV doesn't mean that they were reckless or irresponsible with their sex life,” says Sara, age 30. “I used condoms with all my partners, and I still caught it.” For Jamie, who contracted herpes from her husband three years into their monogamous relationship, he was her first and only sexual partner. And she says that he contracted it from one of his very first sexual encounters. No matter how and why someone contracted the virus, it doesn't erase their humanity and right to respect.
In order to diagnose herpes, a health care provider can swab an area of visibly active herpes infection or, if symptoms aren’t active, a blood test can be given that measures the number of herpes antibodies present in the body. The antibodies don’t indicate herpes itself, but rather show the immune system’s response to the presence of the virus in the body. It’s important to note that sometimes a swab can give false negative results since herpes lesions need to be large enough to yield enough detectable virus and if the outbreak is already healing it also may not be detected in a swab. (6)
Recurrent outbreaks of genital herpes may happen, with some patients having four to six outbreaks in the span of a year. Compared to the first infection, subsequent recurrences are less painful and occur in shorter periods than the first infection. There are some patients, however, who don’t have another outbreak for many years or even once more during their lifetime.11
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There’s herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2). “HSV-1 and HSV-2 are different but closely related viruses,” says Dr. Christine Johnston, MPH, who is the Associate Medical Director of the Virology Research Clinic at the University of Washington. Johnston explains that both are transmitted through close mucosal or skin contact with infected secretions. HSV-1 primarily causes oral outbreaks, also known as cold sores, and HSV-2 usually causes genital outbreaks. But HSV-1 can also cause genital outbreaks through oral-to-genital contact, according to the CDC. According to Johnston, genital HSV-1 is less likely to recur than HSV-2, and there’s less asymptomatic shedding (transmitting the virus without realizing it) with HSV-1 than with HSV-2.

How to get rid of a cold sore The herpes simplex virus that causes cold sores, often on people’s mouths, is highly contagious and a lifelong infection with no cure. Learn about how to treat cold sores when they appear, including anti-viral tablets and creams and home remedies, plus the life cycle of the virus, and how to prevent its spread. Read now
I am so scared. My boyfriend is the only person I have ever had unprotected sex with 4 times. We had a herpes scare. He got tested. They swabbed him and gave him a blood test and his results for Herpes 1 and 2 came back negative. I went to the doctor but the lumps on my vagina healed and they said come back when you have a lesion. I told my BF but he still wanted to have sex, I told him what the doctor said and I told him we should not have sex or use a condom. He said it does not matter because if he did not have herpes I did not have Herpes. He said ok and put the condom on but  when we were done he started to laugh and said he took the condom off. Since then we have had sex twice. I went to the doctor and they gave me a blood test. They said if something was wrong they would send a letter to the house. Since they never sent the letter to the house I thought I was fine and I never had any other lumps since then and my boy friend never had any symptoms I thought I was fine.Today something told me to go to the doctor. I went and they said they never ordered the test. I AM So ANGRY. What Should I do? If I do have it shouldn't it have been in his blood from me? I am so scared that I may have it? I am also worried that one day he may get symptoms because his test was wrong and think I gave it to him when he was the one who may have given it to me if my blood test comes back positive. I have only had sex once with a condom before him. What should I do? He has had other a few partners. What is the likely hood that I may have given him herpes?

If you are pregnant and have genital herpes, it is very important for you to go to prenatal care visits. Tell your doctor if you have ever had symptoms of, or have been diagnosed with, genital herpes. Also tell your doctor if you have ever been exposed to genital herpes. There is some research that suggests that genital herpes infection may lead to miscarriage, or could make it more likely for you to deliver your baby too early.
Herpes infection can be passed from you to your unborn child before birth but is more commonly passed to your infant during delivery. This can lead to a potentially deadly infection in your baby (called neonatal herpes). It is important that you avoid getting herpes during pregnancy. If you are pregnant and have genital herpes, you may be offered anti-herpes medicine towards the end of your pregnancy. This medicine may reduce your risk of having signs or symptoms of genital herpes at the time of delivery. At the time of delivery, your doctor should carefully examine you for herpes sores. If you have herpes symptoms at delivery, a ‘C-section’ is usually performed.
For mild infections, self-care may be adequate for treatment. Other treatments termed "home remedies" are not considered cures but can ease or hasten recovery. These remedies include aloe vera gel, cornstarch paste, and tea or mint leaves. A cool compress may reduce pain. There is no cure for the infection. People with severe infection symptoms, especially children, should be evaluated by a medical caregiver.
Cullins explains that even if you’ve never had an outbreak, if you’ve been exposed to herpes, it lies dormant in your body. A blood test could reveal antibodies for HSV-1 and/or HSV-2, which means that you have been exposed to the infection in your past, you have been infected, and you have developed antibodies because your body has or is fighting the infection.
For mild infections, self-care may be adequate for treatment. Other treatments termed "home remedies" are not considered cures but can ease or hasten recovery. These remedies include aloe vera gel, cornstarch paste, and tea or mint leaves. A cool compress may reduce pain. There is no cure for the infection. People with severe infection symptoms, especially children, should be evaluated by a medical caregiver.

Herpes infection can be passed from you to your unborn child before birth but is more commonly passed to your infant during delivery. This can lead to a potentially deadly infection in your baby (called neonatal herpes). It is important that you avoid getting herpes during pregnancy. If you are pregnant and have genital herpes, you may be offered anti-herpes medicine towards the end of your pregnancy. This medicine may reduce your risk of having signs or symptoms of genital herpes at the time of delivery. At the time of delivery, your doctor should carefully examine you for herpes sores. If you have herpes symptoms at delivery, a ‘C-section’ is usually performed.


Herpes simplex type 1, which is transmitted through oral secretions or sores on the skin, can be spread through kissing or sharing objects such as toothbrushes or eating utensils. In general, a person can only get herpes type 2 infection during sexual contact with someone who has a genital HSV-2 infection. It is important to know that both HSV-1 and HSV-2 can be spread even if sores are not present.

Cullins explains that the first, or initial, outbreak is usually the worst, and “over time when you have recurrent episodes, you may not have systemic symptoms” or frequent symptoms. But everyone’s body and immune system reacts to the virus differently; while some people may never have many outbreaks, other people may be more chronically symptomatic. The National Institutes of Health indicate that infrequent outbreaks, around one or two per year, are not uncommon.


During these periods, it is especially important to abstain from kissing and any form of physical contact with the blistering area, saliva, or sexual discharge. If you are infected, be sure to wash your hands after touching an infected area on either the oral or genital regions. Herpes medications can also help reduce your risk of transmitting the virus to another individual.
Until the 1980s serological tests for antibodies to HSV were rarely useful to diagnosis and not routinely used in clinical practice.[39] The older IgM serologic assay could not differentiate between antibodies generated in response to HSV-1 or HSV-2 infection. However, a glycoprotein G-specific (IgG) HSV test introduced in the 1980s is more than 98% specific at discriminating HSV-1 from HSV-2.[40]

If not treated immediately, it has potential  spread to other parts of the body. Being highly contagious in nature it gets readily transmitted by sharing utensils, clothes, and toothbrush. Maintaining sexual contact, kissing and touching also leads to the spread of virus. It is likely to spread more when the virus is present with physical outbursts. It is less contagious if the virus is present without any outward physical signs.
Primary orofacial herpes is readily identified by examination of persons with no previous history of lesions and contact with an individual with known HSV infection. The appearance and distribution of sores is typically presents as multiple, round, superficial oral ulcers, accompanied by acute gingivitis.[39] Adults with atypical presentation are more difficult to diagnose. Prodromal symptoms that occur before the appearance of herpetic lesions help differentiate HSV symptoms from the similar symptoms of other disorders, such as allergic stomatitis. When lesions do not appear inside the mouth, primary orofacial herpes is sometimes mistaken for impetigo, a bacterial infection. Common mouth ulcers (aphthous ulcer) also resemble intraoral herpes, but do not present a vesicular stage.[39]
In infants for whom the condition is quickly diagnosed and controlled by antiviral medication, prognosis is good. However, in untreated and undiagnosed infants, the virus can attack the body’s organs systems, causing serious and potentially life-threatening complications, including seizures and Encephalitis, which can cause brain and/or spinal damage.
The cell this virus targets is the B lymphocyte. These cells mature in the bone marrow and are a type of mononuclear leukocyte cells - white blood cells with a one-lobed nucleus. The incubation period for the Epstein – Barr Virus (EBV) is about 30 to 50 days, and patients typically have enlarged lymph nodes and spleens. Some patients have signs of hepatitis.

Stage 3 -- Recurrence: When people encounter certain stresses (also termed triggers), emotional or physical, the virus may reactivate and cause new sores and symptoms. The following factors may contribute to or trigger recurrence: stress, illness, ultraviolet light (UV rays including sunshine), fever, fatigue, hormonal changes (for example, menstruation), immune depression, and trauma to a site or a nerve region where previous HSV infection occurred.


Only a health care provider can diagnose herpes by performing a physical exam and tests. A blood test can tell if you are infected with oral or genital herpes — even if you don't have symptoms. Health care providers can also confirm herpes infection by testing fluids taken from the sores. If you think you have herpes sores, get them checked out as soon as possible. Your local Planned Parenthood health center, many other health centers that test for sexually transmitted diseases, private health care providers, and health departments offer herpes tests and herpes treatments.
Do everything possible to prevent spreading it to other people. The virus cannot live long when it is not in contact with the skin, so door handles and towels are not likely to spread it. Do not share your personal belongings, like toothbrushes and combs.  Wash your hands with soap and water often, and immediately if you touch the sores.  This is important so as to minimize the chance of getting ocular herpes (herpes infection of the eye) which is a serious infection. Be especially careful around infants because their immune systems may not be fully developed. Little children often express affection with sloppy wet kisses. This is a common way to spread the herpes virus within the family.
Although it's rare, pregnant women can pass on the herpes infection to their child. This can result in a serious and sometimes deadly infection in the baby. That's why taking steps to prevent an outbreak at time of delivery is recommended starting at 34 weeks into the pregnancy. If you have signs of an active viral infection when it's time to deliver, your doctor will likely recommend a cesarean section for delivery.
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