Hsv 1 in mouth: Oral Herpes | Johns Hopkins Medicine
Oral Herpes | Johns Hopkins Medicine
Whether you call it a cold sore or a fever blister, oral herpes is a common infection of the mouth area that is caused by herpes simplex virus type 1 (HSV-1). Fifty percent to 80 percent of U.S. adults have oral herpes. According to the National Institutes of Health, about 90 percent of adults have been exposed to the virus by age 50.
Once infected, a person will have herpes simplex virus for the rest of his or her life. When inactive, the virus lies dormant in a group of nerve cells. While some people never develop any symptoms from the virus, others will have periodic outbreaks of infections.
Causes of Oral Herpes
Oral herpesis spread most commonly from individuals with an active outbreak or sore. You can catch oral herpes by engaging in intimate or personal contact (e.g., kissing or oral sex) with someone who is infected.
Prevention of Oral Herpes
Since oral herpes is spread through direct, physical contact, the best method of prevention is to avoid physical contact with a person’s herpes sores when they are having an outbreak.
Oral Herpes Symptoms
The initial (primary) infection of oral herpes is usually the worst. It may cause severe, flu-like symptoms, including swollen lymph nodes and headache. However, some people have no symptoms at all. During the initial infection, sores can occur on and around the lips and throughout the mouth.
Recurring infections tend to be much milder, and the sores usually erupt on the edges of the lips. Some people never have any additional outbreaks beyond the initial infection. The following are the most common signs and symptoms of a recurring oral herpes simplex virus infection.
Initial redness, swelling, heat/pain or itching may develop in the area where the infection will erupt.
Painful, fluid-filled blisters may appear on the lips or under the nose. The blisters and fluid are highly contagious.
The blisters will leak fluid and become sores.
After about four to six days, the sores will start to crust over and heal.
The signs and symptoms of an oral herpes outbreak may look like other conditions or medical problems. Always consult your health care provider for an accurate diagnosis.
Diagnosing Oral Herpes
Since oral herpes can be confused with many other infections, including allergic reactions, a virus culture (PCR), blood test or biopsy are the only ways to confirm your diagnosis. However, your health care provider may also diagnose your condition based on the location and appearance of the blisters.
Recurrence of Oral Herpes
Although the specific triggers that cause oral herpes to recur are unclear, several factors may play a role. These include:
While recurrent outbreaks are more common in the first year after the initial episode, they tend to lessen as the body builds antibodies to the virus.
Oral Herpes Treatment Options
Your health care provider will recommend treatment options based on your:
Overall health and medical history
Tolerance for specific medicines, procedures or therapies
Your specific treatment plan may involve:
Keeping the infected area clean and dry
Taking antiviral oral medications, such as acyclovir, famciclovir and valacyclovir (these medications are traditionally the most effective)
Applying antiviral topical ointments, such as acyclovir and penciclovir
Using over-the-counter topical anesthetics or anti-inflammatory agents to alleviate symptoms
Herpes Simplex Virus (HSV): Overview, Symptoms and Treatment
Herpes simplex virus (HSV) is a virus that causes infections. It is very contagious. There are two types of this virus. One type (HSV-1) usually causes sores around the lips or inside the mouth that are sometimes called fever blisters or cold sores. The other type (HSV-2) usually causes sores on the genitals (private parts). Either type can infect the mouth, genital area or another part of the body.
HSV spreads most easily when a person comes in direct contact with an infected person’s mucous membranes, saliva, or the oozing fluid from a sore. Mucous membranes are the moist skin that lines the inside parts of the body such as the mouth, nose and vagina. That is why it is extremely important not to kiss or have sex with anyone when herpes sores are present. However, HSV can be spread even when the infected person has no sores or obvious signs of infection. The herpes virus cannot live very long outside of the body. It is unlikely that you can get it from a toilet seat.
Symptoms of Herpes
Symptoms of herpes usually begin within 2 to 20 days after contact with the HSV virus. The skin becomes painful or it may itch, burn or tingle. Then one or more blisters appear. The blisters open and become sores. The sores turn crusty and heal slowly over 1 to 2 weeks. By 3 weeks, the sores have completely healed without leaving a scar. Sometimes flu-like symptoms, such as swollen glands, headache, body aches and fever also develop. For some, the symptoms may be so mild that the person does not get sores and may not even know that he or she is infected.
When the sores have healed and the skin looks normal again, the virus hides in the nerve cells under the surface of the skin. Once someone is infected with the herpes virus, he or she will have the infection for the rest of his life. The sores can come back at any time when you have a lot of stress, get too tired or have illness, irritated skin, sunburn or a poor diet. They can also come back during menstruation. Sometimes the sores can come back for no reason.
How Herpes is Treated
There is no cure for herpes.
- The health care provider may prescribe antiviral medicine to help speed up the healing process. It also shortens the time when the virus can spread from the herpes sores.
- Pain may be treated with medicine such as Tylenol (acetaminophen) or Motrin (ibuprofen) or by applying an ice pack wrapped in a towel to the affected area.
- If sores are in the mouth, avoid foods high in acid, like citrus fruits and juices.
- The infected area should be kept clean and dry.
- Wash hands often and avoid touching the sores to prevent spreading the virus.
- It is important to stay healthy by getting enough rest, having proper nutrition and exercise and managing stress well.
When to Call the Doctor
Even though HSV sores can hurt and be unsightly, most cases of herpes do not cause serious illness. The sores go away in a few days. Contact the health provider if:
- Sores are present and you think it might be a first herpes infection. The diagnosis is usually made by examining the sores. If the sores have not healed, sometimes a laboratory test is done.
- Sores do not heal by themselves or show signs of infection such as pus, spreading redness or fever.
- Sores are near the eyes.
- You have another health condition with a weakened immune system.
Other Important Points
During a flare-up:
- Avoid touching the sores or the skin around that area. Other parts of the body can become infected. Wash your hands with soap and water right away.
- Protect infants from being kissed by anyone with a cold sore. Babies can get very sick from HSV.
- Do not kiss anyone when mouth sores are present. Do not share things that may have touched the sores.
- Keep drinking glasses, eating utensils, washcloths and towels away from others. Wash these items thoroughly after use.
- Do not have sexual intercourse or oral sex until the sores are completely healed. Latex condoms and dental dams can reduce the risk of spreading or getting herpes. It is best to use them at all times when you have sex.
- If you get pregnant, it is very important to tell your doctor you have herpes. That way, precautions can be taken to keep the baby from coming in contact with the virus.
- In most cases, you can still go to school during a flare-up.
Herpes Simplex Virus (HSV) (PDF)
HH-I-174 6/93 Revised 2/17 Copyright 1993 Nationwide Children’s Hospital
Oral Herpes Signs Symptoms Treatment
Herpes labialis (Oral herpes simplex)
Oral herpes is an infection caused by the herpes simplex virus, characterized by an eruption of small and usually painful blisters on the skin of the lips, mouth, gums or the skin around the mouth. These blisters are commonly called cold sores or fever blisters.
Causes, incidence, and risk factors
Herpes labialis is an extremely common disease caused by infection of the mouth area with herpes simplex virus, most often type 1. Most Americans are infected with the type 1 virus by the age of 20.
The initial infection may cause no symptoms or mouth ulcers. The virus remains in the nerve tissue of the face. In some people, the virus reactivates and produces recurrent cold sores that are usually in the same area, but are not serious. Herpes virus type 2 usually causes genital herpes and infection of babies at birth (to infected mothers), but may also cause herpes labialis.
Herpes viruses are contagious. Contact may occur directly, or through contact with infected razors, towels, dishes, and other shared articles. Occasionally, oral-to-genital contact may spread oral herpes to the genitals (and vice versa). For this reason, people with active herpes lesions on or around the mouth or on the genitals should avoid oral sex.
The first symptoms usually appear within 1 or 2 weeks—and as late as 3 weeks—after contact with an infected person. The lesions of herpes labialis usually last for 7 to 10 days, then begin to resolve. The virus may become latent, residing in the nerve cells, with recurrence at or near the original site.
Recurrence is usually milder. It may be triggered by menstruation, sun exposure, illness with fever, stress, or other unknown causes.
Warning symptoms of itching, burning, increased sensitivity, or tingling sensation may occur about 2 days before lesions appear.
Skin lesions or rash around the lips, mouth, and gums
Small blisters (vesicles) filled with clear yellowish fluid
Blisters on a raised, red, painful skin area
Blisters that form, break, and ooze
Yellow crusts that slough to reveal pink, healing skin
Several smaller blisters that merge to form a larger blister
Mild fever (may occur)
Signs and tests
Diagnosis is made on the basis of the appearance or culture of the lesion. Examination may also show enlargement of lymph nodes in the neck or groin.
Viral culture or Tzanck test of the skin lesion may reveal the herpes simplex virus.
Untreated, the symptoms will generally subside in 1 to 2 weeks. Antiviral medications given by mouth may shorten the course of the symptoms and decrease pain.
Wash blisters gently with soap and water to minimize the spread of the virus to other areas of skin. An antiseptic soap may be recommended. Applying ice or warmth to the area may reduce pain.
Take precautions to avoid infecting others (see Prevention).
Herpes labialis usually disappears spontaneously in 1 to 2 weeks. It may recur. Infection may be severe and dangerous if it occurs in or near the eye, or if it happens in immunosuppressed people.
Spread of herpes to other skin areas
Secondary bacterial skin infections
Recurrence of herpes labialis
Generalized infection—may be life-threatening in immunosuppressed people, including those with atopic dermatitis, cancer, or HIV infections
Herpes infection of the eye is a leading cause of blindness in the US, causing scarring of the cornea.
Calling your health care provider
Call for an appointment with your health care provider if symptoms indicate herpes labialis and symptoms persist for more than 1 or 2 weeks.
Call if symptoms are severe, or if you have a disorder associated with immunosuppression and you develop herpes symptoms.
Avoid direct contact with cold sores or other herpes lesions. Minimize the risk of indirect spread by thoroughly washing items in hot (preferably boiling) water before re-use. Do not share items with an infected person, especially when herpes lesions are active. Avoid precipitating causes (especially sun exposure) if prone to oral herpes.
Avoid performing oral sex when you have active herpes lesions on or near your mouth and avoid passive oral sex with someone who has active oral or genital herpes lesions. Condoms can help reduce, but do not entirely eliminate, the risk of transmission via oral or genital sex with an infected person.
Unfortunately, both oral and genital herpes viruses can sometimes be transmitted even when the person does not have active lesions.
Our thanks to the NIH for allowing us to reprint this article: http://www.nlm.nih.gov/medlineplus/ency/article/000606.htm
Important disclaimer: The information on pkids.org is for educational purposes only and should not be considered to be medical advice. It is not meant to replace the advice of the physician who cares for your child. All medical advice and information should be considered to be incomplete without a physical exam, which is not possible without a visit to your doctor.
What It Is, How It Spreads, Treatment
What is genital herpes?
Genital herpes is a contagious sexually transmitted infection (STI). People with genital herpes develop painful blisters on their genitals. Blisters sometimes form on or inside the anus. These infections can clear up and then return months or years later.
The herpes simplex virus (HSV) causes genital herpes. HSV spreads through vaginal, oral and anal sex. You can also get HSV from kissing or close (skin-to-skin) contact with someone who has open sores.
What are the types of herpes viruses?
Herpes is a group of contagious viruses. All of these viruses cause blisters and sores. Some of the more common herpes viruses include:
- Type 1: HSV-1, or oral herpes, causes cold sores to form on lips, gums, tongue and inside the mouth. It can cause genital herpes in some cases This type usually spreads through saliva when you kiss someone with open herpes sores. You can also get HSV-1 by sharing items like toothbrushes, lipsticks or eating utensils.
- Type 2: HSV-2 causes genital herpes.
- Herpes zoster: This virus causes chickenpox and shingles.
How common is genital herpes?
Around 1 in 6 Americans between the ages of 14 and 49 have HSV-2, the virus that causes genital herpes.
Who might get genital herpes?
Genital herpes affects teens and adults of all genders and races. It can spread if you have multiple sexual partners and don’t use condoms.
Women are more at risk. Delicate vaginal tissue can tear, making it easier for the infection to get in. Black women are especially vulnerable. An estimated 1 in 2 African-American women between the ages of 14 and 49 is infected with HSV-2, the virus that causes genital herpes.
Where do genital herpes form?
Sores from genital herpes can infect the:
- Buttocks, anus and inner thighs.
- Female reproductive system, including the vagina, vulva, labia (vaginal lips) and cervix (tissue that connects the vagina and uterus).
- Lips, mouth, tongue, cheeks and roof of the mouth.
- Penis and testicles (parts of the male reproductive system).
Is genital herpes contagious?
The virus that causes genital herpes is highly contagious. You can give genital herpes to others or get it from someone who’s infected. Even when a person doesn’t have blisters or symptoms, it’s still possible to infect another person with the herpes virus.
Can you get genital herpes from someone who has cold sores?
Yes. The different types of herpes viruses can infect other parts of the body. You can get herpes sores on your genitals if you receive oral sex from someone who has open sores from HSV-1 (oral herpes).
Symptoms and Causes
What causes genital herpes?
Genital herpes is a sexually transmitted infection or STI, also called a sexually transmitted disease or STD. A contagious virus causes the infection.
How does genital herpes spread?
The herpes virus that causes genital herpes spreads through saliva, semen and vaginal secretions. It’s possible to get genital herpes from someone who doesn’t have visible symptoms. You can have the infection, not know it and infect someone else.
Research has found it is possible for genital herpes to spread through:
- Intercourse, including anal, vaginal-penile and vaginal-vaginal.
- Oral sex (giving or receiving) with someone who’s infected.
- Skin-to-skin contact without ejaculation.
- Touching open sores, including while breastfeeding.
- Childbirth by a mother who has an active infection.
You can’t get genital herpes from objects like toilet seats. But you could pass genital herpes through shared sex toys. (To stay safe, wash sex toys before and after using them, and don’t share them. If you do, protect them with a condom.)
What are the symptoms of genital herpes?
Some people never develop symptoms. They don’t know they have the herpes virus that causes genital herpes. They may unknowingly infect others. You can have the herpes virus for years and not have symptoms, so it’s hard to know when or from whom you got it.
When symptoms occur, they’re usually worse during the first outbreak or flare-up (called primary herpes). Symptoms typically appear within two to 20 days after infection. Active symptoms may last up to four weeks.
You may experience:
Can I get genital herpes more than once?
There isn’t a cure for HSV-2, the virus that causes genital herpes. Infections can come back (called a recurrence). Recurring symptoms are usually milder than the first outbreak. Symptoms don’t last as long with later outbreaks. Some people may only have one or two outbreaks during their lifetime. Others may have as many as four or five outbreaks a year.
After infection, the virus moves from skin cells to nerve cells. In the nerve cells, it becomes inactive (latent). Certain things may reactivate the virus, such as:
- Illness or fever.
- Anything that suppresses the immune system.
- Sun exposure.
Diagnosis and Tests
How are genital herpes diagnosed?
Other STIs, like syphilis, cause similar symptoms. In addition to a physical exam, your healthcare provider will take a fluid sample from the blisters to test for the herpes virus. If your blisters are healed or you don’t have blisters, a blood test can check for HSV-2 antibody, a marker that shows you have been exposed to the virus.
Management and Treatment
How is genital herpes managed or treated?
If you have mild symptoms or infrequent outbreaks, you might not need or want treatment. During an outbreak, these steps can ease symptoms:
- Apply an ice pack to your genitals. Wrap the ice pack in a washcloth or apply it over your underwear.
- Keep genitals dry. Wear cotton or other nonsynthetic underpants and avoid tight-fitting clothes. Moist sores take longer to heal.
- Soak in a warm bath.
- Take nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain.
- Wear loose-fitting clothing.
Antiviral medications can prevent outbreaks. They can also lessen symptoms and help symptoms go away faster. You take this medicine as a pill, intravenous injection or skin cream. When taken daily, antivirals can prevent an outbreak. They lower the chances of spreading the virus to other people.
What are the complications of genital herpes?
People who have open sores from genital herpes are twice as likely to get HIV compared to people without herpes. This risk is yet another reason why it’s important to use condoms.
How does genital herpes affect pregnancy?
Genital herpes doesn’t affect fertility or your ability to conceive. Pregnant women with a diagnosis of herpes genitalis are recommended to start a daily antiviral at 36 weeks of pregnancy to prevent outbreaks during time of delivery. If you have an active infection at the time of childbirth, you can pass the herpes virus to your baby. Neonatal (at birth) herpes puts a baby at risk for blindness, brain damage, skin infections and death. Your healthcare provider will perform a cesarean section to lower this risk.
Is it safe to breastfeed if I have genital herpes?
Yes- as long as there is no open lesion on chest or breast . If you have an active outbreak while breastfeeding, it’s possible to spread the infection to your nipples through touch. Careful hand-washing can prevent this spread. You shouldn’t nurse from a breast that has herpes sores. You can pump breast milk until the sores heal. Don’t give your baby expressed breast milk if the pump comes into contact with an open sore.
How can I prevent genital herpes?
If you’re sexually active, you can take these steps to protect yourself and others from herpes virus and other STIs:
- Be monogamous with one sexual partner or limit your number of partners.
- Get tested for STIs and complete any needed treatment.
- Tell your sexual partners if you have genital herpes so they can get tested.
- Use condoms, including dental dams during oral sex.
- Wash your hands often if you have an outbreak or are around someone with symptoms.
If your sexual partner has genital herpes, these actions can lower your risk of getting the virus:
- Don’t have sex when your partner has active symptoms. (Condoms may not cover all sores, so you may still get the virus.)
- Make sure your partner takes antiviral medication as prescribed.
- Wait to have sex until scabs fall off.
Outlook / Prognosis
What can I do if I have herpes?
Many people who find out they have herpes feel depressed knowing they will always have the virus and can give it to others. But you are not alone. Herpes is one of the most common STIs, both in the US and worldwide. Exact numbers of people affected are not known. This is because many people don’t realize they have it, especially if symptoms are minor and are not bothersome. If you have herpes, you should:
- Learn all you can about it. Information will help you to manage your disease and feel better about yourself.
- Talk about your illness with your doctor.
If you have herpes, you can still:
- Have sex if you use a condom (and/or have your partner use a condom), and you tell your partner about your illness. Some couples, who have sexual relations only with each other, may choose not to use condoms even though one partner has herpes. Because each situation is different, you should talk to your doctor if this is a right choice for you in your relationship.
- Have children. Women with herpes can still give birth to healthy babies. If you have herpes and plan to have children, discuss your illness with your health care provider.
If you have herpes, you should also get checked for HIV (AIDS) and other STIs (syphilis, gonorrhea, chlamydia).
When should I call the doctor?
You should call your healthcare provider if you experience:
- Genital irritation or itching.
- Genital or anal blisters.
- Painful intercourse.
- Painful urination (dysuria).
- Unusual or foul-smelling penile or vaginal discharge.
- Vaginal or penile redness, soreness or swelling.
What questions should I ask my doctor?
You may want to ask your healthcare provider:
- What is the best treatment for me?
- What are the side effects of antiviral medications?
- How can I reduce the risk of future outbreaks?
- What’s the best way to prevent getting another STI?
- How can I protect my partner from getting genital herpes?
- Should I look out for signs of complications?
A note from Cleveland Clinic
Millions of people are living with the herpes virus that causes genital herpes. It’s a common STI. You shouldn’t be embarrassed or put off seeking medical care if you develop symptoms. Treatments can ease symptoms, reduce outbreaks and protect sexual partners from infection. Having the virus shouldn’t affect your relationships or sexual health. However, you do need to tell your sexual partners that you have the virus. Your healthcare provider can discuss ways to prevent spreading this STI.
Cold sores (oral herpes)
Oral herpes is a very common mouth infection caused by the Herpes simplex virus (HSV). It causes small, fluid-filled blisters to develop around the lips or inside the mouth. These are commonly known as cold sores.
- About oral herpes
- Special considerations
- Further information
- Related topics
About oral herpes
Oral herpes is caused by the Herpes simplex virus (HSV). You can get oral herpes through skin-to-skin contact with someone who has the herpes virus or by sharing objects which have been in contact with the virus such as a razor or a lipstick.
From the first time you get a HSV infection (primary infection), the virus remains in your body for the rest of your life but is inactive (dormant). However, from time to time the virus can become active again and cause cold sores to develop.
Many people don’t get any symptoms the first time they get oral herpes (primary infection) and the infection goes unnoticed. However for some people, the primary infection can cause symptoms and make them feel unwell. Children under the age of five are most likely to be ill from a primary infection.
Symptoms of a primary oral herpes infection can include:
- blisters on the border between the lip and the surrounding skin (which may crust over)
- blisters inside the mouth (stomatitis)
- swollen and painful gums (gingivitis)
- sore throat and swollen glands
- bad breath (halitosis)
- feeling generally unwell with flu-like symptoms such as a fever and headache
- an increased amount of saliva in your mouth
Children more commonly get blisters in and around the mouth and swollen painful gums. The mouth sores can last for 10 to 14 days, during which time eating and drinking can be difficult.
If you get symptoms from a primary infection during adulthood, you are more likely to have a sore throat and swollen tonsils or a glandular-fever type illness (see Related topics).
After you have the primary infection, whether or not you have symptoms, the virus lies dormant in your body but can become active from time to time. Recurrent episodes of the infection are commonly known as “cold sores”. These usually occur on the border between the lip and the skin surrounding the skin.
Symptoms of a cold sore can include:
- a tingling sensation, redness and swelling around the lip before the cold sore develops
- small, fluid-filled blisters which break open and develop a yellow crust (scab). The scab usually falls off around seven days later
Recurrent cold sores tend to appear in or around the same place each time.
HSV can spread to other areas of skin around the body such as the fingers, eyes or genitals (see Related topics).
A HSV infection can be severe, and sometimes fatal, particularly if you have a weakened immune system (see Special considerations). On very rare occasions individuals with atopic eczema may also get a severe infection.
Rarely, HSV can be passed on to your baby during birth (see Special considerations).
Oral herpes is caused by HSV. There are two types of this virus, HSV-1 and HSV-2.
Oral herpes is usually caused by HSV-1 but HSV-2 can sometimes be the cause. Both types of HSV can also cause genital herpes (see Related topics).
You can get oral herpes through skin-to-skin contact with someone who has the herpes virus or by sharing objects which have been in contact with the virus such as a razor or a lipstick. The herpes virus can also be passed between the mouth and the genitals during oral sex.
There are a number of things that can trigger an episode of cold sores. These include:
- emotional stress
- strong sunlight on the lips
- an injury to the mouth or a dental procedure
- a fever
For many people, however, the trigger is unknown.
You may wish to go and see your GP if you have oral herpes. Usually, your doctor will be able to recognise oral herpes from looking inside and around your mouth. However, he or she may also take a swab of fluid from the blister or sore. The sample will be sent to a laboratory to confirm that you have the herpes virus.
There is no treatment that can get rid of the herpes virus from your body. Once you are infected it will remain in your body, even if you never get another episode. An episode of oral herpes will clear up on its own, usually within a week or so.
Treatment for cold sores
There are steps that you can take to help relieve any pain or discomfort from cold sores and prevent them spreading:
Take an over-the counter painkiller, such as paracetamol or ibruprofen to ease any pain or discomfort if necessary.
Anti-viral cold sore creams (which you can get over-the-counter from your pharmacy) can help the cold sore to clear more quickly, particularly if applied when you first notice symptoms, such as a tingling sensation around your lips, before the blister appears. Don’t share cold sore creams with anyone else.
Occasionally, if the infection is particularly severe or frequent, your GP may prescribe anti-viral tablets
Creams and liquids (which you can get over-the-counter from your pharmacy) can ease irritation once the cold sore has developed. These should be dabbed on, and not rubbed in, to prevent further irritating the skin.
Try not to touch the cold sore and if you do, wash your hands thoroughly to prevent spreading the infection.
Don’t kiss or have oral sex until you (or your partner’s) cold sores have completely healed.
Don’t share any objects which have been in contact with the virus such as a lipstick or lip gloss, razor, face towel or cutlery.
Wash your hands thoroughly before putting your contact lenses in to prevent HSV infection in the eye.
Always follow the instructions in the patient information leaflet that comes with the medicine and ask your pharmacist for advice on if it’s suitable for your individual circumstances.
Treatment for blistering of the mouth and gums
If you or your child has severe blistering of the mouth and gums, there are other treatments that may be needed. Your doctor may give you a cream to help relieve pain and may also give you a mouthwash to help maintain good oral hygiene if brushing your teeth is painful.
The self-help steps for cold-sores can help if you or your child has this problem, but in addition to these you should also:
- drink plenty of water to avoid dehydration; it’s particularly important to check that your child is drinking enough as they may avoid drinking because of a painful mouth
- eat cool, soft foods and avoid foods which are salty or acidic
- use a lip barrier cream (such as Vaseline) to stop your lips sticking together
If you have a weakened immune system
If you have a weakened immune system (for example HIV/AIDS or certain types of cancer treatment), you should visit your GP if you develop either primary or recurrent oral herpes because the infection can be severe and you may develop complications.
If you are pregnant
Although very rare in the UK, HSV can occasionally be passed on to your baby when he or she is born. This is known as neonatal herpes and can cause your baby to be seriously ill. If you have oral herpes when you are pregnant, particularly in the later stages of pregnancy, you should go and see your GP or obstetrician for advice.
You shouldn’t kiss anyone or share anything which may have come into contact with HSV (such as cutlery or lipstick) when you are pregnant.
If you have eczema
If you have eczema and HSV together, this can cause a severe rash called eczema herpeticum. You should see your GP for advice about this.
There are ways that you can lower your risk of getting or passing on oral herpes and prevent recurrent episodes.
- use sun block on your lips if overexposure to sunlight triggers your cold sores to develop
- don’t kiss someone who has a cold sore
- don’t have oral sex if you or your partner has a cold sore or has genital herpes
- don’t share any creams, medicines, make-up or any object which may have come into contact with an infected area
Herpes Viruses Association
- Herpes simplex – oral. NHS library for health. Clinical Knowledge Summaries 2007. www.cks.library.nhs.uk
- Kumar P, Clark M, Clinical medicine. 6th ed. London: Elsevier Saunders, 2005
- Beers M et al (eds) The Merck manual of medical information. 2nd ed. New York: Pocket books, 2004
- Chantel S, Everitt H, Kendrick T. Oxford Handbook of General Practice. 2nd ed. Oxford: Oxford University Press, 2005
- Herpes labialis (oral Herpes simplex). Medline plus. www.nlm.nih.gov/medlineplus, accessed 17 January 2008
- Genital herpes
- HIV and AIDS
- Glandular fever
Can Oral Herpes Be Spread to Genitals?
Pictured above: A herpes simplex lesion on the lower lip on the second day after onset. Image: CDC Public Health Image Library ID# 5434
Herpes simplex virus is mystifying, fascinating, and sneaky. Mystifying because we have yet to unravel all of its secrets; fascinating because when we do uncover one of its mysteries, we are amazed by the capabilities of such a tiny, microscopic object; and sneaky because it enters our bodies by stealth and conceals itself in our cells, taking us by surprise when it comes out of hiding and causes outbreaks of blisters and other lesions.
It can also be confusing. Herpes simplex virus actually comes in two flavors: HSV-1 and HSV-2. HSV-1 is associated more with oral herpes, which can cause “cold sores,” a type of blister that appears on the lips or face. HSV-2 is associated more with genital herpes, which can cause blisters and other lesions in the genital area. It used to be standard to describe HSV-1 as an “above-the-waist” infection and HSV-2 as a “below-the-belt” infection — but now many researchers are pointing out that it’s more appropriate to say that HSV-1 is both an orally and genitally transmitted infection while HSV-2 is a predominantly genitally transmitted infection. If HSV-1 enters the body in the genital area, it can cause a genital herpes infection — and likewise, if HSV-2 enters the body in the facial area, it can cause an oral herpes infection.
Using condoms and dental dams during oral sex reduces risk of herpes transmission.
What exactly is a cold sore, anyway? A cold sore, also known as a fever blister, is a cluster of blisters that can pop up around the lips or even in the mouth. Sometimes, cold sores are so painful that eating or drinking is difficult, and in extreme cases sufferers must be treated for dehydration. An especially severe infection could also cause high fever or swollen lymph nodes, and in young adults a first oral HSV-1 infection might be misdiagnosed as tonsillitis, possibly leading to unnecessary tonsillectomies. Most symptomatic first-time cold-sore outbreaks occur during childhood, and take about two or three weeks to clear up. Luckily, the first infection is almost always the most severe, and when the infection is reactivated it usually happens without symptoms.
Because both cold sores and genital herpes are caused by herpes simplex viruses, and because oral herpes is so common, many people are concerned that they might be more vulnerable to acquiring a genital herpes infection than they previously thought. They might have a lot of questions, and if they’ve sought answers to those questions, they might have heard a lot of conflicting answers. Let’s see what the scientific literature has to say.
- Can I get genital herpes if someone with cold sores performs oral sex on me?
Because HSV-1, the virus responsible for most oral herpes infections, can also cause genital herpes, many people wonder if someone with cold sores can transmit the virus to someone else by performing oral sex, resulting in a genital herpes infection. Other people wonder if HSV-1 can be transmitted via oral contact with the anus, resulting in a herpes infection in the rectal area. The answer to these questions is: Yes!
While HSV-1 only accounts for around 30 percent of genital herpes infections overall, many research teams are finding that HSV-1 is the predominant cause of genital herpes in some countries (such as Sweden) and in some U.S. populations, especially of younger females. For example, among students at a large Midwestern public university, researchers found that HSV-1 caused 31 percent of genital herpes cases in 1993 and grew to 78 percent in 2001. The increase was even more pronounced in females. This trend, in which HSV-1 infections in the genitals predominate over HSV-2, seems to be most common among younger people, women, and men who have sex with men. This change might be due to the fact that condom use for vaginal and anal intercourse is considered normal in most populations — while most people don’t use condoms or dental dams during oral sex, leaving them vulnerable to acquiring HSV-1 (and other infections!) from a partner.
This might sound like terrible news, since most of us are infected with HSV-1 and we might enjoy oral sex. But there is some good news. First of all, HSV-1 likes to live in the trigeminal ganglion — in the face. Because HSV-1 feels more at home in the trigeminal ganglion, an infection in that location is more likely to reactivate and cause cold sores periodically throughout a person’s life. When HSV-1 finds itself living in the sacral ganglion in the genital area, it doesn’t reactivate very often. So, if you are infected with HSV-1 in your genital area after receiving oral sex, recurrences will be uncommon and your infection will be milder than if you were infected with HSV-2, which is a related virus that is more strongly associated with genital herpes.
- Can I be infected with HSV-2 in my facial area if I perform oral sex on someone with an HSV-2 infection in their genitals?
Just as HSV-1 can pass from the mouth to the genitals to cause a genital herpes infection, so too can HSV-2 pass from the genitals to the mouth to cause an oral herpes infection. However, oral HSV-2 infections aren’t as common as genital HSV-1 infections. Although there are some documented cases of oral HSV-2 infections, they aren’t very widespread. Furthermore, just as a genital HSV-1 infection is milder and less prone to recurrences than an HSV-2 infection in that area, so too is an oral HSV-2 infection milder and less prone to future outbreaks.
- Can the virus be transmitted if someone isn’t showing any symptoms?
Unfortunately, just because someone lacks a telltale cold sore doesn’t mean they’re not infectious. It is quite possible for the virus to reactivate, not cause symptoms, but still “shed” from a carrier, at which point it can be transmitted to someone else — via skin-to-skin contact, saliva, or even tears. One large study, using a sensitive DNA amplifying technique called PCR, detected the asymptomatic shedding of HSV-1 on 33.3 percent of days. Another study of 50 people found that 90 percent of them had HSV-1 in their saliva at least once during a 30-day period.
Shedding patterns can be further influenced by what triggered the virus to reactivate — for example, higher-than-average amounts of virus are found in saliva samples from patients with oro-facial fractures.
- If I’ve already been exposed to HSV-1 in my facial region, am I immune to reinfection in my genitals?
Some people think that already being orally infected with the cold sore virus makes them immune to HSV-1 infections in their genitals. It’s true that if you have an oral HSV-1 infection, you might have some degree of protection against acquiring HSV-1 infection in your genitals — but we don’t know to what degree a previous HSV-1 infection protects us from subsequent infections elsewhere in our bodies. More study is needed to answer this question more fully, but the short answer is that yes, reinfection in the genitals is possible.
- Does a previous HSV-1 infection protect me from a subsequent HSV-2 infection?
As mentioned previously, most of us are orally infected with HSV-1 as children. Unfortunately, a preexisting HSV-1 infection doesn’t protect us from acquiring an HSV-2 infection later in life, though it’s possible that it will help mitigate symptoms of a first HSV-2 outbreak. Those who already have an HSV-1 infection are much less likely to experience symptoms upon an initial HSV-2 infection. Likewise, a previous HSV-2 infection does not protect someone from acquiring an HSV-1 infection. It’s possible for HSV-1 and HSV-2 to infect the genitals at the same time — it just might not be as likely.
- Can my genital HSV-1 infection be transmitted to my partner’s genitals?
When HSV-1 infects the genitals, it usually got there as a result of oral sex. Because genital HSV-1 infections have fewer recurrences and are associated with less asymptomatic shedding, the genital-to-genital spread of HSV-1 is not as common.
If you want to find out if you’ve been infected with HSV-1 or HSV-2, you can get a blood test at a Planned Parenthood health center. This test will only tell you if you’ve been infected with either of these viruses, but in the absence of symptoms it won’t tell you where in your body the infections are located. We can also answer any questions you have about herpes and discuss antiviral medications with you.
sexually transmitted infections,
Foothill Dermatology Medical Center: Dermatology
Herpes simplex: After clearing, herpes simplex sores can return. When the sores return, the outbreak tends to be milder than the first outbreak.
Herpes simplex: Overview
Herpes simplex is a common viral infection. If you’ve ever had a cold sore or fever blister, you picked up the herpes simplex virus. Most cold sores are caused by herpes simplex virus type 1 (HSV-1). Other names for cold sores caused by HSV-1 are:
- Oral herpes.
- Mouth herpes.
- Herpes simplex labialis.
A closely related herpes simplex virus, HSV-2, causes most cases of genital herpes. But either HSV-1 or HSV-2 can cause a herpes sore on the face or genitals.
Image used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.
Herpes simplex: If a person has HSV-1, a bad sunburn can trigger a herpes simplex outbreak.
Herpes simplex: Signs and symptoms
Many people who get the virus that causes herpes never see or feel anything. If signs (what you see) or symptoms (what you feel) occur, a person may experience:
- Tingling, itching, or burning: Before the blisters appear, the skin may tingle, itch, or burn for a day or so.
- Sores: One or more painful, fluid-filled blisters may appear. Blisters break open and often ooze fluid and form a crust, before healing. The first time sores appear, they will show up between 2 and 20 days after a person has contact with an infected person. The sores can last from 7 to 10 days. Where the sores appear often varies with type:
- Oral herpes (HSV-1): Most blisters appear on the lips or around the mouth. Sometimes blisters form on the face or on the tongue. Although these are the most common places to find oral herpes, the sores can appear anywhere on the skin.
- Genital herpes (HSV-2): Sores typically occur on the penis, vagina, buttocks, or anus. Women can have sores inside the vagina. Like oral herpes, these sores can appear anywhere on the skin.
- Flu-like symptoms. Fever, muscle aches, or swollen lymph nodes (glands) in the neck (oral herpes) or groin (genital herpes) are possible.
- Problems urinating. People (most often women) with genital herpes may have trouble urinating or have a burning feeling while urinating.
- An eye infection (herpes keratitis). Sometimes the herpes simplex virus can spread to one or both eyes. If this happens, you can have pain, light sensitivity, discharge, and a gritty feeling in the eye. Without prompt treatment, scarring of the eye may result. Scarring can lead to cloudy vision and even loss of vision.
Herpes simplex: Outbreaks usually develop around the mouth or on the genitals, but the sores can appear almost anywhere on the skin.
If you develop signs and symptoms of herpes simplex, you can expect to have these for as long as listed below:
- Oral (mouth) herpes: 2 to 3 weeks
- Genital herpes: 2 to 6 weeks (the first outbreak)
Images used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.
Herpes simplex: Who gets and causes
Who gets herpes simplex?
Most people get HSV-1 (herpes simplex type 1) as an infant or child. This virus can be spread by skin-to-skin contact with an adult who carries the virus. An adult does not have to have sores to spread the virus.
A person usually gets HSV-2 (herpes simplex type 2) through sexual contact. About 20% of sexually active adults in the United States carry HSV-2. Some people are more likely to get HSV-2. These people:
- Are female.
- Have had many sex partners.
- Had sex for the first time at a young age.
- Have (or had) another sexually transmitted infection.
- Have a weakened immune system due to a disease or medicine.
What causes herpes simplex?
Herpes simplex viruses spread from person to person through close contact. You can get a herpes simplex virus from touching a herpes sore. Most people, however, get herpes simplex from an infected person who does not have sores. Doctors call this “asymptomatic viral shedding.”
How people get herpes around their mouth
A person with HSV-1 (herpes simplex type 1) can pass it to someone else by:
- Touching the person’s skin, such as pinching a child’s cheek.
- Sharing objects such as silverware, lip balm, or a razor.
How people get herpes on their genitals
You can get genital herpes after coming into contact with HSV-1 or HSV-2. Most people get genital herpes from HSV-2, which they get during sex. If someone has a cold sore and performs oral sex, this can spread HSV-1 to the genitals — and cause herpes sores on the genitals.
Mothers can give the herpes virus to their baby during childbirth. If the baby is born during the mother’s first episode of genital herpes, the baby can have serious problems.
What happens once you have HSV-1 or HSV-2?
Once a person becomes infected with a herpes virus, the virus never leaves the body. After the first outbreak, the virus moves from the skin cells to nerve cells. The virus stays in the nerve cells forever. But it usually just stays there. In this stage, the virus is said to be dormant, or asleep. But it can become active again.
Some things that can trigger (wake up) the virus are:
- Sun exposure.
- Menstrual periods.
Herpes simplex: Diagnosis and treatment
How do dermatologists diagnose herpes simplex?
During an outbreak, a dermatologist often can diagnose herpes simplex by looking at the sores. To confirm that a patient has herpes simplex, a dermatologist may take a swab from a sore and send this swab to a laboratory.
When sores are not present, other medical tests, such as blood tests, can find the herpes simplex virus.
How do dermatologists treat herpes simplex?
There is no cure for herpes simplex. The good news is that sores often clear without treatment. Many people choose to treat herpes simplex because treatment can relieve symptoms and shorten an outbreak.
Most people are treated with an antiviral medicine. An antiviral cream or ointment can relieve the burning, itching, or tingling. An antiviral medicine that is oral (pills) or intravenous (shot) can shorten an outbreak of herpes.
Prescription antiviral medicines approved for the treatment of both types of herpes simplex include:
Taken daily, these medicines can lessen the severity and frequency of outbreaks. They also can help prevent infected people from spreading the virus.
The first (primary) outbreak of herpes simplex is often the worst. Not all first outbreaks are severe, though. Some are so mild that a person does not notice. When the first outbreak of genital herpes is mild and another outbreak happens years later, the person can mistake it for a first outbreak.
Some people have 1 outbreak. For others, the virus becomes active again. When they have another outbreak, it is called a recurrence. These tend to be more common during the first year of infection. Over time, the outbreaks tend to become less frequent and milder. This is because the body makes antibodies (defenses) to the virus.
Serious complications rarely occur in healthy people with herpes simplex. They occur most often in unborn babies, newborns, and people who have a long-term illness or weak immune system. If you have cancer or HIV/AIDS, or you had an organ transplant, seek medical help right away if you have signs or symptoms of a herpes infection.
Herpes simplex: Tips for managing
There are things you can do at home to help manage herpes sores.
The following can help:
- Apply medicine that you can buy without a prescription, such as benzocaine and L-lysine, to the blisters.
- Put ice on the blisters.
- Avoid things that could trigger another outbreak, such as stress and getting a sunburn.
Avoid spreading the virus
The following may reduce the risk of spreading the herpes simplex virus:
Oral herpes (herpes simplex type 1)
If you have sores on your face:
- Do not kiss anyone.
- Do not have oral sex.
- Do not share items such as silverware, cups, towels, and lip balms.
If you have tingling, burning, itching, or tenderness where you had a herpes sore, keep that area of your body away from others.
You can prevent spreading the sores to other parts of your body by:
- Washing your hands after touching a cold sore.
- Using a cotton-tip swab to apply herpes medicine to a cold sore also helps.
Genital herpes (herpes simplex type 2)
When you have sores or symptoms do not have sex with uninfected partners.
- If you do not have sores or symptoms, use a latex condom to lower the risk of spreading the virus. You should know that even with a condom, it is possible to spread the virus if it lies on nearby skin that the condom does not cover.
- If you are pregnant tell your doctor if you or your partner has genital herpes. You may need to take medicine at the end of your pregnancy to prevent passing the virus to your baby.
Anti-HSV-IgG (IgG class antibodies to herpes simplex virus types 1 and 2, HSV-1, 2)
Method of determination
Enzyme-linked immunosorbent assay (ELISA).
Antibodies of class G to herpes simplex virus types 1 and 2 (HSV, HSV), indicating previous or current infection with herpes simplex virus types 1 or 2.
Antibodies of class G are produced during the period of chronic infection with herpes simplex virus of the first or second type.
Features of the infection.
Genital herpes is caused by two different but related forms of the Herpes simplex virus (herpes simplex), known as herpes simplex virus type 1 (HSV-1), it more often causes “fever” on the lips – and herpes virus type 2 (HSV-2). The most common cause of genital lesions is the second type. But the disease of the lips, caused by the type I virus, can gradually spread to other mucous membranes, including the genitals. Infection can occur as a result of direct contact with infected genitals during sexual intercourse, when the genitals rub against each other, during oral-genital contact, anal intercourse or oral-anal contact.And even from a sick sexual partner, who has no external signs of the disease.
A common property of the listed viruses is their constant presence in the human body, from the moment of infection. The virus can be in a “dormant” or active state and does not leave the body, even under the influence of drugs. The manifest manifestation of any herpes infection indicates a decrease in immunity.
Herpes simplex virus type 1 is extremely common.Primary infection occurs, in most cases, during preschool age. In the future, the likelihood of infection drops sharply. A typical manifestation of infection is a “cold” on the lips. However, oral contact can damage the genitals. Internal organs are affected only with a significant decrease in immunity.
Genital herpes is characterized by the appearance on the genitals of clusters of small painful vesicles. They soon burst, leaving small ulcers. In men, blisters form most often on the penis, sometimes in the urethra and rectum.In women – usually on the labia, less often in the cervix or in the anal region. After 1 – 3 weeks, the disease seems to pass. But the virus penetrates the nerve fibers and continues to exist, hiding in the sacral spinal cord. In many patients, genital herpes gives recurrence of the disease. They occur with varying frequency – from once a month to once every several years. They are provoked by other illnesses, troubles, and even just overheating in the sun.
The genital herpes virus Herpes simplex type 2 affects mainly the integumentary tissues (epithelium) of the cervix in women and the penis in men, causing pain, itching, the appearance of transparent vesicles (vesicles) at the site of which erosion / ulcers are formed.However, oral contact may damage the integumentary tissue of the lips and oral cavity.
In pregnant women, the virus can cross the placenta into the fetus and cause birth defects. Herpes can also cause spontaneous abortion or premature birth. But the danger of infection of the fetus during childbirth is especially likely, when passing through the cervix and vagina with a primary or recurrent genital infection in the mother. Such infection increases the death rate of newborns by 50% or the development of severe damage to the brain or eyes.At the same time, there is a certain risk of infection of the fetus even in cases where the mother does not have any symptoms of genital herpes at the time of delivery. A baby can become infected after birth if the mother or father has lesions in the mouth, or get the virus in breast milk.
Herpes simplex virus type II appears to be associated with cervical and vaginal cancer and increases susceptibility to HIV infection that causes AIDS! In response to the introduction of HSV in the body, the production of specific class M immunoglobulins (IgM) begins.In the blood, they can be determined 4 to 6 days after infection. They reach their maximum value on the 15-20th day. From 10 to 14 days, the production of specific IgG begins, a little later – IgA
IgM and IgA remain in the human body for a short time (1 – 2 months), IgG – throughout life (seropositivity). Detection of IgM and / or a fourfold increase in titers of specific immunoglobulins G (IgG) in paired blood sera obtained from the patient with an interval of 10 to 12 days is of diagnostic value in primary infection with the herpes virus.Recurrent herpes usually occurs against the background of high IgG values, indicating constant antigenic stimulation of the body. The appearance of IgM in such patients is a sign of an exacerbation of the disease.
Important! HSV infection belongs to the group of TORCH infections (the name is formed by initial letters in Latin names – Toxoplasma, Rubella, Cytomegalovirus, Herpes), which are considered potentially dangerous for the development of the child. Ideally, a woman needs to consult a doctor and undergo a laboratory examination for TORCH infection 2 to 3 months before the planned pregnancy, since in this case it will be possible to take appropriate therapeutic or preventive measures, as well as, if necessary, in the future, compare the research results obtained before pregnancy with the results of examinations during pregnancy.
90,000 Pass an analysis for IgM antibodies to herpes simplex virus types 1 and 2
Method of determination
Enzyme-linked immunosorbent assay (ELISA).
Home visit available
Attention. In case of positive and questionable reactions, the term for issuing the result can be increased up to 2 working days.
Class M antibodies to herpes simplex virus types 1 and 2 (HSV, HSV). A marker of primary infection with herpes simplex virus.
Antibodies to the herpes virus class M are the first antibodies formed after infection with the herpes virus, appearing in the blood within 1 to 2 weeks from the onset of infection. IgM antibodies to the herpes virus are predominantly a marker of primary infection.IgM antibodies can also be found in 10 to 30% of people with reactivation of an old infection. Features of the infection.
Genital herpes is caused by two different but related forms of the Herpes simplex virus (herpes simplex), known as herpes simplex virus type 1 (HSV-1) – which is more likely to cause “fever” on the lips – and herpes simplex virus type 2 (HSV-2). The most common cause of genital lesions is the second type. But the disease of the lips, caused by the type I virus, can gradually spread to other mucous membranes, including the genitals. Infection can occur as a result of direct contact with infected genitals during sexual intercourse, when the genitals rub against each other, during oral-genital contact, anal intercourse or oral-anal contact. And even from a sick sexual partner, who has no external signs of the disease. The common property of the listed viruses is their constant presence in the human body, from the moment of infection. The virus can be in a “dormant” or active state and does not leave the body, even under the influence of drugs.The manifest manifestation of any herpes infection indicates a decrease in immunity. Herpes simplex virus type 1 is extremely common. Primary infection occurs, in most cases, during preschool age. In the future, the likelihood of infection drops sharply. A typical manifestation of infection is a “cold” on the lips. However, oral contact can damage the genitals. Internal organs are affected only with a significant decrease in immunity. Genital herpes is characterized by the appearance on the genitals of clusters of small painful vesicles. They soon burst, leaving small ulcers. In men, blisters form most often on the penis, sometimes in the urethra and rectum. In women – usually on the labia, less often in the cervix or in the anal region. After 1 – 3 weeks, the disease seems to pass. But the virus penetrates the nerve fibers and continues to exist, hiding in the sacral spinal cord. In many patients, genital herpes gives recurrence of the disease. They occur with varying frequency – from once a month to once every several years.They are provoked by other illnesses, troubles, and even just overheating in the sun. The genital herpes virus Herpes simplex type 2 affects mainly the integumentary tissues (epithelium) of the cervix in women and the penis in men, causing pain, itching, and the appearance of transparent vesicles (vesicles) at the site of which erosion / ulcers are formed. However, oral contact may damage the integumentary tissue of the lips and oral cavity. In pregnant women: the virus can cross the placenta into the fetus and cause birth defects. Herpes can also cause spontaneous abortion or premature birth. But the danger of infection of the fetus during childbirth is especially likely, when passing through the cervix and vagina with a primary or recurrent genital infection in the mother. Such infection increases the death rate of newborns by 50% or the development of severe damage to the brain or eyes. At the same time, there is a certain risk of infection of the fetus even in cases where the mother does not have any symptoms of genital herpes at the time of delivery.A baby can become infected after birth if the mother or father has lesions in the mouth, or get the virus in breast milk. Herpes simplex virus type II appears to be associated with cervical and vaginal cancers and increases susceptibility to HIV infection that causes AIDS! In response to the introduction of HSV in the body, the production of specific class M immunoglobulins (IgM) begins. In the blood, they can be determined 4 to 6 days after infection. They reach their maximum value on the 15-20th day. From 10 to 14 days, the production of specific IgG begins, a little later – IgA. IgM and IgA remain in the human body for a short time (1 – 2 months), IgG – throughout life (seropositivity). Detection of IgM and / or a fourfold increase in titers of specific immunoglobulins G (IgG) in paired blood sera obtained from the patient with an interval of 10 to 12 days is of diagnostic value in primary infection with the herpes virus. Recurrent herpes usually occurs against the background of high IgG values, indicating constant antigenic stimulation of the body.The appearance of IgM in such patients is a sign of an exacerbation of the disease.
Important! HSV infection belongs to the group of TORCH infections (the name is formed by initial letters in Latin names – Toxoplasma, Rubella, Cytomegalovirus, Herpes), which are considered potentially dangerous for the development of the child. Ideally, a woman needs to consult a doctor and undergo a laboratory examination for TORCH infection 2 to 3 months before the planned pregnancy, since in this case it will be possible to take appropriate therapeutic or preventive measures, as well as, if necessary, in the future, compare the research results obtained before pregnancy with the results of examinations during pregnancy.
▷ Eurolab Medical Center
Analysis for the determination of the herpes virus type I-II, most often manifested in the form of small bubbles on the lips and genitals of a person.
Herpes virus type I-II or herpes simplex is a viral disease in the form of small grouped bubbles on the mucous membranes and skin. It is caused by two types of herpes viruses: HSV-1 and HSV-2.
Most common on the lips. In second place in terms of frequency of manifestations – genital herpes affecting the genital area.
HSV-1 causes infections:
- central nervous system.
Anogenital lesions are most common for HSV-2.
At the same time, it is possible that the locations of origin may vary and appear in a wide variety of places.
Indications for appointment
- Rash of vesicular herpetiformis
- Preparation for conception and pregnancy (for both partners)
- Manifestations of intrauterine infection, feto-placental insufficiency
- Differential diagnosis of urogenital infections
- Conditions of immunodeficiency nature
Help in express diagnostics of herpes simplex virus.
Real-time polymerase chain reaction
Material for research
Whole blood, scrapings:
- mucous membrane of the urogenital tract,
- discharge of blistering eruptions,
- erosive and ulcerative lesions of the skin and mucous membranes; liquor.
90,061 oral cavity;
Patient Preparation Guidelines
Standard conditions.8-12 hours after the last meal. A break of 6 hours after a meal is allowed (fatty foods should be excluded).
- Urogenital scraping
Reference conditions. For three hours before the analysis, they will refrain from urinating. Exclude sexual intercourse within three days. Do not take antibacterial drugs for two weeks.
For women, three days before the study, the following are contraindicated: douching, setting intravaginal suppositories, ointments, tampons.The material does not surrender during menstruation (3 days after its end).
- Oropharyngeal scraping
Reference conditions. On an empty stomach or 2-4 hours after eating. Before analysis, rinse your mouth with boiled water.
Herpes Simplex Virus 1/2, DNA [real-time PCR]: research in the laboratory KDLmed
A study to identify the causative agent of herpesvirus infection of the 1st and 2nd type (Herpes Simplex Virus 1/2), during which the genetic material (DNA) of the virus is determined using the real-time polymerase chain reaction (RT-PCR) method herpes simplex in a sample obtained from the urogenital tract.
Herpes simplex virus, herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2), determination of herpes by DNA.
Herpes Simplex Virus, Type 1 and Type 2, HSV-1 or HSV-2 IgM or IgG, HSV-1, HSV-2, HHV1, HHV2.
Real-time polymerase chain reaction.
Which biomaterial can be used for research?
Urogenital swab, first portion of morning urine, urogenital swab with prostate secretion, ejaculate, rectal swab.
How to properly prepare for the study?
- Women are advised to have a urogenital swab or urine before menstruation or 2 days after it ends.
- Men should not urinate for 3 hours before having a urogenital smear or urine test.
General information about the study
By PCR it is possible to detect even a small amount of viral particles in biological material. It allows you to identify herpes viruses, regardless of the time of infection, even in the period when antibodies in the blood have not yet formed.
The most common are the 1st and 2nd types of herpes. Both are contagious and cause small vesicles (vesicles) to appear on the mucous membranes, which burst to form open wounds. In HSV-1, vesicles appear around the mouth and in the mouth, whereas HSV-2 usually affects areas around the genitals.
Herpes simplex virus can be transmitted through skin contact if there are vesicles on the skin, and sometimes in the absence of visible lesions on it. HSV-2 is often referred to as a sexually transmitted disease, but HSV-1 herpes can also be contracted through, for example, oral sex.According to the WHO, from 50% to 80% of the adult population of developed countries is infected with herpes type 1 and about 20% – type 2. Since type 2 symptoms are subtle, 90% of those infected with it may not be aware of their infection.
In the case of primary infection, painful blisters usually form at the site of infection after two weeks, which usually disappear after four weeks. They appear on the genitals, around the anus, on the buttocks, or on the thighs, after which they can burst.You may also experience flu-like symptoms such as chills and sore throat.
However, bubbles are not always formed with herpes. Sometimes the manifestations of the disease are so weak that they go unnoticed or are mistaken for something else, such as insect bites or allergies. After the infection enters the body and spreads, the herpes virus is in a latent form. With stress or other diseases that lead to a decrease in immunity, it can be reactivated.In most cases, herpes simplex is not dangerous to health, but it can cause serious illnesses: neonatal herpes (if the child becomes infected during childbirth from a mother infected with genital herpes) and encephalitis. They can lead to serious, incurable neurological diseases and even death. The following factors increase the risk of contracting herpes:
- diseases in which the immune system is suppressed (e.g. HIV / AIDS),
- organ transplants.
Currently, a cure for herpes is not possible, however, there are antiviral drugs that suppress its spread, as well as shorten the duration of the acute phase of viral infection and alleviate the symptoms of the disease.
What is the research used for?
- For the detection of herpesvirus infection of the genital organs in men and women and control over its treatment.
- To test a woman for herpes before and during pregnancy (if there is a risk of infection).
When is the study scheduled?
If necessary, confirm or deny the fact of genital herpes infection.
What do the results mean?
Reference values: negative.
- The body is infected with a virus. The result is indicated in crosses, depending on the amount of genetic material identified during the study.
2 copies of DNA
10 2 -10 3 DNA copies
10 3 -10 4 DNA copies
10 4 -10 5 DNA copies
> 10 5 DNA copies
- Most often, the absence of infection of the genitals with the herpes virus.
What can influence the result?
- Antiviral therapy can reduce the amount of virus in epithelial cells, but due to the high sensitivity of the PCR method, this rarely leads to false negative results.
- Errors at the stage of taking biological material, when a sufficient number of cells infected with the virus does not enter the sample for research, can lead to false negative indicators.
- The most dangerous herpes is for newborns who were infected from the mother, and for patients with weakened immunity.
- Herpes increases the risk of HIV infection. Moreover, it can make HIV-infected patients even more infectious by increasing the amount of immunodeficiency virus in their blood.
- Herpes simplex virus in combination with papilloma virus increases the risk of cervical cancer.
- Herpes Simplex Virus 1/2, IgM
- Herpes Simplex Virus 1/2, IgG, titer
- Herpes Simplex Virus 1/2, DNA [real-time PCR]
- Herpes Simplex Virus 1/2, immunofluorescence
- Human Papillomavirus of high carcinogenic risk (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59), DNA genotyping [real-time PCR]
Who orders the study?
Gynecologist, urologist, dermatologist, infectious disease specialist, pediatrician.
90,000 Genital herpes – symptoms, diagnosis, treatment.
Primary infection is when a virus first enters the body and a person has not yet developed antibodies to it. This can manifest itself both with new-onset rashes on the body, and asymptomatic, which happens most often. External manifestations of primary infection with the virus continue up to 14-22 days with an increase in symptoms in the first week. The disease can last for quite a long time, not only the genitals can be affected, and accompanied by general and local / local symptoms.Common symptoms include fever, headache, malaise, and myalgia. Localized symptoms include pain, painful urination, itching, and discharge (from the vagina or urethra). Symptoms may gradually disappear up to 2–3 weeks. Sometimes a more complex course of HSV may occur, which requires hospitalization (severe aseptic meningitis, disseminated infection, etc.). In such cases, the course of the disease can be delayed up to 1.5 months.
Non-primary infection occurs in people who have already encountered the virus and who have antibodies to it.In these patients, the disease, as a rule, proceeds with less pronounced symptoms: the duration of which is about 15 days. Sometimes, the virus can be shed asymptomatically, and the course of the disease lasts 7-8 days.
Recurrent infection is detected in those patients who have both symptoms of genital herpes and antibodies to the reactivated type of the virus. The course of relapse can also be asymptomatic, and therefore, HSV can be diagnosed by performing specific research methods.The severity and duration of the course of the disease with relapse is even less than with the above forms of genital infection, and is only 2-3 days. Recurrence with HSV type 2 occurs more often than with HSV type 1. The frequency and nature of the appearance in patients can be quite different and affect the state of health.
Causes of activation and / or relapse of HSV:
- decreased immunity;
- hypothermia, or vice versa, overheating of the body.
- stress and some physiological conditions of the body .;
- medical manipulations / surgical interventions.
- intercurrent diseases (an acute disease that has joined already existing chronic ones, for example: a secondary infection).
The first manifestation of herpesvirus infection, as a rule, manifests itself more violently than subsequent relapses. In some patients, they are short-lived. Most of those infected have no symptoms of genital herpes.
HSV affects the skin and mucous membranes (most often on the face and genitals), the central nervous system, causing meningitis, encephalitis, eyes (conjunctivitis, keratitis). Also, HSV can provoke a pathological course during pregnancy and childbirth, and cause a frozen pregnancy, spontaneous miscarriage, developmental anomalies and / or death of the fetus, generalized damage by the causative agent of the virus in all organs and systems of the newborn. There has been a link between cervical cancer in women and prostate cancer in men.HSV, like some other herpes viruses, is capable of a latent process, which is subsequently reactivated and can cause permanent exacerbations of the disease and asymptomatic virus shedding.
Routes of transmission of HSV
Airborne. Contact and household. Through non-sterile instruments, personal hygiene products (razors, etc.). Sexually. The vertical route of transmission of the virus (from mother to fetus). The disease is transmitted mainly sexually, regardless of the form of intimacy (genital, oral, anal) from a patient with genital herpes or a carrier of the virus.Infection can occur when the partner who is the source of the infection has a relapse of the disease or, which is especially important, when he sheds the virus without having clinical symptoms. Sometimes, HSV can infect individuals who do not have active manifestations of the virus at the time of intercourse or even episodes of virus activation, and therefore do not even know that they are infected. The likelihood of infection by household means through personal hygiene products is not excluded. HSV is introduced into the body through the skin mucous membranes, after which it is captured with the help of viral receptors by sensory nerve endings.Herpes destructively affects the patient’s immune system and, therefore, becomes the cause of secondary immunodeficiency. Recurrences of HSV disrupt the patient’s full sex life, and are often the cause of neuropsychic and psychological disorders. Manifestations on the mucous membrane and skin are the most frequent manifestations of the disease, and infection with genital herpes is one of the most common sexually transmitted diseases.
The risk of infection of a baby during pregnancy and childbirth depends on many factors, and can reach 75% of the probability.Intrauterine infection with HSV-2 is less common. In the overwhelming majority of cases, infection of a newborn occurs during childbirth when the baby passes through the birth canal of the mother. Moreover, the transmission of infection is possible both in the presence of lesions in the cervix and vulva, and in the case of asymptomatic virus isolation. When the virus is released during pregnancy, it can cause fetal death, causing frozen / undeveloped pregnancies and provoke miscarriages, both in the early and late periods of gestation.HSV ranks second after rubella virus in fetal anomalies. Possible infection of the newborn after childbirth, with an active manifestation in the woman in labor and honey. staff, but this is extremely rare.
Typical localization in women: on the labia majora and labia minora, on the vulva, clitoris, in the vagina, and on the cervix, as well as often on the perianal region, and the buttocks. In men, these are the glans penis, foreskin and urethra.
There are several forms of recurrent genital herpes:
- The manifest form of recurrent herpes is characterized by the presence of herpetic elements in the lesion.Typical manifestations of the disease are vesicles, erosion, ulcers, exudation, recurrent nature of the disease. Some patients with genital herpes complain of general malaise throughout the body, headaches, fever up to subfebrile values, some have disturbed sleep, as well as anxiety and irritability. As a rule, at the stage of development of the disease, patients note a burning sensation, itching, “irritation and” tickling “, pain in the genital area. The affected area becomes somewhat edematous, turns red, and then, there are single or multiple small vesicles up to 2-3 mm.The contents of these vesicles are initially transparent, then cloudy and become purulent. Within a few days, the bubbles empty, dry out, crusts form, which gradually disappear, and spots remain on the site of these rashes for several days, and subsequently disappear altogether.
- Atypical form occurs in the form of swelling and itching. The affected area is represented by deep recurrent cracks in the skin, mucous membrane of the genitals and underlying soft tissues, which heal in 4-5 days.
- The abortive form of herpes most often occurs in patients who have already received antiviral drugs and vaccine therapy. Herpetic lesions in this form of herpes bypass the stages associated with the manifest form, and can manifest itself in the form of itchy spots or papules, which resolve on their own within 1-3 days. The abortive forms of herpes include: erythematous, papular, and prurigoneurotic, in which there are no vesicular elements. Diagnosis of varieties of genital herpes, flowing in an erased abortive form, sometimes causes great difficulties.The disease is usually recognized when typical recurrences of herpes alternate with rashes or occur simultaneously with them.
- Subclinical form of genital herpes is mainly detected during examination of persons with STDs (sexually transmitted diseases), or in married couples with impaired reproductive functions. This form is characterized by “microsymptomatics” (short-term appearance of mild, superficial cracks, accompanied by slight itching), or the complete absence of any external manifestations.
Depending on the location and severity in patients with genital herpes, three stages are conditionally divided:
- Stage 1 – damage to the external genital organs.
- Stage 2 – herpetic colpitis, cervicitis, urethritis.
- Stage 3 – herpetic endometritis (infection with the virus of the uterine mucosa), salpingitis (damage to the fallopian tubes) or cystitis (inflammation of the bladder).
Herpetic vesicles form characteristic polycyclic scalloped shapes.Subsequently, superficial ulcers covered with a grayish bloom are formed, according to the number of former bubbles, or continuous erosion with a smooth bottom and not undermined edges, surrounded by a bright red rim. The sores are neither deep nor bleeding. Herpetic ulceration is sometimes very painful. Ulcers and erosions heal without scarring. Herpetic eruptions on the labia minora and vulva in women, in some cases, cause significant swelling of the labia. With herpetic cervicitis, the cervix is swollen, often with erosion.Relapses occur either spontaneously, or after sexual intercourse, or before and after menstruation. Often the appearance of herpes of the genitals is provoked by other infections. Recurrent herpetic infection can be localized not only in the external genital area, but also, affect the mucous membrane of the vagina, cervix and ascending through the mucous membrane of the uterus, fallopian tubes, mucous membrane of the urethra and bladder, and cause a specific lesion in them.
The clinical picture of the lesion of the herpes virus in men appears most often in the form of small bubbles, and the formation of superficial ulcers on the head of the penis, foreskin, and groove area.The course of the disease is characterized by recurrent episodes. Complaints with herpetic urethritis in men begin with the appearance of pain, with irradiation to the scrotum, penis, urethra, legs, buttocks, perineum, burning sensation in the urethra. Patients also note these complaints during urination, the appearance of light or yellowish discharge from the urethra, redness and swelling in the area of the urethral opening. At the stage of erosion healing, erythematous or pigmented spots are visualized in this place. The chronic course of recurrent balanoposthitis is detected in most patients with herpes.
The defeat of the genital infection caused by HSV, in some patients provokes psychological and even psychosexual disorders, in the form of embarrassment, fear of sexual intercourse, depression, loss of self-confidence, mental trauma, anger, loss of self-esteem, loss of self-esteem, increased anxiety, negative emotions, hostility and even aggressiveness towards the source of infection. Many, for fear of rejection, hide information about the presence of genital herpes.Women perceive and transfer this news more emotionally, due to the psychological characteristics of the weaker sex. Moreover, those patients who first encountered genital herpes have deeper psychological problems than with other sexually transmitted diseases. Frequent exacerbations and pronounced manifestations of the disease can affect his behavior and even change the character of the patient.
Herpes tests – get tested for herpes virus – prices in St. Petersburg
Laboratory tests of herpes infection
The herpes virus is widespread in the world – it is carried by 90% of the world’s population.True, this infection does not manifest itself in everyone and not always. She is waiting for the moment when a person’s immunity for some reason weakened. Depending on the state of the immune system and the type of pathogen, herpes infection can affect the skin, mucous membranes and nerve cells and manifest itself in different ways – from a mild rash on the lips to severe damage to internal organs. With chronic immunodeficiencies, such as HIV, the disease takes on the most severe forms.
There are eight types of human herpes – Herpes human Virus, but the most common is Herpes Simplex Virus – herpes simplex virus.It is of the first and second type.
Herpes simplex virus and routes of infection
Herpes simplex virus type 1 penetrates the skin and mucous membranes and causes local inflammation in the area of the nasolabial folds or in the mouth (stomatitis). Vesicles form on the lip, wings of the nose or in the mouth – small bubbles with a watery content. Most often, they go away on their own after a week. In rare cases, the disease is accompanied by fever and joint aches.The herpes virus of the first type is transmitted from person to person by airborne droplets and contact-household means.
The second type of herpes simplex virus affects the genital mucosa and has a sexual transmission. The disease is called genital herpes and is much more severe. And most importantly, the virus can be transmitted to the fetus during pregnancy, as well as when passing through the birth canal of the mother.
Primary infection with genital herpes in the first trimester poses the greatest risk to the fetus and can cause miscarriage.A child can contract herpes through the placenta or birth canal, and get a generalized form of infection, which is most dangerous because it affects the internal organs. Therefore, it is very important for all pregnant women and women planning to become a mother to be screened for Herpes Simplex Virus. If the pathogen has been identified in the mother, the presence of herpes infection is also checked in newborns. Laboratory studies of the herpes virus are also indicated for characteristic signs of the disease and for prophylactic purposes if infection is suspected.
After an illness, antibodies to the herpes virus are produced in the blood. They neutralize the infection during its exacerbation, but do not completely destroy the pathogen. Therefore, a person can get herpes several times, but each subsequent exacerbation is easier than the previous one.
Diagnosis of herpes infection
Diagnosis of herpes is based on two main studies – PCR and ELISA. The PCR test allows you to identify the DNA of herpes during an exacerbation of the infectious process.This analysis shows whether a person is sick at the moment or not.
In Laborstory, PCR tests for Herpes Simplex Virus 1 and 2 types are carried out in total, as well as a PCR test for Herpes Simplex Virus of the first type and PCR test for Herpes Simplex Virus of the second type. The choice of the type of study and the biomaterial that is submitted for analysis depends on the localization of inflammation – on the face or genitals. If herpes simplex virus type 1 is suspected, saliva or oropharyngeal swab is taken for examination. With genital herpes (herpes simplex virus type 2), a urogenital scraping is done or urine is taken for analysis.
To understand whether there is a herpes simplex virus in the human body, whether he had a herpes infection before or is sick now, an enzyme-linked immunosorbent assay (ELISA) is performed – immunoglobulins IgM and IgG are examined in the blood serum. Immunoglobulin IgM is a marker of primary infection, however, IgM antibodies can also be detected in 20-30% of people with reactivation of an old infection.
IgG immunoglobulins are produced starting from the 10th day of illness and persist throughout life.
Research for the herpes virus requires special preparation.Here are some rules to follow.
How to prepare for the delivery of a urogenital smear for PCR:
- Women should not have a smear during menstruation;
- do not carry out the toilet of the external genital organs for 12 hours before the study;
- within two weeks before the study, antibiotics and antiviral drugs should be discontinued.
How to collect urine for PCR research:
- before collecting urine, hold the toilet of the external genital organs;
- for analysis, collect the first portion of morning urine in a sterile urinary container.
- saliva is collected after three times processing (rinsing) the oral cavity with water, in sterile plastic containers in an amount of at least 1 ml.
What to do before donating blood for ELISA:
- Do not eat for eight hours before testing;
- the day before the analysis, exclude alcohol, fried and fatty foods.
Analyzes at KDL. Antibodies to herpes simplex virus I, II types (Herpes simplex virus I, II), IgG
Herpes is a very common viral disease, a distinctive feature of which is a rash in the form of groups of bubbles on the skin and mucous membranes of a person.These vesicles (vesicles) burst over time, forming wounds that later dry out. There are several types of virus, the most common are type I (HSV-1) and II (HSV-2).
HSV-1 – the so-called herpes simplex, causes rashes mainly in the mouth, lips, face, neck and eyes.
HSV-2 – genital herpes that affects the skin and mucous membranes in the genital area.
The disease is contagious, the main routes of transmission are contact, through the skin (for example, by kissing), sexual, through household items, and airborne transmission is also possible.The presence of diseases in which the immune system is weakened (for example, HIV), and treatment with immunosuppressants, for example, after organ transplantation, contributes to the manifestation of herpes viral infection.
After the incubation period, painful blisters develop on the skin or mucous membranes that last up to four weeks. The presence of rashes is the main symptom of the disease, but there may be other manifestations similar to influenza and SARS: chills, sore throat, itching or burning on the skin.After the symptoms disappear, the virus remains in the body and goes into a latent form, in which it can exist throughout the patient’s life. With stress, a decrease in immunity, the virus can become active – a relapse occurs. In most cases, herpes is not dangerous to health, but it can have serious consequences for newborns (in the case of initial infection during pregnancy) and in immunodeficiency states.
According to the WHO, up to 80% of the population of the Russian Federation is infected with type I virus and about 20% with type II virus.At the same time, 90% of carriers may not even know about their infection. You can find out about the presence of an infection only with the help of laboratory diagnostics. One of the most common and effective tests is the analysis for antibodies to the herpes virus type I and II.
Antibodies of the IgM and IgG classes are produced by the body in response to infection and to fight it. IgM first appears, they can be detected within a few days after infection, they are a marker of acute infection and can be detected in the blood for up to several weeks.
Antibodies of the IgG class to herpes simplex virus are usually formed 2-3 weeks after infection. The concentration of IgG in the blood increases for several weeks, then stabilizes. When a dormant viral infection is activated, an increase in the level of IgG is possible. After an acute illness or as a result of an asymptomatic infection, a certain level of IgG remains in a person until the end of life.
When a study is usually prescribed
- To confirm the diagnosis in case of symptoms of herpes (the presence of ulcers and blisters on the skin and mucous membranes).
- During preparation for pregnancy and when examining pregnant women.
What exactly is determined during the analysis
The concentration of IgG antibodies to the herpes virus type I and II in the blood is determined by the IHLA method (modification of the enzyme-linked immunosorbent assay).
Test Results Mean
A negative result indicates the absence of antibodies to herpes viruses type I and II, which is possible if the body has not previously been in contact with the virus.Also, antibodies are not detected if little time has passed after infection, and the body has not yet had time to develop immunoglobulins of the IgG class. A positive result indicates a current or past infection. In case of a dubious result (borderline value of the level of antibodies), it is recommended to pass an analysis for IgM antibodies to herpes simplex virus type I and II and conduct a control test for IgG after a few weeks.
Timing of the test
The result of the study can be obtained in 1-2 days after the delivery of the analysis.