What are the key facts about herpes simplex virus infections. How do HSV-1 and HSV-2 differ in transmission and symptoms. What treatment options are available for managing herpes outbreaks.

The Prevalence and Types of Herpes Simplex Virus

Herpes simplex virus (HSV) infections are extremely common worldwide. There are two main types of HSV:

• HSV-1: Primarily causes oral herpes, but can also cause genital herpes
• HSV-2: Mainly causes genital herpes

According to global estimates:

• Approximately 3.7 billion people under age 50 (67% of the population) have HSV-1 infection
• About 491 million people aged 15-49 (13%) have HSV-2 infection

These high prevalence rates highlight how widespread herpes infections are in the general population. Many people carry the virus without ever experiencing symptoms or knowing they are infected.

Transmission and Risk Factors for HSV Infections

HSV spreads primarily through direct skin-to-skin contact. The specific transmission routes differ between HSV-1 and HSV-2:

HSV-1 Transmission

• Typically spread through oral contact
• Can be transmitted through kissing or oral sex
• Often acquired during childhood through non-sexual contact

HSV-2 Transmission

• Spread almost exclusively through sexual contact
• Transmitted through genital-to-genital or genital-to-anal contact
• Can be passed from mother to child during childbirth

Is it possible to reduce the risk of HSV transmission? Yes, there are several preventive measures:

• Using condoms and dental dams during sexual activity
• Avoiding sexual contact during active outbreaks
• Taking daily antiviral medication to suppress viral shedding
• Open communication with sexual partners about HSV status

Recognizing the Symptoms of Herpes Infections

While many HSV infections are asymptomatic, both oral and genital herpes can cause noticeable symptoms during outbreaks. Common signs and symptoms include:

Oral Herpes (HSV-1) Symptoms

• Cold sores or fever blisters around the mouth and lips
• Tingling or burning sensation before blisters appear
• Painful, fluid-filled blisters that eventually crust over
• Sore throat and swollen lymph nodes during initial outbreaks

Genital Herpes (HSV-2) Symptoms

• Painful blisters or ulcers on or around the genitals, rectum, or anus
• Itching or tingling in the genital or anal area
• Flu-like symptoms during the first outbreak (fever, body aches, swollen glands)
• Painful urination or vaginal/penile discharge

Can herpes symptoms vary between individuals? Absolutely. The severity and frequency of outbreaks can differ greatly from person to person. Some may experience frequent, painful recurrences, while others may have very mild or no symptoms at all.

The Stages of a Herpes Outbreak

Herpes outbreaks typically follow a predictable pattern, occurring in stages:

1. Prodrome: Tingling, itching, or burning sensation in the affected area
2. Blister Formation: Small, fluid-filled blisters appear on the skin
3. Ulceration: Blisters break open, creating painful sores or ulcers
4. Crusting: Sores begin to dry out and form scabs
5. Healing: Scabs fall off, and the skin heals without scarring

How long does a typical herpes outbreak last? The duration can vary, but most outbreaks last between 7-10 days from the first signs of symptoms to complete healing.

Diagnosing Herpes Simplex Virus Infections

Accurate diagnosis of HSV infections is crucial for proper management and prevention of transmission. Healthcare providers may use several methods to diagnose herpes:

• Visual examination of symptoms
• Viral culture from a blister or sore
• Polymerase chain reaction (PCR) test to detect viral DNA
• Blood tests to check for HSV antibodies

Why is early diagnosis important? Early diagnosis allows for prompt treatment, which can help manage symptoms and reduce the risk of complications. It also enables individuals to take steps to prevent transmitting the virus to others.

Treatment Options for Managing Herpes Outbreaks

While there is no cure for herpes, several treatment options can help manage symptoms and reduce the frequency of outbreaks:

Antiviral Medications

The primary treatment for herpes involves antiviral drugs, such as:

• Acyclovir
• Valacyclovir
• Famciclovir

These medications can be used in different ways:

1. Episodic therapy: Taking medication at the first sign of an outbreak to shorten its duration
2. Suppressive therapy: Daily medication to reduce the frequency of recurrences

Topical Treatments

Over-the-counter and prescription topical treatments can help alleviate symptoms:

• Lidocaine or benzyl alcohol for pain relief
• Docosanol cream to speed healing of cold sores
• Zinc oxide or aloe vera to soothe affected areas

Home Remedies and Self-Care

Several self-care measures can help manage herpes symptoms:

• Keeping the affected area clean and dry
• Applying cool compresses to soothe blisters
• Wearing loose-fitting clothing to prevent friction
• Taking over-the-counter pain relievers like acetaminophen or ibuprofen

How effective are these treatments in managing herpes? While they cannot cure the infection, these treatments can significantly reduce the severity and duration of outbreaks, improving quality of life for those with herpes.

The Psychological Impact of Herpes Diagnoses

A herpes diagnosis can have significant psychological effects on individuals. Common emotional responses include:

• Shock and disbelief
• Anger or resentment
• Guilt or shame
• Anxiety about future relationships
• Depression or low self-esteem

How can individuals cope with the emotional aspects of a herpes diagnosis? Several strategies can help:

• Seeking support from friends, family, or support groups
• Educating oneself about the condition to dispel myths and misconceptions
• Practicing self-compassion and focusing on overall health and well-being
• Considering counseling or therapy to address persistent emotional concerns
• Open communication with sexual partners about the condition

It’s important to remember that herpes is a common infection that does not define a person’s worth or character. With time and support, most people are able to adjust to living with herpes and maintain healthy, fulfilling relationships.

Herpes and Pregnancy: Special Considerations

Herpes infections can pose unique challenges during pregnancy, particularly the risk of neonatal herpes. This rare but serious condition occurs when a newborn contracts HSV during delivery.

Risks and Complications

• Increased risk of miscarriage or preterm labor
• Potential for transmission to the baby during vaginal delivery
• Severe complications for the newborn if infected, including neurological damage

Management and Prevention

Pregnant women with herpes require special care to minimize risks:

• Regular prenatal check-ups and discussions about herpes status
• Antiviral therapy during the third trimester to reduce viral shedding
• Consideration of cesarean delivery if active lesions are present at the time of labor
• Monitoring of the newborn for signs of infection after birth

Can women with herpes have healthy pregnancies and deliveries? Yes, with proper medical care and management, the vast majority of women with herpes are able to have healthy pregnancies and babies. The key is early disclosure to healthcare providers and following recommended precautions.

The Link Between Herpes and HIV

Research has shown a significant connection between herpes simplex virus infections, particularly HSV-2, and HIV. This relationship works in both directions:

HSV-2 Increasing HIV Risk

• People with HSV-2 are approximately three times more likely to acquire HIV if exposed
• Herpes lesions can provide an entry point for HIV
• HSV-2 infection increases the number of CD4 cells in the genital area, which are targets for HIV

HIV Impact on Herpes

• People with HIV may experience more severe and frequent herpes outbreaks
• HIV-positive individuals may have higher rates of asymptomatic viral shedding
• Herpes lesions in HIV-positive people may take longer to heal

How does this relationship affect prevention strategies? The link between HSV-2 and HIV underscores the importance of comprehensive sexual health strategies. Preventing and managing herpes infections can play a role in HIV prevention efforts, and vice versa.

Emerging Research and Future Prospects in Herpes Management

The field of herpes research is dynamic, with ongoing efforts to improve diagnosis, treatment, and prevention. Some promising areas of research include:

Vaccine Development

While no effective herpes vaccine is currently available, several candidates are in various stages of development:

• Therapeutic vaccines to reduce symptoms and viral shedding in infected individuals
• Preventive vaccines to protect against initial infection
• Novel approaches using mRNA technology, similar to COVID-19 vaccines

New Antiviral Therapies

Researchers are exploring new antiviral treatments with different mechanisms of action:

• Drugs targeting different stages of the viral life cycle
• Combination therapies to enhance effectiveness
• Long-acting formulations for less frequent dosing

Improved Diagnostic Tools

Efforts are underway to develop more accurate and accessible diagnostic methods:

• Rapid point-of-care tests for quicker diagnosis
• More sensitive tests to detect asymptomatic viral shedding
• Advanced imaging techniques to study viral activity in the body

What impact could these advancements have on herpes management? If successful, these research efforts could lead to more effective prevention strategies, better symptom control, and potentially even a cure for herpes infections in the future. However, it’s important to note that bringing new treatments and vaccines to market is a long and complex process, often taking many years of research and clinical trials.

In conclusion, while herpes simplex virus infections remain a significant global health concern, our understanding of the condition continues to evolve. With ongoing research and improved management strategies, the outlook for those affected by herpes is increasingly positive. By staying informed about the latest developments and maintaining open communication with healthcare providers, individuals can effectively manage their condition and lead healthy, fulfilling lives.

Herpes simplex virus

Herpes simplex virus

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• Herpes simplex virus

Key facts

• An estimated 3. 7 billion people under age 50 (67%) globally have herpes simplex virus type 1 (HSV-1) infection, the main cause of oral herpes.
• An estimated 491 million people aged 15–49 (13%) worldwide have herpes simplex virus type 2 (HSV-2) infection, the main cause of genital herpes.
• Most HSV infections are asymptomatic or unrecognized, but symptoms of herpes include painful blisters or ulcers that can recur over time.
• Infection with HSV-2 increases the risk of acquiring and transmitting HIV infection.

Overview

Herpes simplex virus (HSV), known as herpes, is a common infection that can cause painful blisters or ulcers. It primarily spreads by skin-to-skin contact. It is treatable but not curable.

There are two types of herpes simplex virus.

Type 1 (HSV-1) mostly spreads by oral contact and causes infections in or around the mouth (oral herpes or cold sores). It can also cause genital herpes. Most adults are infected with HSV-1.

Type 2 (HSV-2) spreads by sexual contact and causes genital herpes.

Most people have no symptoms or only mild symptoms. The infection can cause painful blisters or ulcers that can recur over time. Medicines can reduce symptoms but can’t cure the infection.

Recurrent symptoms of both oral and genital herpes may be distressing. Genital herpes may also be stigmatizing and have an impact on sexual relationships. However, in time, most people with either kind of herpes adjust to living with the infection.

Symptoms

Most people with herpes have no symptoms or only mild symptoms. Many people aren’t aware they have the infection and can pass along the virus to others without knowing.

Symptoms can include painful, recurring blisters or ulcers. New infections may cause fever, body aches and swollen lymph nodes.

Symptoms may be different during the first episode (or ‘outbreak’) of infection than during a recurrent episode. If symptoms occur, they often begin with tingling, itching or burning near where the sores will appear.  

Common oral herpes symptoms include blisters (cold sores) or open sores (ulcers) in or around the mouth or lips.

Common genital herpes symptoms include bumps, blisters, or open sores (ulcers) around the genitals or anus.

These sores and blisters are typically painful. Blisters may break open, ooze and then crust over. 

During their first infection, people may experience: 

• fever
• body aches
• sore throat (oral herpes)
• headache
• swollen lymph nodes near the infection.

People can have repeated outbreaks over time (‘recurrences’). These are usually shorter and less severe than the first outbreak.

Treatment

Medicines are often used to treat first or recurrent episodes of herpes. They can decrease how long symptoms last and how severe they are, but they can’t cure the infection.

Treatment for recurrent episodes is most effective when started within 48 hours of when symptoms begin.  

Antiviral medicines commonly given include acyclovir, famciclovir and valacyclovir.

Taking a lower daily dose of one of these medicines can also decrease how often symptoms occur (‘outbreaks’).

Treatment is often recommended for people who get very painful or frequent recurrent episodes or who want to lower the risk of giving herpes to someone else.

Medicines to help with pain related to sores include paracetamol (acetaminophen), naproxen or ibuprofen. Medicines that can be applied to numb the affected area include benzocaine and lidocaine. 

Herpes simplex virus lives inside of nerve cells and alternates between being inactive and active. Certain triggers can make the virus active including:

• illness or fever
• sun exposure
• menstrual period
• injury
• emotional stress
• surgery.

For people whose oral herpes is activated by sunlight, avoiding sun exposure and wearing sunscreen can lower the risk of recurrences.  

To decrease symptoms of oral herpes, people can: 

• drink cold drinks or suck on popsicles
• use over-the-counter pain medicines.

For genital herpes, people can:

• sit in a warm bath for 20 minutes (without soap)
• wear loose fitting clothes
• use over-the-counter pain medicines.

There are ways to lower the risk of spreading herpes including:

• talk to your partner about having herpes
• don’t have sex if you have symptoms and always wear a condom
• don’t share items that touched saliva (oral herpes).

Talk to your healthcare provider if you are pregnant, because there is a risk of passing herpes to your baby.

Scope of the problem

In 2016 (last available estimates), 3.7 billion people under the age of 50, or 67% of the global population, had HSV-1 infection (oral or genital). Most HSV-1 infections are acquired during childhood.

Genital herpes caused by HSV-2 affects an estimated 491 million (13%) people aged 15–49 years worldwide (2016 data). HSV-2 infects women almost twice as often as men because sexual transmission is more efficient from men to women. Prevalence increases with age, though the highest number of new infections are in adolescents.

Transmission

HSV-1 is mainly transmitted via contact with the virus in sores, saliva or surfaces in or around the mouth. Less commonly, HSV-1 can be transmitted to the genital area through oral-genital contact to cause genital herpes. It can be transmitted from oral or skin surfaces that appear normal; however, the greatest risk of transmission is when there are active sores. People who already have HSV-1 are not at risk of reinfection, but they are still at risk of acquiring HSV-2.

HSV-2 is mainly transmitted during sex through contact with genital or anal surfaces, skin, sores or fluids of someone infected with the virus. HSV-2 can be transmitted even if the skin looks normal and is often transmitted in the absence of symptoms.

In rare circumstances, herpes (HSV-1 and HSV-2) can be transmitted from mother to child during delivery, causing neonatal herpes.

Possible complications

HSV-2 and HIV infection

HSV-2 infection increases the risk of acquiring HIV infection by approximately three-fold. Additionally, people with both HIV and HSV-2 infection are more likely to spread HIV to others. HSV-2 infection is among the most common infections in people living with HIV.

Severe disease

In immunocompromised people, including those with advanced HIV infection, herpes can have more severe symptoms and more frequent recurrences. Rare complications of HSV-2 include meningoencephalitis (brain infection) and disseminated infection. Rarely, HSV-1 infection can lead to more severe complications such as encephalitis (brain infection) or keratitis (eye infection).

Neonatal herpes

Neonatal herpes can occur when an infant is exposed to HSV during delivery. Neonatal herpes is rare, occurring in an estimated 10 out of every 100 000 births globally. However, it is a serious condition that can lead to lasting neurologic disability or death. The risk for neonatal herpes is greatest when a mother acquires HSV for the first time in late pregnancy.

Prevention

People with symptoms of oral herpes should avoid oral contact with others (including oral sex) and sharing objects that touched saliva. Individuals with symptoms of genital herpes should abstain from sexual activity while experiencing symptoms. Both HSV-1 and HSV-2 are most contagious when sores are present but can also be transmitted when no symptoms are felt or visible.

For sexually active people, consistent and correct use of condoms is the best way to prevent genital herpes and other STIs. Condoms reduce the risk; however, HSV infection can still occur through contact with genital or anal areas not covered by the condom. Medical male circumcision can provide life-long partial protection against HSV-2 infection, as well as against HIV and human papillomavirus (HPV).

People with symptoms suggestive of genital herpes should be offered HIV testing.

Pregnant women with symptoms of genital herpes should inform their health care providers. Preventing acquisition of HSV-2 infection is particularly important for women in late pregnancy when the risk for neonatal herpes is greatest.

WHO response

WHO is working to increase awareness about HSV infection and its symptoms, improve access to antiviral medications, and promote HIV prevention efforts for those with genital herpes, such as pre-exposure prophylaxis (PrEP). 

WHO and partners are also supporting research to develop new strategies for prevention and control of HSV infections, such as vaccines and topical microbicides.

• Global estimates of prevalent and incident Herpes Simplex Virus Type 2 infections in 2012
  PLoS ONE 9(12): e114989
• More about sexually transmitted diseases

 

 

 

 

 

STD Facts – Genital Herpes

People who are sexually active can get genital herpes, a common sexually transmitted disease (STD).

This fact sheet answers basic questions about genital herpes.

What is genital herpes?

Genital herpes is an STD caused by two types of viruses – herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2).

What is oral herpes?

HSV-1 often causes oral herpes, which can result in cold sores or fever blisters on or around the mouth. However, most people with oral herpes do not have any symptoms. Most people with oral herpes get it during childhood or young adulthood from non-sexual contact with saliva.

Is there a link between genital herpes and oral herpes?

Yes. Oral herpes caused by HSV-1 can spread from the mouth to the genitals through oral sex. This is why some cases of genital herpes are due to HSV-1.

How common is genital herpes?

Genital herpes is common in the United States. In 2018, CDC estimates show there were 572,000 new genital herpes infections in the United States among people aged 14 to 49.¹

How is genital herpes spread?

You can get genital herpes by having vaginal, anal, or oral sex with someone who has the infection. You can get herpes if you have contact with:

• A herpes sore;
• Saliva from a partner with an oral herpes infection;
• Genital fluids from a partner with a genital herpes infection;
• Skin in the oral area of a partner with oral herpes; or
• Skin in the genital area of a partner with genital herpes.

You also can get genital herpes from a sex partner who does not have a visible sore or is unaware of their infection. It is also possible to get genital herpes if you receive oral sex from a partner with oral herpes.

You will not get herpes from toilet seats, bedding, or swimming pools. You also will not get it from touching objects, such as silverware, soap, or towels.

If you have more questions about herpes, consider discussing your concerns with a healthcare provider.

How do I know if I have genital herpes?

Most people with genital herpes have no symptoms or have very mild symptoms. Mild symptoms may go unnoticed or be mistaken for other skin conditions like a pimple or ingrown hair. Because of this, most people do not know they have a herpes infection.

Herpes sores usually appear as one or more blisters on or around the genitals, rectum or mouth. This is known as having an “outbreak”. The blisters break and leave painful sores that may take a week or more to heal. Flu-like symptoms (e.g., fever, body aches, or swollen glands) also may occur during the first outbreak.

People who experience an initial outbreak of herpes can have repeated outbreaks, especially if they have HSV-2. However, repeat outbreaks are usually shorter and less severe than the first outbreak. Although genital herpes is a lifelong infection, the number of outbreaks may decrease over time.

Ask a healthcare provider to examine you if:

• You notice any symptoms; or
• Your partner has an STD or symptoms of an STD.

STD symptoms can include an unusual sore, a smelly genital discharge, burning when peeing, or bleeding between periods (if you have a menstrual cycle).

How will my healthcare provider know if I have genital herpes?

Your healthcare provider may diagnose genital herpes by simply looking at any sores that are present. Providers can also take a sample from the sore(s) and test it. If sores are not present, a blood test may be used to look for HSV antibodies.

Have an honest and open talk with your healthcare provider about herpes testing and other STDs.

Please note: A herpes blood test can help determine if you have herpes infection. It cannot tell you who gave you the infection or when you got the infection.

How can I prevent genital herpes?

The only way to completely avoid STDs is to not have vaginal, anal, or oral sex.

If you are sexually active, you can do the following things to lower your chances of getting genital herpes:

• Being in a long-term mutually monogamous relationship with a partner who does not have herpes.
• Using condoms the right way every time you have sex.

Be aware that not all herpes sores occur in areas that a condom can cover. Also, the skin can release the virus (shed) from areas that do not have a visible herpes sore. For these reasons, condoms may not fully protect you from getting herpes.

If your sex partner(s) has/have genital herpes, you can lower your risk of getting it if:

• Your partner takes an anti-herpes medicine every day. This is something your partner should discuss with his or her healthcare provider.
• You avoid having vaginal, anal, or oral sex when your partner has herpes symptoms (i.e., during an “outbreak”).

Is there a cure for genital herpes?

There is no cure for genital herpes. However, there are medicines that can prevent or shorten outbreaks. A daily anti-herpes medicine can make it less likely to pass the infection on to your sex partner(s).

What happens if I don’t receive treatment?

Genital herpes can cause painful genital sores and can be severe in people with suppressed immune systems.

If you touch your sores or fluids from the sores, you may transfer herpes to another body part like your eyes. Do not touch the sores or fluids to avoid spreading herpes to another part of your body. If you do touch the sores or fluids, quickly wash your hands thoroughly to help avoid spreading the infection.

If you are pregnant, there can be problems for you and your unborn fetus, or newborn baby. See “I’m pregnant. How could genital herpes affect my baby?” for information about this.

I’m pregnant. How could genital herpes affect my baby?

If you are pregnant and have genital herpes, prenatal care visits are very important. Some research suggest that a genital herpes infection may lead to miscarriage or make it more likely to deliver your baby too early. You can pass herpes to your unborn child before birth, but it more commonly passes during delivery. This can lead to a deadly infection in your baby (called neonatal herpes). It is important that you avoid getting genital herpes during pregnancy. Tell your healthcare provider if you have ever had a genital herpes diagnosis or symptoms. Also tell them about any possible exposure to genital herpes.

If you have genital herpes, you may need to take anti-herpes medicine towards the end of your pregnancy. This medicine may reduce your risk of having signs or symptoms of genital herpes when you deliver. At the time of delivery, your healthcare provider should carefully examine you for herpes sores. If you have signs or symptoms of genital herpes at delivery, a ‘C-section’ is likely to occur.

Can I still have sex if I have herpes?

If you have herpes, you should talk to your sex partner(s) about their risk. Using condoms may help lower this risk but it will not get rid of the risk completely. Having sores or other symptoms of herpes can increase your risk of spreading the disease. Even if you do not have any symptoms, you can still infect your sex partners.

You may have concerns about how genital herpes will impact your health, sex life, and relationships. While herpes is not curable, it is important to know that it is manageable with medicine. Daily suppressive therapy (i.e., daily use of antiviral medication) can lower your risk of spreading the virus to others. Talk to a healthcare provider about your concerns and treatment options.

A genital herpes diagnosis may affect how you will feel about current or future sexual relationships. Knowing how to talk to sexual partners about STDs is important.

What is the link between genital herpes and HIV?

Herpes infection can cause sores or breaks in the skin or lining of the mouth, vagina, and rectum. This provides a way for HIV to enter the body. Even without visible sores, herpes increases the number of immune cells in the lining of the genitals. HIV targets immune cells for entry into the body. Having both HIV and genital herpes increases the chance of spreading HIV to a HIV-negative partner during oral, vagina, or anal sex.

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HERPES SIMPLE VIRUS ᐉ Symptoms • Treatment • Causes • Signs • Drugs at Low Price Pharmacy (ANC)

Herpes simplex virus is one of the most common infections in the world. According to the World Health Organization, approximately 60-95% of the world’s population is infected with it. The virus can be asymptomatic in the body for many years.

The appearance of the characteristic symptoms of herpes is due to exacerbations of the infection. As a rule, they occur when immunity is weakened or under the influence of strong provoking environmental factors. The herpes simplex virus has a short reproduction cycle – only 24 hours. This means that the clinical manifestations of infection appear very quickly, shortly after exposure to a provoking factor.

Characteristics of the virus

There are two types of herpes simplex virus: HSV-1 and HSV-2. The first most often affects the skin of the lips and the area around the mouth, causing the development of the oral form of the disease. The second is the causative agent of genital herpes and provokes the appearance of a herpetic rash in the vulva.

Herpes simplex virus is characterized by chronic persistence in the human body. After the initial infection, he “settles” in the nerve ganglia (nodes), where he lives for many years. An infected person can infect others by airborne droplets, contact-household or sexual contact (the latter is typical for genital herpes).

The frequency of exacerbations varies from person to person. It directly depends on the degree of suppression of the immune system. If some people experience clinical manifestations of herpes once every few years, others may suffer from exacerbations several times a year or even monthly.

Clinical course

Most often, herpes simplex is manifested by the formation of clustered vesicles (vesicles) on reddened, edematous skin. After a few days, they spontaneously open, forming painful erosions. Over time, they heal without leaving any traces behind. On average, the duration of the course of the disease is from 10 to 14 days.

In medical practice, there are:

• Primary herpes simplex is the first clinical episode of the disease that occurs immediately after infection. It can develop only once in a lifetime.
• Herpes simplex recurrence – all subsequent episodes that develop repeatedly in the same person.

According to the nature of the course, herpes can be:

• rarely recurrent – with exacerbations 1-2 times a year;
• moderate – with 3-4 exacerbations per year;
• often recurrent – 6 or more exacerbations per year.

In some cases, herpes can occur in severe bullous or erosive-ulcerative form. And in people with sharply weakened immunities, it can cause serious complications, spreading to other organs.

Women with genital herpes (which belongs to the group of TORCH infections) may become infertile. Herpetic infection can provoke miscarriage, intrauterine infection of the fetus and even death of the child from complications in the first year of life.

Diagnostics and treatment

In most cases, the herpes simplex virus is recognized on the basis of its characteristic manifestations during exacerbations.