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Initial cold sore outbreak: Primary Cold Sore Infection. Oral herpes simplex; treatment


Primary Cold Sore Infection. Oral herpes simplex; treatment

A first (primary) infection with the cold sore virus is often different to the repeated (recurring) cold sores which many people have. Frequently there are no symptoms. Sometimes an unpleasant mouth infection develops. Treatment aims to ease symptoms while the infection gradually settles over 1-3 weeks.

What is a primary cold sore infection?

Cold sores are caused by the herpes simplex virus (HSV). The first time you are infected with this virus is called the primary infection. The mouth is the area commonly affected. This is because normal skin is resistant to the virus but the moist inner skin of the mouth is not. The first (primary) infection is usually in childhood. It is often caught by kisses from a family member who has a cold sore. Primary cold sore infection can be worse than recurrent mouth ulcers but luckily some people don’t experience any symptoms at all.

This leaflet will deal with primary cold sore infection. See separate leaflet called Cold Sores for more details on recurrent cold sores.

What are the symptoms of a primary cold sore infection?

Symptoms of the first (primary) infection are often different to recurring cold sores.

  • You may have no symptoms, or only trivial ones. For example, you may not realise that a tiny spot on the tongue is a first cold sore. However, you may then develop typical cold sores from time to time in the future.
  • You may have a more severe infection in and around the mouth.
    • Small blisters or ulcers may develop on the mouth, tongue, gums, lips, or throat. This is called gingivostomatitis. There may be only a few blisters but sometimes there are many.
    • The blisters and ulcers are painful. Swallowing or eating may become quite painful. The pain may cause you to pool (collect) saliva in the mouth and children may drool (dribble).
    • The glands in your neck may swell and become tender.
    • You may develop a high temperature (fever) and general aches and pains.
    • The infection gradually subsides and goes within 1-3 weeks.

What are the treatments for a primary cold sore infection?

  • Painkillers such as paracetamol or ibuprofen can ease the pain.
  • Benzydamine mouthwash or spray may be useful in relieving the pain from a sore ulcerated mouth.
  • Choline salicylate gel (Bonjela® dental gel) can be used in the mouth to reduce pain. Bonjela® should not be used in children under the age of 16, due to a potential risk of Reye’s syndrome if it is overused. This is the same reason why aspirin cannot be used in children too. Note: Bonjela teething gel® no longer contains choline salicylate and has been reformulated with lidocaine, a local anaesthetic (to cause temporary numbing). This means that Bonjela teething gel® can be used in children.
  • Have plenty to drink. It may be painful to drink but it is important to drink to prevent lack of fluid in the body (dehydration).
  • If it is too painful to clean your teeth, chlorhexidine mouthwash (brand name Corsodyl® or Chlorohex®) can be used in place of brushing. It may help adults or children old enough to use it to keep the mouth and teeth clean, to prevent plaque build-up and secondary infection with germs (bacteria).
  • Sloppy foods such as yoghurts and soups are easier to eat when your mouth is painful. Cold or cool foods may be less painful than hot foods.
  • An antiviral medicine (such as aciclovir) is sometimes prescribed if the symptoms are severe. It is taken by mouth, rather than the topical creams used to rub on cold sores. It does not clear the virus but prevents the virus from multiplying. It may not have much effect once the blisters and ulcers are well developed. However, if taken early in the infection, it may reduce the duration of the pain and speed recovery a little.
  • Lip barrier preparations such as Vaseline® or Lypsyl® may make the lips feel more comfortable and may stop them from sticking or scabbing together.
  • General measures include trying to minimise the chances of passing the cold sore virus on to others. Careful hand washing with soap and water is important after touching the mouth and cold sores. You should avoid touching cold sores or ulcers in the mouth associated with first (primary) infection, except when applying medication. You should not have oral sex when you have either a primary cold sore infection or an individual cold sore. Finally, it is important not to share items that come into contact with infected areas – this would include lipsticks and lip balms.


Young children may be distressed with the pain and refuse to take medicine or drinks. Tips to help include:

  • Try using a syringe (which you can buy at pharmacies) to squirt medicine into the side of the mouth slowly. Do not squirt into the back of the mouth, as this may cause choking.
  • Keep offering cool drinks. You can also use a syringe to give some drinks. Again, slowly squirt into the side of the mouth, not towards the back of the mouth.
  • Sucking ice pops or ice cubes may help to ease the pain and are also a way of giving fluids.

Occasionally, a child stops drinking because of the pain in their mouth. They are then in danger of becoming dehydrated. If your child has stopped passing urine, or if their urine is dark in colour and strong-smelling, they are likely to be dehydrated. See a doctor if you are concerned that your child is not drinking enough and is becoming dehydrated. Some children who are at risk of dehydration are admitted to hospital for a short while until the infection settles and they are drinking normally again. In hospital they can have their fluid intake monitored and they can be given an intravenous drip if needed.

If your child is generally well with a primary herpes virus infection, they do not need to be kept off school or nursery.

When should I see a doctor?

You should seek medical advice at any time if you are worried about yourself or your child. This is particularly important if you have a weakened immune system (immunocompromised). Immunocompromised people include those with conditions such as AIDS, or those receiving chemotherapy or other medicines which lower the body’s resistance to infections. Pregnant women and mothers with a young baby who is affected, should also seek prompt medical attention. Anyone with a first (primary) cold sore infection where the symptoms are not settling after five days, should see their GP.

Recurrent cold sores

After a first (primary) infection has cleared, the virus remains dormant (inactive) in a nerve sheath. For most of the time it causes no problems. In some people the virus ‘activates’ from time to time to cause cold sores around the mouth and nose. Repeated (recurrent) cold sores may be unpleasant but do not cause severe mouth infections like some primary infections. About 1 in 5 people in the UK have recurrent cold sores.

Cold Sore Outbreaks: Causes, Symptoms, Stages, Treatments

The small blisters around the mouth and nostrils that define cold sores (also known as fever blisters) are due to a virus that, once contracted, stays with you, hiding until triggered. Anyone can get a cold sore, and most people contract the herpes simplex virus (HSV) through physical contact with an affected person.

Once you get it, the virus responsible for cold sores stays with you for the rest of your life, hiding until triggered. Even without a visible cold sore, a person can infect others via their saliva.

Cold Sore Outbreak Symptoms

The herpes simplex virus generally remains dormant in the body, which means you won’t present any symptoms unless it is reactivated. Many carriers of the herpes simplex virus never experience symptoms or an outbreak.

When someone does experience a breakout, symptoms become apparent within a few days of exposure to the HSV virus. After the first infection, the virus is dormant, hiding inside the nerve cells of the face, which means symptoms may not be experienced. However, triggers can lead to recurrences of the virus. 

Symptoms may include:

  • Red, fluid-filled blisters around the lips and occasionally on the nose or cheeks
  • Pain in affected areas
  • Fluid secretion from blisters
  • Formation of scabs after blisters have dried
  • Itching and irritation of affected areas
  • Mild fever
  • Headache
  • Swollen lymph nodes
  • Muscle aches or general body pain
  • Difficulty swallowing
  • Fatigue

If you’re experiencing your first outbreak, you may have fluid-filled blisters as well as flu-like symptoms, such as fever, sore throat, headache, swollen lymph nodes, and body aches.

The initial infection of the herpes simplex virus is the most severe because the body has yet to build up its defenses to the virus. High and persistent fever, problems swallowing, trouble breathing, or red, irritated eyes, especially in children, should be brought to the attention of a doctor.

If you’re experiencing a recurrence, expect to develop blisters in the same place as previous outbreaks; the virus reactivates in the same spot each time. You can expect fewer severe symptoms with a recurrence, as the severity of outbreaks generally lessens over time.

Children can develop cold sores inside the mouth, which are commonly mistaken for canker sores (small lesions in the mouth). If your child begins to develop sores in the mouth, see the pediatrician as soon as possible. The doctor will be able to provide an accurate diagnosis based on a physical exam and other present symptoms.

Verywell / Brianna Gilmartin 


After initial symptoms develop, it can take two to four weeks to heal completely. During that time, cold sores go through three distinct stages. The symptoms and stages of an outbreak can vary depending on whether or not this is your first case or a recurrence.

Stage 1

During the first stage of a cold sore outbreak—or the first one to two days, approximately—many people experience tingling, itching, or even soreness around the mouth.

If you’re having a recurrence, you’ll likely feel these sensations in the same locations as previous outbreaks. Some people experience these sensations and never actually develop fluid-filled blisters. 

Stage 2

After a few days, small, hard, fluid-filled blisters begin to form on the lips, nose, cheeks, or other parts of the face. If you develop a blister (or blisters) near the eyes, make an appointment with an eye doctor immediately. Watch out for eye symptoms, such as sensitivity to light, pain, or grittiness in the eyes.

At this stage, the blisters and fluid are extremely contagious, so it’s important to avoid close physical contact with others. You can also spread blisters to other locations on the body by touching sores and then another body part. If you touch a cold sore, wash your hands immediately. 

Stage 3

The blisters may merge together and burst, resulting in small, open sores that ooze fluid. These sores are very painful and highly contagious. After a few days, the open sores will begin to dry out and scab. Scabs can be very itchy and even crack, so avoid biting or picking at them, as this can worsen discomfort.

Between five and 15 days after the initial outbreak, scabs will begin to fall off and affected areas will begin to heal.


Until cold sores have scabbed over, you can still infect others. Until then, be sure to avoid:

  • Touching cold sores
  • Kissing
  • Intimate contact (e.g., oral sex)
  • Sharing food, drinks, or personal items
  • Having physical contact with anyone who has a weakened immune system
  • Having physical contact with children

Cold sores can cause serious health issues in newborns, children, and people with a weakened immune system. It is, therefore, important to remain vigilant and take steps to avoid infecting others with HSV.


Cold sores are generally harmless in most healthy adults, but they’re also extremely contagious. Many people don’t realize when they’re being exposed to the virus through physical contact with an infected person.

Kissing and intimate contact, as well as sharing food, drinks, and personal items (e.g., lip balm, razors, or towels) can put you at risk of contracting herpes simplex.

In one 2014 report in the journal Human Genome Variation, researchers suggested that a susceptibility gene is the main risk factor for cold sores. However, the exact mechanism of such a gene is unknown.

Once infected with herpes simplex, you will have the virus for the rest of your life. Recurrent cold sore outbreaks can be triggered by many different factors like stress, fatigue, hormonal changes (including menstruation), illness, dental work and even exposure to extreme weather.


Researchers have found that more than half of Americans ages 14 to 49 carry the herpes simplex virus type 1 (HSV)—the virus that causes cold sores to develop—and up to 90% of Americans will have at least one cold sore during their lifetime.


Cold sores cause pain, irritation, and even embarrassment. Fortunately, there are a number of ways to treat pain and symptoms to feel better faster.


If taken within 72 hours of an outbreak, certain oral antiviral medications (prescribed by your doctor) can help shorten the time it takes for cold sores to heal. For recurrences, be sure to talk to your doctor or dermatologist about prescription treatments.

Your doctor may also recommend applying antiviral ointments directly to your cold sores. Remember to wash your hands immediately after applying topical medicines.

Over-the-counter pain relievers such as Advil (ibuprofen) or Tylenol (acetaminophen) can alleviate pain, swelling, and irritation caused by blisters or open sores.

Home Remedies and Lifestyle

A cold compress can reduce pain and irritation. Be sure to use a cool, damp towel, rather than an ice pack. Apply compresses a few times each day for five to 10 minutes at a time.

Otherwise, keep the affected area clean and dry, and avoid applying make-up over cold sores. Also, stay away from foods that worsen symptoms. Anything acidic, such as citrus, tomatoes, or coffee, can irritate cold sores and prolong symptoms.

If you develop cold sores near the eyes, have frequent/recurring cold sore outbreaks, have a weakened immune system, or have a cold sore that lasts for more than 15 days, make an appointment with your doctor.

Your doctor can get cold sores under control so as to avoid potential complications, which may include ocular herpes (HSV-1 transfer to the eyes) and various skin infections.

A Word From Verywell

Fortunately, cold sores tend to be harmless and clear up within a few weeks. If you start to develop symptoms of a cold sore outbreak, and especially if outbreaks are recurrent, talk to your doctor about the best treatment plan for your age, medical history, and lifestyle.  

What Are the Symptoms & Signs of Herpes?

The most common herpes symptom are sores on your genitals or mouth. But most of the time there are no symptoms, so lots of people don’t know they have herpes.

Herpes might not have any symptoms.

You or your partner may not have any herpes symptoms that you can see or feel, or the signs of herpes may be so mild you don’t even notice them. Sometimes people confuse herpes symptoms with other things, like pimples, ingrown hairs, and the flu.

Herpes symptoms come and go, but that doesn’t mean the infection goes away or that you can’t spread it to other people. Once you have herpes, it stays in your body for life.

Genital herpes symptoms

The most common symptoms of genital herpes is a group of itchy or painful blisters on your vagina, vulva, cervix, anus, penis, scrotum (balls), butt, or the inside of your thighs. The blisters break and turn into sores.

You might have these other symptoms too:

  • burning when you pee if your urine touches the herpes sores

  • having trouble peeing because the sores and swelling are blocking your urethra

  • itching

  • pain around your genitals

If your genital herpes is caused by HSV-2, you might also have flu-like symptoms, such as:

When blisters and other genital herpes symptoms show up, it’s called an outbreak. The first outbreak (also called the “first episode” or “initial herpes”) usually starts about 2 to 20 days after you get infected with herpes. But sometimes it takes years for the first outbreak to happen.

The first herpes outbreak lasts about 2 to 4 weeks. Even though the blisters go away, the virus stays in your body and can cause sores again. It’s really common to get repeat outbreaks, especially during the first year you have herpes. You might notice some warning signs a few hours or days before outbreaks flare up, like itching, burning, or a tingly feeling on your genitals.

Herpes outbreaks are no fun, but the first one is the worst. Repeat outbreaks are usually shorter and less painful. Most people with herpes get fewer outbreaks as time goes on, and some stop having them altogether.

Herpes symptoms may be more painful and last longer in people with illnesses that damage your immune system — like leukemia and HIV.

Oral herpes symptoms

Usually, oral herpes is less painful than genital herpes and doesn’t make you feel as sick. Oral herpes causes sores on your lips or around your mouth — called cold sores or fever blisters. You can also get sores inside your mouth, but that usually only happens the first few times you have symptoms.

Cold sores last a few weeks and then go away on their own. They can pop up again in weeks, months, or years. Cold sores are annoying, but usually harmless in kids and adults — they can be really dangerous to newborn babies, though.

More questions from patients:

What are the signs of genital herpes in men?

The most common symptom of genital herpes in men is a cluster of blistery sores — usually on your penis or anus. Symptoms may last up to a few weeks and go away. They may return in weeks, months, or years.

Many people with genital herpes have no symptoms, or have very mild symptoms that go unnoticed.

The first time genital herpes symptoms appear is called the “first episode” or “initial herpes.” Initial herpes symptoms are usually more noticeable than later outbreaks.

Symptoms of genital herpes in men may include

  • blistery sores

  • burning when you pee if you have sores

  • trouble peeing if you have sores covering your urethra

  • itching or pain around your genitals

During initial herpes, symptoms may also include

  • swollen, tender glands in the pelvic area, throat, or under the arms

  • fever

  • chills

  • headache

  • general run-down feelings

  • achy, flu-like feelings

Initial herpes symptoms usually show up 2 to 20 days after you’re infected. But it may be years before the first symptoms appear.

Herpes sores usually heal in a few weeks. But the virus stays in your body – and it can flare up and cause sores again.

The only way to find out for sure if you have genital herpes is to get checked out by a doctor or nurse. If you have symptoms, they can tell you if it’s herpes by looking at or testing the sores. If you don’t have symptoms, they can do a blood test.

Planned Parenthood health centers, many other clinics, private health care providers, and health departments offer herpes tests and herpes treatments.

What are signs of genital herpes in women?

The only way to know for sure if you have genital herpes is to get checked out by a doctor or nurse.

The most common genital herpes symptoms in women is a cluster of blistery sores that show up on your vulva, cervix, or anus. Symptoms may last several weeks and go away. They may return in weeks, months, or years. A doctor or nurse can tell you if the sores are caused by herpes by looking at them or by testing fluid from the sores.

The thing is, many people with genital herpes have no symptoms, or have very mild symptoms that go unnoticed. Blood tests for herpes are also available, and may be useful if you’ve recently had unprotected sex with someone who has it.

Not sure if you should visit a health center for testing? Here’s a little more info on symptoms of genital herpes.

Symptoms of genital herpes in women may include:

  • blistery sores

  • burning when you pee if you have sores

  • trouble peeing if you have sores covering your urethra

  • itching or pain around your genitals

During your first outbreak, symptoms may also include:

  • swollen, tender glands in the pelvic area, throat, or under the arms

  • fever

  • chills

  • headache

  • general run-down feelings

  • achy, flu-like feelings

Your first outbreak can happen anywhere from 2 to 20 days after you’re infected. After that, you may never have another outbreak again. Or you may find that you get one several weeks or months later. There’s no way to know for sure how often you’ll get outbreaks — it’s different for every person with herpes. Medicine can make them happen less often, and ointments can make sores heal faster and be less of a bother.

Your nearest Planned Parenthood health center can help you figure out if you have herpes, give you other STD tests, and help you get treatment.

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Cold sores – Better Health Channel

Cold sores (herpes labialis) are small blisters that usually form on the lips or skin around the mouth, nose and on the chin. They are caused by infection with the herpes simplex virus (HSV). People are usually infected in childhood or young adulthood, and the infection persists for life. 

HSV infection is very common

Around 90 per cent of adults have herpes simplex antibodies in their bloodstream, which means that they have been infected with the virus at some time. However, the first (or primary) infection does not usually cause any symptoms. One-third of infected people experience cold sores, which are a recurrence of the earlier infection and do not indicate recent infection. Most of these people would not have experienced symptoms from the first infection. 

Symptoms of a primary HSV infection

For some people (mainly children) infected with HSV, the first (primary) infection can cause symptoms. These can include:

  • fever
  • tiredness
  • blisters (lesions) and ulcers in and around the mouth
  • swelling 
  • pain inside the mouth and on the gums
  • a sore throat
  • swollen neck glands. 

The symptoms can last up to 14 days and may cause dehydration, especially in young children, because it is painful to swallow. Primary infections are more likely to be severe in newborn babies, people with atopic dermatitis (often called eczema) and in people whose immune system is suppressed.

Triggers for cold sores

In some people the HSV infection causes cold sores, which erupt following a trigger event such as a cold. This explains the term ‘cold sore’. Other triggers that may cause an attack of cold sores include:

  • feverish illnesses, like influenza, or chest infections
  • sunlight
  • exposure to windy conditions
  • hormonal changes, such as the menstrual period
  • emotional or physical stress.

It is important to remember that cold sores are a symptom of ongoing infection rather than a new infection. The sores usually recur in the same place. 

Cold sore symptoms

Cold sores usually develop as follows:

  • Most people experience localised itching and tingling a day or two before the cold sore appears.
  • A collection of small blisters forms.
  • These blisters can be accompanied by pain, tenderness and a sensation of heat and burning.
  • The blisters burst after a few days.
  • The site develops a crust.
  • The crust dries up and eventually falls off after about 10 days.

Cold sore complications

Cold sores are an annoying problem for most people who get them, but they get better without any specific treatment. However, in people with some types of immunosuppression (such as people undergoing chemotherapy, or taking very high doses of corticosteroids such as prednisolone), the cold sores can spread more widely and the symptoms can be more severe. Medication may be required in these cases.

Uncommon complications that require medical attention include:

  • bacterial infections – possible symptoms include redness around the blisters, pus in the blisters and fever
  • cold sores that spread to the eyes, fingers or other parts of the body – a cold sore in the eye causes a painful red eye. Immediate medical attention should be sought, as the herpes virus causes an ulcer on the cornea that can damage sight. However, permanent damage can usually be prevented by early treatment, including medication to suppress the virus. There are other more common causes of a painful red eye, which also require medical review.

There is more than one type of herpes infection

There are two types of herpes simplex infection: herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2). Cold sores around the mouth (often called ‘oral herpes’) are generally caused by HSV-1. Most cases of genital herpes are caused by HSV-2. 

Cold sores on the mouth can cause genital infection during oral sex for people who do not already carry the cold sore virus. 

There are many other viruses that are also in the herpes virus family, however the infection and symptoms are different. One example is varicella zoster virus (VZV) which causes chickenpox and shingles.

How HSV is transmitted

The herpes simplex virus spreads between people, usually through contact with saliva or direct contact with a blister. The most infectious time is in the first few days when the blister is forming. Sometimes, people can pass the virus to others when they have no symptoms. This is because the virus may be lying dormant in the skin cells of the lips. 

How to avoid transmitting HSV

If you have a cold sore, be sure to wash your hands after touching it and be especially careful to avoid touching your own eyes after touching your cold sore. It is the fluid contained in the blisters that is considered to be the most infectious. While you have a cold sore it is also important to avoid: 

  • sharing toothbrushes
  • sharing drinking glasses or bottles
  • sharing cutlery
  • sharing towels or other personal items 
  • close contact (such as kissing and hugging) with newborn and young babies
  • kissing others
  • close contact with children with burns or eczema
  • close contact with people with suppressed immune systems.

Preventing the transmission of HSV among children

If young children with a cold sore are unable to follow good hygiene practices, it is recommended that they be excluded from childcare or school until the blister stops weeping. It is also recommended that blisters be covered by a dressing, where possible. 

Treatment for cold sores

Cold sores are generally not dangerous and do not cause any permanent damage to the skin. Treatment does not cure the infection and is not necessary for most cases. Avoid picking the scab or breaking blisters as this can cause secondary infection with bacteria, or scarring. 

Creams to treat the symptoms can be soothing, as can ice on the blisters. Simple painkillers may occasionally be required. Povidone-iodine ointments (commonly known as Betadine) can be dabbed onto the cold sores and may reduce symptoms in some people.

Antiviral medications come in many forms, including creams and tablets. Medications such as aciclovir and famciclovir shorten the duration of the cold sore by reducing the ability of the virus to reproduce. Aciclovir cream works best when applied to the blister at the earliest stages of cold sore development, when the area is tingling. However, not everyone experiences warning signs of an impending cold sore. 

Preventing a cold sore outbreak

There is no cure for cold sores. Suggestions to reduce the number of outbreaks include: 

  • Avoid known triggers, if possible.
  • Wear sunblock on your face and lips when outdoors.
  • Pay attention to your general health and stress levels.
  • Avoid getting ill or run down.

Where to get help

  • Your doctor
  • NURSE-ON-CALL. Tel. 1300 60 60 24 – for expert health information and advice (24 hours, 7 days)
  • Your local pharmacist

What Are Cold Sores? Symptoms, Causes, Diagnosis, Treatment, and Prevention

A number of treatments are helpful for cold sore outbreaks.

Medication Options

Because cold sores are caused by a virus, the first line of defense is the over-the-counter antiviral Abreva (docosanol) to help your body fight the virus and reduce the duration of an outbreak. (3) This medication is most effective when taken at the first sign of tingling and itching. (6)

Additionally, use an over-the-counter oral pain reliever, such as lidocaine, benzocaine (Orajel), dibucaine, or benzyl alcohol, to relieve cold sore pain and inflammation. (3) Apply ointments and creams directly to the cold sore as directed. Other pain relief options include a cool compress, or take ibuprofen (Advil), aspirin, or acetaminophen (Tylenol). (2,3)

If a cold sore doesn’t respond to over-the-counter treatment, ask your doctor about a prescription antiviral to shorten the duration of an outbreak. If you have frequent outbreaks, you may need an antiviral daily to suppress the virus and control symptoms. (8) You can also ask about the topical therapy Denavir (penciclovir), which can be used to shorten the duration of a cold sore outbreak, according to Medline Plus. (9) To use, you typically apply it every two hours while awake, for four days.

Alternative and Complementary Therapies

Other tips to reduce an outbreak include getting plenty of rest, managing stress, and wearing sunscreen to protect against strong sun exposure. (7)

Alternative therapies may also relieve a cold sore, though more research is needed. According to a past study, researchers found that a combination of rhubarb and sage had the same healing effect as acyclovir, a topical antiviral commonly used to treat herpes infections. (10)

Additionally, research published in 2018 in Integrative Medicine found that 3 percent propolis ointment applied to areas affected by HSV-1 reduced symptoms of infection by three to four days. Propolis is a compound produced by bees. Participants applied the ointment four to five times a day for 10 days. (11)

Learn More About Treatment for Cold Sores: Medication, Complementary Therapies, and More

Prevention of Cold Sores

Cold sores are highly contagious, but you can protect yourself. Since the virus can spread through close personal contact, it’s important that you don’t share personal items with anyone — especially during an outbreak, notes the Cleveland Clinic. (12)

Personal items include clothes, makeup, razors, and towels. You should also avoid sharing food and drinks with others.

Keep in mind, too, cold sores can spread to other parts of the body. So if you have an outbreak, avoid touching your cold sore with your hands. After applying creams or ointments over a cold sore, wash your hands immediately with warm soap and water. (1)

If you’re prone to cold sores in the summer, sunlight might be a trigger. Wear a moisturizing lip balm with SPF protection to help prevent an outbreak. (7)

Oral Herpes

Oral Herpes Overview

Oral herpes is an infection caused by the herpes simplex virus. The virus causes painful sores on your lips, gums, tongue, roof of your mouth, and inside your cheeks. It also can cause symptoms such as fever and muscle aches.

  • The herpes simplex virus affects only humans. Mouth sores most commonly occur in children aged 1-2 years, but they can affect people at any age and any time of the year.
  • People contract herpes by touching infected saliva, mucous membranes, or skin. Because the virus is highly contagious, most people have been infected by at least 1 herpes subtype before adulthood.
  • After the herpes virus infects you, it has a rather unique ability to proceed to 3 stages.
    • Primary infection: The virus enters your skin or mucous membrane and reproduces. During this stage, oral sores and other symptoms, such as fever, may develop.
      • The virus may not cause any sores and symptoms. You may not know that you have it. This is called asymptomatic infection.
      • Asymptomatic infection occurs twice as often as the disease with symptoms.
    • Latency: From the infected site, the virus moves to a mass of nervous tissue in your spine called the dorsal root ganglion. There the virus reproduces again and becomes inactive.
    • Recurrence: When you encounter certain stresses, emotional or physical, the virus may reactivate and cause new sores and symptoms.

Oral Herpes Causes

Herpes simplex is a DNA virus that causes sores in and around your mouth. Two herpes subtypes may cause these sores.

  • Herpes simplex virus, type 1 or herpes-1, which causes 80% of cases of oral herpes infections
  • Herpes simplex virus, type 2 or herpes-2, which causes the rest

Oral Herpes Symptoms

Incubation period: For oral herpes, the amount of time between contact with the virus and the appearance of symptoms, the incubation period, is 2-12 days. Most people average about 4 days.

  • Duration of illness: Signs and symptoms will last 2-3 weeks. Fever, tiredness, muscle aches, and irritability may occur.
    • Pain, burning, tingling, or itching occurs at the infection site before the sores appear. Then clusters of blisters erupt. These blisters break down rapidly and, when seen, appear as tiny, shallow, gray ulcers on a red base. A few days later, they become crusted or scabbed and appear drier and more yellow
    • Oral sores: The most intense pain caused by these sores occurs at the onset and make eating and drinking difficult.
      • The sores may occur on the lips, the gums, the front of the tongue, the inside of the cheeks, the throat, and the roof of the mouth.
      • They may also extend down the chin and neck.
      • The gums may become mildly swollen and red and may bleed.
      • Neck lymph nodes often swell and become painful.
      • In people in their teens and 20s, herpes may cause a painful throat with shallow ulcers and a grayish coating on the tonsils.

When to Seek Medical Care

When to call the doctor

  • Because the sores are painful, you may have difficulty eating or drinking. To prevent dehydration, call your doctor as soon as you cannot eat or drink.
  • Call your doctor immediately if any of these symptoms, which suggest dehydration, occur:
    • A decrease in urination (fewer wet diapers in infants)
    • Drowsiness
    • Irritability
    • Dry mouth
  • Call your doctor if you or your children are not sure what the sores are.
  • If your child is younger than 8 weeks, notify your doctor when sores appear. Severe infection or disease complications occur more commonly in infants. For instance, besides affecting the mouth, the herpes simplex virus may go to the brain and produce damage.
  • People whose immune systems are weakened should also call their doctor when sores appear. Your immune system protects you from infection or fights infection. If your system is weakened, you are more likely to have severe infection or disease complication.

When to go to the hospital

Signs and symptoms of dehydration may warrant going to a hospital’s emergency department.

Exams and Tests

A doctor will base a diagnosis on information you provide and on physical examination. The characteristic appearance of the herpes sores leaves little doubt. Further testing is usually not necessary.

If you require a definitive diagnosis, for instance, if your infection involves other organ systems, the doctor may conduct laboratory tests.

  • A sample from the sores to identify the virus
  • A culture analysis
  • A staining test called the Tzanck smear
  • Antigen and antibody studies
  • Blood sampling for antibody studies

Oral Herpes Treatment Self-Care at Home

Medical Treatment

Treatment includes medication for fever and taking plenty of fluids.

  • A topical anesthetic such as viscous lidocaine (Dilocaine, Nervocaine, Xylocaine, Zilactin-L) may be prescribed to relieve pain.
  • Oral or IV medication does exist for herpes but is not recommended for people with a normal immune system. It is used only for people with weakened immune systems, infants younger than 6 weeks, or people with severe disease.
  • Some people may require hospital admission:
    • Those with severe local infection
    • People whose infection has spread to other organ systems
    • People with weakened immune systems
    • Dehydrated individuals who need IV hydration
    • Infants younger than 6 weeks

Next Steps Follow-up

  • Drink plenty of fluids.
  • Use pain medications as instructed by the doctor.
  • Use medications to control fever.
  • Watch for signs and symptoms of dehydration.


Avoid touching saliva, skin, or mucous membranes that have sores.


The sores and symptoms of oral herpes completely clear up in 2-3 weeks. But the sores may reappear under certain stressful situations.


Media file 1: Oral Herpes. Clusters of blisters erupt on the lips, tongue, and inside the mouth. Most people have been infected by at least 1 herpes subtype before adulthood.

Synonyms and Keywords

herpes labialis, herpes gingivostomatitis, herpes pharyngitis, cold sores, fever blisters, herpes simplex virus, herpes simplex virus type 1, herpes-1, herpes simplex virus, type 2 or herpes-2, herpes blister, oral blister, oral herpes

Herpes simplex virus


Herpes simplex virus type 1 (HSV-1)

HSV-1 is a highly contagious infection, that is common and endemic throughout the world. Most HSV-1 infections are acquired during childhood, and infection is lifelong. The vast majority of HSV-1 infections are oral herpes (infections in or around the mouth, sometimes called orolabial, oral-labial or oral-facial herpes), but a proportion of HSV-1 infections are genital herpes (infections in the genital or anal area).

Scope of the problem

In 2016, an estimated 3.7 billion people under the age of 50, or 67% of the population, had HSV-1 infection (oral or genital). Estimated prevalence of the infection was highest in Africa (88%) and lowest in the Americas (45%).

With respect to genital HSV-1 infection, between 122 million to 192 million people aged 15-49-years were estimated to have genital HSV-1 infection worldwide in 2016, but prevalence varied substantially by region. Most genital HSV-1 infections are estimated to occur in the Americas, Europe and Western Pacific, where HSV-1 continues to be acquired well into adulthood.

Signs and symptoms

Oral herpes infection is mostly asymptomatic, and most people with HSV-1 infection are unaware they are infected. Symptoms of oral herpes include painful blisters or open sores called ulcers in or around the mouth. Sores on the lips are commonly referred to as “cold sores.” Infected persons will often experience a tingling, itching or burning sensation around their mouth, before the appearance of sores. After initial infection, the blisters or ulcers can periodically recur. The frequency of recurrences varies from person to person.

Genital herpes caused by HSV-1 can be asymptomatic or can have mild symptoms that go unrecognized. When symptoms do occur, genital herpes is characterised by 1 one or more genital or anal blisters or ulcers. After an initial genital herpes episode,\r\nwhich can be severe, symptoms may recur. However, genital herpes caused by HSV-1 typically does not recur frequently, unlike genital herpes caused by herpes simplex virus type 2 (HSV-2; see below).


HSV-1 is mainly transmitted by oral-to-oral contact to cause oral herpes infection, via contact with the HSV-1 virus in sores, saliva, and surfaces in or around the mouth. However, HSV-1 can also be transmitted to the genital area through oral-genital contact to cause genital herpes.

HSV-1 can be transmitted from oral or skin surfaces that appear normal and when there are no symptoms present. However, the greatest risk of transmission is when there are active sores.

Individuals who already have HSV-1 oral herpes infection are unlikely to be subsequently infected with HSV-1 in the genital area.

In rare circumstances, HSV-1 infection can be transmitted from a mother with genital HSV-1 infection to her infant during delivery to cause neonatal herpes (see below).

Possible complications

Severe disease

In immunocompromised people, such as those with advanced HIV infection, HSV-1 can have more severe symptoms and more frequent recurrences. Rarely, HSV-1 infection can also 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 (HSV-1 or HSV-2) in the genital tract during delivery. Neonatal herpes is rare, occurring in an estimated 10 out of every 100,000 births globally, but\r\nis a serious condition that can lead to lasting neurologic disability or death. Women who have genital herpes before they become pregnant are at very low risk of transmitting HSV to their infants. The risk for neonatal\r\nherpes is greatest when a mother acquires HSV infection for the first time in late pregnancy., in part because the levels of HSV in the genital tract are highest early in infection.

Psychosocial impact

Recurrent symptoms of oral herpes may be uncomfortable and can lead to some social stigma and psychological distress. With genital herpes, these factors can have an important impact on quality of life and sexual relationships. However, in time, most people with either kind of herpes adjust to living with the infection.


Antiviral medications, such as acyclovir, famciclovir, and valacyclovir, are the most effective medications available for people infected with HSV. These can help to reduce the severity and frequency of symptoms, but cannot cure the infection.


HSV-1 is most contagious during an outbreak of symptomatic oral herpes, but can also be transmitted when no symptoms are felt or visible. People with active symptoms of oral herpes should avoid oral contact with others and sharing objects that have contact with saliva. They should also abstain from oral sex, to avoid transmitting herpes to the genitals of a sexual partner. Individuals with symptoms of genital herpes should abstain from sexual activity whilst experiencing any of the symptoms.

People who already have HSV-1 infection are not at risk of getting it again, but they are still at risk of acquiring herpes simplex virus type 2 (HSV-2) genital infection (see below).

The consistent and correct use of condoms can help to prevent the spread of genital herpes. However, condoms can only reduce the risk of infection, as outbreaks of genital herpes can occur in areas not covered by a condom.

People who already have HSV-1 infection are not at risk of getting it again, but they are still at risk of acquiring HSV-2 genital infection (see below).

Pregnant women with symptoms of genital herpes should inform their health care providers. Preventing acquisition of a new genital herpes infection is particularly important for women in late pregnancy, as this is when the risk for neonatal herpes is greatest.

Additional research is underway to develop more effective prevention methods against HSV infection, such as vaccines. Several candidate HSV vaccines are currently being studied.

Herpes simplex virus type 2 (HSV-2)

HSV-2 infection is widespread throughout the world and is almost exclusively sexually transmitted, causing genital herpes. HSV-2 is the main cause of genital herpes, which can also be caused by herpes simplex virus type 1 (HSV-1). Infection with HSV-2 is lifelong and incurable.

Scope of the problem

Genital herpes caused by HSV-2 is a global issue, and an estimated 491 million (13%) people aged 15 to 49 years worldwide were living with the infection in 2016.

More women are infected with HSV-2 than men; in 2016 it was estimated that 313 million women and 178 million men were living with the infection. This is because sexual transmission of HSV is more efficient from men to women than from\r\nwomen to men.

Prevalence of HSV-2 infection was estimated to be highest in Africa (44% in women and 25% in men), followed by the Americas (24% in women and 12% in men). Prevalence was also shown to increase with age, though the highest\r\nnumbers of people newly-infected were adolescents.

Signs and symptoms

Genital herpes infections often have no symptoms, or mild symptoms that go unrecognised. Most infected people are unaware that they have the infection. Typically, about 10-20% of people with HSV-2 infection report a prior diagnosis\r\nof genital herpes. However, clinical studies following people closely for new infection demonstrate that up to a third of people with new infections may have symptoms.

When symptoms do occur, genital herpes is characterised by one or more genital or anal blisters or open sores called ulcers. In addition to genital ulcers, symptoms of new genital herpes infections often include fever, body aches,\r\nand swollen lymph nodes.

After an initial genital herpes infection with HSV-2, recurrent symptoms are common but often less severe than the first outbreak. The frequency of outbreaks tends to decrease over time but can occur for many years. People infected\r\nwith HSV-2 may experience sensations of mild tingling or shooting pain in the legs, hips, and buttocks before the appearance of genital ulcers.


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

In rare circumstances, HSV-2 infection can be transmitted from a mother to her infant during delivery to cause neonatal herpes (see below).

Possible complications

HSV-2 and HIV

HSV-2 and HIV have been shown to influence each other. HSV-2 infection increases the risk of acquiring a new HIV infection by approximately three-fold. In addition, people with both HIV and HSV-2 infection are more likely to spread HIV to others. HSV-2 is amongst the most common infections in people living with HIV, occurring in 60-90% of HIV-infected persons.

Infection with HSV-2 in people living with HIV (and other immunocompromised individuals) can have a more severe presentation and more frequent recurrences. In advanced HIV disease, HSV-2 can lead to more serious, but rare, complications such as meningoencephalitis, esophagitis, hepatitis, pneumonitis, retinal necrosis, or disseminated infection.

Neonatal herpes

Neonatal herpes can occur when an infant is exposed to HSV (HSV-2 or HSV-1) in the genital tract during delivery. Neonatal herpes is rare, occurring in an estimated 10 out of every 100,000 births globally, but is\r\na serious condition that can lead to lasting neurologic disability or death. Women who have genital herpes before they become pregnant are at very low risk of transmitting HSV to their infants. The risk for neonatal herpes\r\nis greatest when a mother acquires HSV infection for the first time in late pregnancy, in part because the levels of HSV in the genital tract are highest early in infection.

Psychosocial impact

Recurrent symptoms of genital herpes may be painful and the infection can lead to social stigma and psychological distress. These factors can have an important impact on quality of life and sexual relationships. However, in time, most people with herpes adjust to living with the infection.


Antivirals, such as acyclovir, famciclovir, and valacyclovir are the most effective medications available for people infected with HSV. These can help to reduce the severity and frequency of symptoms, but cannot cure the infection.


Individuals with genital HSV infection should abstain from sexual activity whilst experiencing symptoms of genital herpes. HSV-2 is most contagious during an outbreak of sores, but can also be transmitted when no symptoms are felt or visible.

People with symptoms suggestive of genital HSV infection should also receive HIV testing, and those in settings or populations with high HIV incidence might benefit from more focused HIV prevention efforts, such as pre-exposure\r\nprophylaxis.

The consistent and correct use of condoms can help reduce the risk of spreading genital herpes. However, condoms only provide partial protection, as HSV can be found in areas not covered by a condom. Medical male circumcision can provide men life-long partial protection against HSV-2, in addition to HIV and human papillomavirus (HPV).

Pregnant women with symptoms of genital herpes should inform their health care providers. Preventing acquisition of a new genital herpes infection is particularly important for women in late pregnancy, as this is when the risk for neonatal herpes is greatest.

Additional research is underway to develop more effective prevention methods against HSV infection, such as vaccines or topical microbicides (compounds which can be applied inside the vagina or rectum to protect against sexually transmitted infections).

WHO response to herpes (HSV-1 and HSV-2)

As well as increasing awareness about HSV infection and its symptoms, improved access to antiviral medications and heightened HIV prevention efforts for those with genital HSV symptoms are needed globally. 

In addition, development of better treatment and prevention interventions is needed, particularly HSV vaccines. WHO and partners are working to accelerate research to develop new strategies for prevention and control of genital and neonatal HSV-1 and HSV-2 infections. Such research includes the development of HSV vaccines and topical microbicides. Several candidate vaccines and microbicides are currently being studied.


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90,000 Herpes in the intimate area

Genital herpes is a very common sexually transmitted disease caused by the herpes simplex virus. According to clinical statistics, every fifth adult in Ukraine is infected with this virus, but many people do not have any external manifestations, and therefore they believe that they are not infected.

After infection, most people experience repeated episodes of genital ulcers over several years.Despite the fact that this infection can be present in the body for many years, over time, relapse of the disease appears less and less. Infection can be suppressed with medication and personal hygiene.

People with herpes in an intimate place should talk to their sexual partner, use condoms, and take other preventive measures to avoid transmitting the virus to others through the affected area. Genital herpes can also spread even if there are no visible manifestations of the disease (ulcers and blisters).

The diagnosis of genital herpes can be emotionally difficult and even lead to depressive episodes, so it is very important to talk to your doctor about how to manage symptoms and prevent transmission of the virus to partners. Various counseling and support groups can also help people with this genital infection.

Causes of genital herpes

Genital herpes is caused by an infection of the herpes simplex virus (HSV, usually type 2). It can also be caused by the herpes simplex virus type 1, which causes oral herpes (herpes on the lips and mouth).

Symptoms of genital herpes in women

Symptoms of genital herpes can vary depending on whether it is an initial episode or a recurrent episode. However, many people – both women and men – with genital herpes never experience symptoms.

Primary Episode

For most people, the first outbreak is the most severe, and symptoms tend to be more severe in women than in men. The first outbreak usually occurs within a few weeks after infection.Symptoms usually resolve within 2–3 weeks.

External manifestations of a primary episode of genital herpes include the presence of a large number of blisters in the genital area. In women, they most often appear on the external genitals, buttocks, anal region and thighs; in men – on the penis, scrotum, anal area, buttocks and thighs. Signs and symptoms are usually blisters that develop into painful sores over time. Blisters on the penis or outer labia will crust over and heal.New lesions may appear within five to seven days after the first sores appear.

Another manifestation of the disease is the appearance of painful swollen lymph nodes, and flu-like symptoms such as joint pain, fever and headache may appear. Possible discomfort when urinating.

Only a small percentage of people experience headache, nausea, or difficulty urinating. These symptoms occur when the herpes virus attacks the nervous system.

People who feel pain during bowel movements may be diagnosed with proctitis (inflammation of the rectum). Men who have sex with men are more prone to this complication than other patients.

Latent stage

After the first outbreak, the virus moves towards the nerve nodes near the spine, where it remains inactive for a certain period of time. This is called the latent stage. There are usually no symptoms at this stage.


Many people suffer from repeated episodes of genital herpes, which begin when the virus travels through the nerves to the surface of the skin, causing an on-call outbreak. These recurrent episodes are usually weaker than the primary one.

Ulcers may appear in the same area of ​​the skin as in the primary infection, or may occur in other areas. The lesions can occur even in areas that have not been in direct contact with the infection.For example, a lesion may appear around the anus when the person has not had anal sex.

Latent stage

After the first outbreak, the virus moves towards the nerve nodes near the spine, where it remains inactive for a certain period of time. This is called the latent stage. There are usually no symptoms at this stage.


Many people suffer from repeated episodes of genital herpes, which begin when the virus travels through the nerves to the surface of the skin, causing an on-call outbreak.These recurrent episodes are usually weaker than the primary one. Ulcers may appear in the same area of ​​the skin as in the primary infection, or they may occur in other areas. The lesions can occur even in areas that have not been in direct contact with the infection. For example, a lesion may appear around the anus when the person has not had anal sex.

Provoking factors

Illness, stress, sunlight and fatigue can cause recurrent herpes outbreaks.In women, menstruation can also affect flare-ups.

When could I get infected?

When a person first notices any visible signs or symptoms, this does not mean that they have a primary outbreak. For example, you can first become infected, or you may not observe symptoms (or they are invisible), and only after a few years you will see periodic outbreaks and noticeable visible symptoms. For this reason, it is often difficult to determine exactly when the infection took place, especially in the case when a person has had more than one sexual partner. Therefore, it is not necessary that your real sexual partner is the source of the infection.

Diagnosis of genital herpes

The diagnosis of genital herpes is usually based on medical history, signs and symptoms, and test results. It is especially important to distinguish genital herpes from other sexually transmitted diseases, in particular those that also cause genital ulcers such as syphilis and chancroid. Some tests can be used to diagnose genital herpes.They can confirm the presence of infection and determine the type of virus (HSV-1 or HSV-2). The type of test will depend on the symptoms and the presence of blisters or sores at the time of the examination. The doctors of the Diamed-Express Medical Center, thanks to years of practice, can easily diagnose such diseases. In case of any manifestations or concerns, please call (044) 413 38 45; (063) 693 15 45; (067) 232 60 58 and make an appointment at a convenient time for you.

Analysis of ulcers. This test detects whether herpes simplex virus is present in blisters or sores.However, he only detects the virus in 50 percent of people with genital ulcers. The test will be more accurate if the ulcers are fresh or open rather than when they have already begun to heal. It is therefore important to seek medical attention within 48 hours of the onset of the first symptoms. The test is also more sensitive in people with a primary outbreak of genital herpes than in people who have a relapse.

Blood test. Blood tests are often performed on patients who believe they may have been infected with the herpes virus in the past but have no visible symptoms.A blood test will detect IgG and IgM antibodies (proteins that are produced by the body in response to a foreign substance) to HSV type 1 and type 2. If the test is positive, the presence of these antibodies will indicate that the person was infected with the virus at some point in the past, however, it is usually impossible to know when and who transmitted the virus to him.

Antibody test results may be negative in the early stages of the disease during the initial episode of infection, as it takes several weeks for antibodies to form.It is worth noting that the antibody test remains positive for life.

Blood tests may be helpful for couples in which one partner has genital herpes and the other does not. If the other partner is not infected, it is important to learn and apply all methods to prevent transmission.

Determining the type of herpes (1 or 2) will help predict the likelihood of future relapses, given that type 2 recurs more often than the first type.

Polymerase chain reaction (PCR). This test is more sensitive than the analysis of ulcers, it is aimed at detecting the herpes virus in cells and secretions from the urinary tract. This type of analysis is rarely used due to its high cost.

Transmission of genital herpes and risk factors

Infection through a sexual partner. The herpes virus is most commonly spread from partner to partner during oral, anal or vaginal sex. Infection can occur even if there are no visible ulcers at the time of contact.

The risk of contracting genital herpes is not possible through such surfaces as: doorknobs, toilet bowl, dishes, bed linen. Higher risk of transmitting the virus from an infected man to a healthy woman than from an infected woman to a healthy man. As with any sexually transmitted disease, the more sex partners you have, the higher your risk of contracting genital herpes. The risk also depends on how often you have sex and how often you use condoms.

When is an infected person most likely to spread the virus? The risk of spreading infection increases when a person develops signs or symptoms. But do not forget that there is an opportunity to spread the infection even when there are no ulcers. In one study that examined the transmission of genital herpes in heterosexual couples with the disease in one of the partners, it was found that within one year the virus was transmitted to the other partner in only 10 percent of cases.In 70 percent of them, the infection took place at a time when there were no symptoms.

Using condoms and using antiviral drugs to control the virus can reduce the risk of transmission to healthy partners, especially during the first year after infection.

Pregnancy and herpes

Women in whom the first manifestation of genital herpes occurs shortly before childbirth may put an unborn child at risk. Careful pregnancy planning and precautions during pregnancy and during labor can reduce the chances of transmission of the virus.

Since herpes in young children is a very serious condition, women should tell their doctor if they have this infection. Women who have been infected with genital herpes before pregnancy most likely will not transmit this disease to their child, but the likelihood still remains. For example, mother-to-child transmission can occur accidentally if the mother relapses during labor.

For this reason, prophylactic antiviral therapy with acyclovir is often recommended for women with one or more relapses during pregnancy.Caesarean section is generally recommended for women who have flare-ups at the time of delivery.

Healthy women whose partner has oral herpes (usually HSV type 1) or genital herpes (usually HSV type 2) should avoid oral, vaginal and anal sex during the last trimester of pregnancy. Condoms are recommended to be used throughout pregnancy.

90,000 Herpes on the tongue, symptoms and treatments

Call it herpes, or think it’s a fever blister, oral herpes is a common infection in the mouth caused by the herpes simplex virus type 1 (HSV-1).Oral herpes affects 50 to 80 percent of the world’s adult population. According to the National Institutes of Health, about 90 percent of adults have been exposed to the virus by age 50.

Herpes simplex virus, also known as HSV, is an infection that causes cold sores. Herpes can appear in various parts of the body, most often on the genitals or in the mouth. There are two types of herpes simplex virus.

HSV-1: Primarily causes oral herpes and usually causes cold sores and blisters around the mouth and face.

HSV-2: Primarily causes genital herpes and usually causes outbreaks of genital herpes.

Once infected, the person will be sick with the herpes simplex virus for the rest of their life. In an inactive state, the virus is dormant in a group of nerve cells. While some people do not develop symptoms of the virus, others have periodic outbreaks of infections.

Causes of oral herpes

Oral herpes is most commonly spread from people with an active flare-up or illness.You can get oral herpes by having intimate or personal contact (such as kissing or oral sex) with an infected person.

What causes herpes simplex?

Herpes simplex virus is a contagious virus that can be spread from person to person through direct contact. Children often become infected with HSV-1 through early contact with an infected adult. They then carry the virus with them for the rest of their lives.

HSV-1 can be infected through common interactions such as:

  • is from the same dish
  • exchange lip balm
  • kissing

The virus spreads faster when an infected person experiences an outbreak.An estimated 67 percent of people aged 49 and younger are HSV-1 seropositive, although they may never experience an outbreak. It is also possible to contract genital herpes from HSV-1 if the person who had oral sex had herpes at that time.

HSV-2 is transmitted through sexual contact with a person infected with HSV-2. According to the American Academy of Dermatology (AAD), about 20 percent of sexually active adults worldwide are infected with HSV-2. HSV-2 infections are transmitted through contact with a herpetic ulcer.In contrast, most people acquire HSV-1 from an infected person who is asymptomatic or has no ulcers.

Who is at risk of developing herpes simplex infections?

Any person, regardless of age, can become infected with HSV. Your risk is almost entirely based on exposure to infection.

For sexually transmitted HSV, people are at greater risk if they have sex without condoms or other barrier methods.

Other risk factors for HSV-2 include:

  • have multiple sexual partners
  • have sex at a younger age
  • to be a woman
  • presence of another sexually transmitted infection (STI)
  • weakened immune system

Prevention of oral herpes

Since oral herpes is transmitted through direct physical contact, the best prevention method is to avoid physical contact with a person’s herpes sores during an outbreak.

Symptoms of herpes

The initial (primary) oral herpes infection is usually the most severe. This can cause severe flu symptoms, including swollen lymph nodes and headaches. However, some people have no symptoms. During the initial infection, sores may form on the lips, around the lips, and in the mouth.

Recurrent infections tend to be much easier and ulcers usually erupt at the edges of the lips. Some people never have additional outbreaks beyond the initial infection.Below are the most common signs and symptoms of recurrent herpes simplex virus infection.

  • Initial redness, swelling, fever / pain, or itching may develop at the site of infection breakout.
  • Painful fluid-filled blisters may appear on the lips or under the nose. Blisters and fluid are highly contagious.
  • The blisters will leak fluid and become ulcers.
  • After about four to six days, the ulcers will begin to crust over and heal.
  • Signs and symptoms of an oral herpes outbreak may be similar to other conditions or health problems. Always consult your physician for an accurate diagnosis.

How do I recognize the signs of herpes simplex?

It is important to understand that someone may not have visible ulcers or symptoms, but they still have the virus. They can also transmit the virus to other people.

Some of the symptoms associated with this virus include:

You may also experience flu-like symptoms.These symptoms may include:

  • high temperature
  • enlarged lymph nodes
  • headaches
  • fatigue
  • lack of appetite

HSV can also spread to the eye, causing a condition called herpetic keratitis. This can cause symptoms such as eye pain, discharge, and gritty eyes.

How is herpes simplex diagnosed?

Because oral herpes can be confused with many other infections, including allergic reactions, virus culture (PCR), blood tests, or biopsies are the only ways to confirm your diagnosis.However, your healthcare provider can also diagnose your condition based on the location and appearance of the blisters.

This type of virus is usually diagnosed by physical examination. Your doctor may check your body for ulcers and ask you about some of your symptoms.

Your doctor may also request testing for HSV. This is known as a herpes culture. This will confirm the diagnosis if you have sores on your genitals. During this test, your doctor will take a fluid sample from the ulcer and send it to a laboratory for analysis.

Blood tests for antibodies to HSV-1 and HSV-2 can also help diagnose these infections. This is especially helpful in the absence of ulcers.

How is herpes simplex treated?

There is currently no cure for this virus. Treatment is aimed at getting rid of ulcers and limiting flare-ups.

Your sores may go away without treatment. Medication can also help reduce the intensity and frequency of flare-ups.

Medicines can be taken as oral tablets or as a cream.For severe flare-ups, these drugs can also be given by injection.

What are the long-term prospects for the development of herpes simplex?

People infected with HSV will be infected with the virus for the rest of their lives. Even if it does not show any symptoms, the virus will continue to live in the nerve cells of the infected person.

Some people may have regular outbreaks. Others will experience only one outbreak after infection, in which case the virus can go into hibernation.Even if the virus is dormant, certain stimuli can trigger an outbreak. These include:

  • stress
  • menstrual cycle
  • fever or illness
  • sun exposure or sunburn

It is believed that outbreaks may become less intense over time as the body begins to produce antibodies. If a generally healthy person is infected with the virus, there are usually no complications.

Treatment options for herpes in the mouth

Your healthcare professional will recommend treatment options based on yours:

  • Age
  • Expected Result
  • General health and medical history
  • Personal preference
  • Tolerance to certain drugs, procedures or treatments

Your specific treatment plan may include:

  • Keeping the infected area clean and dry
  • Taking oral antiviral drugs
  • Application of topical antiviral ointments
  • Using over-the-counter local anesthetics or anti-inflammatory drugs to relieve symptoms
  • Find a Doctor

Preventing the spread of herpes simplex infections

Although there is no cure for cold sores, you can take steps to avoid catching the herpes virus or to prevent the transmission of HSV to another person.

If you are experiencing an HSV-1 outbreak, consider taking a few preventive steps:

  • Try to avoid direct physical contact with other people.
  • Do not transfer any items that can transmit the virus, such as cups, towels, silverware, clothing, makeup, or lip balm.
  • Do not engage in any type of sexual activity during an outbreak.
  • Wash hands thoroughly and apply medication with cotton swabs to reduce contact with ulcers.

People with HSV-2 should avoid any sexual activity with others during an outbreak. If a person has no symptoms but has been diagnosed with the virus, a condom should be used during intercourse. But even when using a condom, the virus can still be transmitted to your partner through uncovered skin.

Pregnant and infected women may need to take medication to prevent the virus from infecting their unborn children.

If you feel the symptoms indicated above, then sign up for a free consultation at the Before & After clinic: the symptoms of herpes are easily eliminated if you are treated by professional dentistry in Kiev.

90,000 Herpes Simplex Virus – diagnosis and analysis. HSV type 1 and 2.

Herpes Simplex Virus – diagnosis and analysis. HSV type 1 and 2.

CDC MNIIEM named after G.N. Gabrichevsky “Infectious diseases” Herpes simplex virus – diagnosis and analysis. HSV type 1 and 2.

Research Price (first / repeated) How to take
Laboratory diagnostics of herpes caused by HSV types 1 and 2
Identifying herpes specific antibodies to Human 2 types IgM, IgG (ELISA) 1990-00
HSV (Herpes) IgG type 6 (ELISA) 815-00
DNA Human herpes virus 1,2 types (PCR) 380-00


HSV was first isolated by W. Gruter in 1912. This is a DNA-containing virus, the virion of which consists of a centrally located dense nucleotide, a protein capsule – a capsid and an outer shell. The outer shell of an irregular shape contains proteins, carbohydrates, lipids and other substances, and in the antigenic relation it exhibits an affinity for the antigens of the host cell. On its shell, HSV has antireceptors, due to which it attaches to tissues of ecto- and endodermal origin (pan-tropism).That is, it can affect the skin, mucous membranes, central and peripheral nervous system, liver, vascular endothelium, blood cells (T-lymphocytes, erythrocytes, platelets). “HSV”, as a DNA-containing “virus”, can integrate the genetic apparatus of the host cell and cause malignant transformation of cells ( -2 and cervical cancer). In this case, the constant presence of the virus in the cell is not necessary. The genome of “HSV” can integrate with the genes of some other “viruses”, causing their activation.On the other hand, the development of a number of “viral” and bacterial infections is accompanied by the activation of latent “herpes”.

HSV is thermolabile, when heated to 50-52 ° C it is inactivated after 30 minutes. The virus is killed by exposure to ultraviolet and X-rays. HSV is sensitive to the action of ethyl alcohol, proteolytic enzymes, phosphatase, bile and other organic solvents. The virus tolerates low temperatures well and remains viable for years or decades at temperatures from -20 ° C to -70 ° C.It is also resistant to repeated freezing and thawing, ultrasound and can be kept dry for years.


Sources of infection in diseases caused by HSV are patients with various forms of the disease, including latent, as well as virus carriers. The virus is transmitted mainly by contact (direct contact), transmission of the pathogen is also possible by contact-household, airborne and vertical routes (from mother to fetus).The latter can be carried out during childbirth (contact with the birth canal of the mother), transplacentally, or the virus enters the uterine cavity through the cervical canal (ascending path). Due to the fact that during the generalization of the process viremia takes place, transfusion and parenteral transmission are possible.

General susceptibility, antibodies to HSV are detected in 80-90% of adults. The greatest number of diseases is recorded in the cold months, but there is no epidemic, although small outbreaks can be observed in preschools, schools, hospitals.


Regardless of the way in which the “HSV” enters the body, the initial reproduction of the “virus” occurs at the entrance gate, then it penetrates into the regional lymph nodes, then into the blood and hematogenous is brought into the internal organs, the brain. It can also penetrate into the central nervous system along the nerve trunks. Primary infection usually occurs in early childhood and primary herpes occurs in 80% of patients asymptomatic. Already a few days after infection, antibodies appear in the blood serum (85% of children under 3 years old already have them).Once in the body, HSV remains in it throughout life, being in an inactive (latent) state. Carriage of viruses occurs in more than 90% of people and is one of the features of herpes. Moreover, the virus can be detected only after its reactivation as a result of weakened immunity under the influence of various factors, since the virus is in the cells of the paravertebral sensory ganglia in an unproductive state. Defects in the immune system lead to a relapse of the disease.

But there is another point of view, according to which the reproduction and isolation of HSV from the ganglion occurs constantly, but in small quantities.Migrating centrifugally, it reaches epithelial cells from the ganglion along the axon of the peripheral nerve, but the defense mechanisms eliminate micro-foci of infection, that is, prevent clinical manifestations. The protective properties of the skin also play a role.

Despite the fact that the reasons for the long-term persistence of the “virus” in the human body are not yet fully understood, it is safe to say that the immune mechanisms control the reproduction of


Diseases caused by HSV are divided into primary and secondary (recurrent) herpes infection. According to clinical manifestations, 4 forms are distinguished: latent, localized, generalized and mixed.

Primary herpes infection occurs when a person first comes into contact with HSV. As a rule, this occurs in early childhood (up to 5 years).

After a short (from 2 to 14 days) incubation period, bodies for HSV begin to be detected in the blood, and in 80-90% of the primary infected, the disease proceeds in a latent form. 10-20% have clinical manifestations, which are characterized by a general infectious syndrome with fever and other signs of intoxication. Most often it is acute respiratory infections or aphthous stomatitis.Primary herpes can be manifested by lesions of the skin and mucous membranes, including the conjunctiva or cornea of ​​the eye. Primary herpes infection is especially difficult in newborns and against the background of severe immunodeficiency. Here, generalization of the process with damage to internal organs and / or the brain is possible. Without etiotropic therapy, it usually ends in death.

Secondary (recurrent) herpes infection occurs at any age after primary herpes. Since relapses occur in the presence of antiviral antibodies, they occur with a mild general infectious syndrome and, as a rule, against the background of diseases and / or conditions that reduce immunity: other infectious and somatic diseases, hypothermia, overheating, ultraviolet radiation, endocrine changes (for example, menstruation) , emotional stress, etc.p.

Herpes simplex relapses can occur with varying frequency. If they appear once every few years (but not more than 2 times a year), the rash is moderately expressed and fixed in the same place, then this is a good prognostic sign. If relapses occur more often (once a quarter or more often), then we can talk about a defect in the immune system and the need for its correction.

Clinical manifestations of primary and secondary herpes have much in common and differ mainly in quantitative rather than qualitative characteristics.With primary herpes, symptoms of general intoxication are more pronounced, local lesions are more severe, and generalization of the process occurs more often.

Localized forms of herpes simplex (syn. Blister lichen – herpes simplex) are differentiated primarily by the localization of lesions (skin, mucous membranes, eyes, etc.).


The most common form of herpes infection. The clinical picture is characterized by the appearance on the skin after the incubation period (2-12 days, usually 3-4 days) of a group of vesicles with a diameter of 0.1-0.3 cm against the background of a limited, slightly edematous pink spot.Often 1-2 days before the rash, patients feel a burning sensation and itching of the skin at the site of the future rash. The content of the bubbles is initially transparent, after a few days it becomes cloudy. The bubbles are located closely and often merge into a multi-chamber solid bubble. Subsequently, the bubbles break open, forming small erosion. The resulting crusts fall off, erosion is epithelized and heals on the 6-8th day without causing scarring of the skin. Sometimes the healing time is lengthened to 3-4 weeks or more. The eruption of bubbles is accompanied by a sensation of itching, burning, general malaise, pain.

Bubble eruptions have a fixed character and are located at the site of introduction of the virus in the case of primary infection, and in the zone of innervation of one or another nerve in the case of a secondary infection. The usual localization is the skin of the face: the circumference of the mouth, especially the red border of the lips (herpes labialis), nose (herpes nasalis), less often the skin of the cheeks, eyelids, ears.

Common herpetic lesions of the skin can occur with a massive infection, for example, in wrestlers, when, in close contact, the virus is rubbed into the skin.The usual localization of the rash in this case is the arms, trunk, face. The temperature often rises (up to 38 ° C) and other symptoms of general intoxication occur. The elements of the rash are in different stages of development (vesicles, pustules, crusts).

HERPETIFORAL ECZEMA (Kaposi’s eczema, vaccine-forming pustulosis) develops at the site of eczema, erythroderma, neurodermatitis and other chronic skin lesions. Most often, this form of herpes simplex occurs in children. Usually, after an acute onset with an increase in temperature to 40 ° C, chills, symptoms of general intoxication for 3-4 days, numerous, rather large, single-chamber bubbles with transparent contents appear on the affected skin areas (sometimes the contents of the bubbles are hemorrhagic), gradually spreading to neighboring healthy plots.Then crusts form, there may be peeling of the skin. Temperature and other symptoms of general intoxication (weakness, weakness, muscle pain, loss of appetite, etc.) persist for 8-10 days. Patients are also worried about itching, burning, skin tension, regional lymphadenitis. In children under 1 year old, the disease is especially difficult and ends in 10-40% of cases with a lethal outcome.

Rarely occurring (atypical) manifestations of skin lesions in herpes simplex include:

1.Zosteriform type of herpes simplex. It is characterized by the location of the rash along the nerve trunks more often in the lower extremities, buttocks and face. This form of herpes simplex differs from shingles in the absence of pain radiating along the nerve.

2. Hemorrhagic form with bloody vesicles.

3. Hemorrhagic-necrotic, characterized by the formation of necrosis at the site of the rash.

The ulcerative necrotic form is also atypical and occurs against the background of severe immunodeficiency of any genesis.In patients, against the background of typical rashes, ulcers are formed, which gradually increase, reaching 2-5 cm in diameter. Later, they merge into extensive ulcerative surfaces with uneven edges. Such lesions persist for several months, and the reverse development occurs slowly (if they persist for more than 3 months, then they are referred to as AIDS marker diseases).

The atypical forms of herpes simplex also include erythomatous, papular, itchy and edematous. With them, vesicles are not formed, and at the site of relapse, hyperemia, small papules, sharp | swelling of tissues in the affected area.Frequent relapses of this form in the same place can cause persistent elephantiasis (elephantiasis-like herpes).

Abortive herpes simplex can also be classified as atypical. It occurs predominantly in people who are in frequent contact with patients (health care workers). The entrance gate for viruses is the skin of the fingers and palms. At the same time, typical vesicles are absent. The disease is accompanied by itching, burning sensation and, often, pain along the nerves. Local changes are characterized by edema and flushing of the skin.Quite often the diagnosis of “panaritium” is made.


Herpetic stomatitis can be a manifestation of both primary and recurrent herpes infection. Most often this form occurs in children 1-3 years old. The disease begins acutely with a rise in temperature and general malaise. Children have poor appetite, anxiety, and sleep disturbances. After 1-2 days, a lot of bubbles appear on the hyperemic and edematous mucous membranes of the cheeks, tongue, palate, gums, lips, which burst after 2-3 days, forming very painful erosion, covered with a white bloom in the form of aft.Intense salivation, soreness and enlargement of regional lymph nodes appear. Recovery occurs in 2-3 weeks.

After recovery, 40% of patients may develop chronic recurrent herpetic stomatitis. It proceeds, as a rule, without fever and intoxication.

If there is a HSV lesion of the mucous membranes of the upper respiratory tract, then acute respiratory diseases occur, which clinically do not differ from acute respiratory infections of another etiology.Their frequency is 5-7% of all acute respiratory infections.

Genital herpes is most often asymptomatic. HSV can persist in men in the genitourinary tract and in women in the cervical canal, vagina, and urethra. Individuals with asymptomatic genital herpes are sources and reservoirs of infection.

Clinical manifestations of genital herpes are most clearly observed with primary infection. After the incubation period (about 7 days), edema and hyperemia appear on the genitals, then vesicular rashes appear on the head and shaft of the penis, on the inner surface of the foreskin, on the skin of the scrotum; in women – on the large and small labia, vagina, perineum.The rash is usually profuse, the bubbles quickly burst, forming erosive or erosive-ulcerative surfaces. Almost always, the appearance of rashes is preceded by itching, burning and soreness of the mucous membranes.

Genital herpes may be accompanied by fever, swollen lymph nodes, neuralgic pain, and the formation of extensive erosions and edema of the genitals is possible. With orogenital and anagenital contacts, herpetic tonsillitis, pharyngitis, urethritis and proctitis may occur.

50-75% of people after the initial infection of herpes takes a relapsing course. In case of relapse, the nature of the disease will be determined by the severity of immunodeficiency. With severe immunodeficiency, relapses of herpes are accompanied by severe local changes of an erosive and ulcerative nature, the spread of the process to nearby skin areas, and regional inguinal lymphadenitis. Sometimes ulcers are accompanied by necrosis and scars remain in their place.

In other cases, during the relapse period, the changes differ from those in primary herpes by the absence of intoxication syndrome and less profuse rashes.In a number of patients, abortive relapses may occur, manifested by slight hyperemia, against the background of which small, rapidly opening bubbles appear. Often, all clinical manifestations are limited only by the appearance of a burning sensation and itching, as well as slight edema and hyperemia of the skin and mucous membranes of the genital organs.

Often recurrent genital herpes leads to the involvement of lymphatic vessels in the pathological process. In this case, patients may develop lymphostasis, as a result – elephantiasis of the genitals.

Genital herpes is an important medical and social problem. Recurrent genital herpes often interferes with the creation of a family, frequent relapses disrupt normal sex life. Long-term genital herpes can result in neurasthenic and depressive disorders. In women, genital herpes, even with an asymptomatic course, can cause miscarriage, infection of the fetus and newborn, which leads to mental underdevelopment, deformities or death.The causative agent of genital herpes is associated with the occurrence of cervical cancer.

Ophthalmic herpes can be primary and secondary (recurrent).

Primary herpes develops in people who do not have antiviral immunity (children from 6 months to 5 years old or adults aged 16 to 25 years). The primary infection in children is caused by HSV-1, after 16 years – by HSV-2. Clinically, quite often (up to 40%), there is a combination of keratoconjunctivitis with lesions of the skin of the eyelids and face.

More than 90% of herpetic lesions of the eyes are secondary (recurrent) ophthalmic herpes. Since relapses occur against the background of circulating antiviral antibodies, the spread of the process is usually not observed. Most often, this form of ophthalmic herpes occurs in men aged 20-40 years.

Superficial lesions of the anterior part of the eye are characterized by the development of conjunctivitis (follicular, catarrhal, vesicular-ulcerative), combined lesions of the conjunctiva and eyelids – blepharo-conjunctivitis, canaliculitis, various keratitis (point, vesicular, geographic, marginal).The development of recurrent corneal erosion is possible, as well as an isolated lesion of the sclera in the form of diffuse (often bilateral) episcleritis. With herpetic conjunctivitis, the mucous membrane of the eyelids, the eyeball, the edges of the eyelids is hyperemic. Moderate photophobia and lacrimation are characteristic. For vesicular and treelike keratitis, the development of moderately expressed photophobia, lacrimation, pericorneal injection, and then neuralgia (often significant) along the I and II branches of the trigeminal nerve is characteristic.

Deep lesions of the anterior part of the eye are characterized by the spread of infiltration into the stroma of the cornea and proceed in the form of stromal keratitis (with and without ulceration). Most of them are combined with inflammation of the anterior part of the vascular tract, that is, they are keratoirido-cyclitis.

Recurrent herpetic lesions of the inner membranes of the eye are manifested in the form of isolated iridocyclitis, choroiditis, perivasculitis and phlebothrombosis of the retina, optic neuritis.

Visceral forms of herpes simplex are manifested by the involvement of the nervous system, lungs, liver and other internal organs in the pathological process.

Damage to the central nervous system occurs most often in the form of serous meningitis and acute encephalitis. By the nature of the clinical manifestations, herpetic meningitis and encephalitis are difficult to distinguish from similar diseases caused by other pathogens. According to the literature, about 10% of all encephalitis, 0.6% of aseptic meningitis and 20% of meningoencephalitis have herpetic nature.

The defeat of the peripheral nervous system proceeds as neuritis and polyradiculoneuritis.

Herpetic pneumonia results from the activation of herpes infection under the influence of various immunosuppressants. In this case, there is almost always a stratification of a secondary bacterial infection.

Herpetic hepatitis is one of the manifestations of generalized infection. Not all scientists agree with the possibility of isolated HSV liver damage in adults.Herpetic hepatitis is characterized by an acute onset, severe intoxication, a short preicteric period, the rapid development of jaundice and a severe course with the development of acute hepatic encephalopathy. The outcome of the disease is usually fatal.

90,000 Herpes simplex viruses types 1 and 2 – Sunflower Charitable Foundation

HHV-1 and HHV-2: Herpes simplex virus

Human herpes simplex viruses 1, 2, known as herpes simplex viruses 1, 2, are extremely common : HSV-1 is present in 90 percent of adults and HSV-2 is present in 10-30 percent of adults.

Labial herpes , also known as oral herpes, cold sores, or lip fever, is caused by HSV-1. He is characterized by recurrent outbreaks of painful blisters on the lips and is highly contagious. The entrance gate is usually the mucous membrane of the mouth, but the virus can also enter the body through a small wound. Transmission can occur through direct contact with a herpes blister or with the saliva of a person who currently has a herpes blister. You can also get infected if you share crockery, cutlery, towels, or a razor with someone who currently has herpes.

Genital herpes is characterized by itchy, painful blisters on the genitals and genital area. It is usually caused by HSV-2 and is almost always sexually transmitted.

After the virus usually persists for some time in the nervous system of the affected person without causing discomfort, certain factors can lead to its reactivation, and then to an exacerbation. These factors include:

  • high fever
  • menstruation
  • sun exposure
  • upper respiratory tract infections
  • injuries
  • emotional stress
  • weakened immune system
  • certain medications

painful blisters on the lips and mouth follow, eventually forming crusted wounds.Symptoms can last up to two weeks. During the first bout of herpes, the blisters can be very painful and can also be accompanied by fever, muscle pain, and swollen lymph nodes in the face and neck. Young children often have symptoms of stomatitis with multiple ulcers, profuse salivation, and refusal to eat. The temperature can be very high (up to 40) and last up to 5-7 days.

Subsequent herpes outbreaks usually resolve more easily and in several stages:

Prodromal stage

  • This stage lasts from one to two days.Initially, the victim only notices tingling and possible redness at the site of the blister. If treatment is already started at this stage, the entire duration of the outbreak can be shortened.

Blister stage

  • This stage lasts about two to three days. One or more blisters appear on and around the lips, less commonly around the nostrils. Blistering is usually accompanied by mild pain.

Oozing stage

  • This is the most painful stage.This lasts from one to three days. The blisters burst and clear liquid comes out.

Crusting stage

  • At this stage, the bubbles are crusty. This often leads to itching, and therefore patients often describe this stage as the most unpleasant.

Healing Stage

  • At this stage, scabs and crusted areas fall off. Small temporary scars may form before the skin is completely healed.

Good to know:

Herpes is contagious at all of these stages. However, the greatest risk of infection occurs during the third stage. A herpes outbreak usually goes away on its own. The victim is no longer contagious to others from the moment the skin on which the blister was located completely healed again.

Diagnosis is based on symptoms. The doctor will examine blisters and sores, ask about other symptoms, and can usually make a diagnosis based on them.Examination of the fluid or tissue sample from the blister can be used to confirm the diagnosis (PCR method). But this is done only if the diagnosis is unclear or if there is a likelihood of other causes.

If there are no visible symptoms of the herpes virus, blood tests can be done to diagnose herpes simplex virus infection. This is called a serum herpes simplex antibody test. After taking the blood, the sample will be sent to the laboratory and will be tested not for the virus itself, but for the presence of antibodies produced by the body to fight the virus.Positive antibodies of class M (IgM) will speak in favor of primary infection. After the transferred infection, immunoglobulins of the IgG class persist for life, therefore, only by their presence, it is impossible to diagnose an exacerbation and prescribe treatment. There are several questions, the answers to which determine the exact type of treatment, namely:

  • Is it a severe initial infection or is it usually easier to reactivate?
  • Do you experience severe pain or fever?
  • How common are symptoms?
  • Does the patient have a confirmed immunodeficiency?

If symptoms are rare, fairly mild and the current outbreak is already in one of its advanced stages (seeAbove), treatment may not be required at all. The available medications are specifically designed to counteract the multiplication of the virus. For this reason, treatment is much more effective when started early, even before the virus can multiply and until the blistering stage.

Medicines for herpes:

  • If the victim is alert and notices the appearance of herpes at an early stage (when it is only a tingling sensation), you can apply an over-the-counter antiviral cream, such as acyclovir cream.This often prevents blistering and greatly reduces the outbreak of the virus. After blistering, applying creams is less effective.
  • Alternatively, creams containing zinc or creams with mild analgesic effects can be used. While these creams can relieve pain, they are not as effective as antiviral creams.
  • Occasionally, doctors prescribe oral antiviral drugs (tablets). However, this is an exception and is usually only required in very severe cases or in immunocompromised patients.Since the active ingredient in antiherpetic pills is the same as in antiviral creams, the pills are also more effective if treatment is started during the first phase (see above). However, if the patient already has blisters, doctors may prescribe oral antiviral medications in certain cases so that the patient can take them to prevent future outbreaks.

There is some evidence that oral antiviral drugs may be most effective when prescribed when a patient has a cold sore caused by a known trigger, such as strong sunlight.In such cases, the antiviral pill may be taken immediately after the person has been exposed. This is another form of lip herpes prevention that can prevent an outbreak.

There is no evidence that the combination of oral antiviral drugs and antiviral creams shortens the duration of an outbreak more than using only one of the two drugs.

  • When cold sores appear, steps must be taken to avoid sharing saliva with other people.
  • Mothers with herpes simplex virus can continue to breastfeed if there is no lesion on the breast and if the lesions on other parts of the body are completely covered. If there are active lesions on the breast, the mother should temporarily stop breastfeeding from the affected breast and should not breastfeed expressed from the affected breast. Before holding an infant in your arms, you should take care of proper hand hygiene.
  • Antiviral drugs are effective in reducing the duration and severity of outbreaks and are most effective when given at the first sign of an outbreak.In some cases, antiviral pills may be prescribed so that the patient can take them as a prophylaxis against future outbreaks.

What is the prognosis for herpes?

Herpes is a chronic viral infection in which asymptomatic intervals may alternate with recurrent exacerbations. The periods vary from person to person. Some people may have frequent flare-ups, while others have no symptoms at all. Although herpes on the lips is contagious and painful, it is usually a harmless infection.However, it can have serious health consequences if it affects newborns or people with weakened immune systems.

Neonatal herpes

Most babies born to mothers infected with HSV-1 or HSV-2 are not affected by the virus at all, but if the mother first becomes infected with HSV in the third trimester of pregnancy, the chances of the baby developing complications are increased … The infection in newborns is known as neonatal herpes.

Most cases of neonatal herpes occur when a baby is exposed to a virus in the birth canal during childbirth. In an affected child, symptoms usually appear during of the first month of life in three main subcategories of neonatal herpes:

-Skin infection in which a rash develops on the skin, around the eyes and in the mouth.

– Encephalitis, an inflammation of the brain that can cause problems such as seizures, further disability due to neurological disorders

– Generalized infection in which the virus spreads throughout the body and affects various organs.

Exactly the same severe manifestations of herpes infection are possible in people diagnosed with immunodeficiency. Therefore, it is these two categories of patients that need careful observation even after a treated infection and the possible receipt of preventive therapy with tablets, and not local ointments at the first manifestations of relapse, like everyone else.

  • The following article will focus on Human Herpes Virus 3 (HHV-3), also known as Varicella Zoster Virus (VZV), which causes both chickenpox at any age and herpes zoster mainly in adults.

Oral herpes – Medical center “Liko-Med”

Oral herpes

Oral herpes is a common and highly contagious viral infection. The condition is characterized by rashes around the mouth, on the tongue, on the skin or on the face. Oral herpes differs in manifestation from genital herpes and is transmitted during childbirth from mother to child, during sexual intercourse, as well as when using other people’s personal hygiene items and untreated tableware.

The disease may be asymptomatic, but the infected person may carry oral herpes. In most cases, no treatment is required at the initial stage of the disease. If the primary signs of infection appear, discomfort can be reduced with a special ointment or gel. Antiviral drugs can help reduce the severity of the illness, making it less severe. A complete cure for oral herpes is impossible, because the virus remains in the human body for life, asymptomatic or in the form of periodic outbreaks.

What to expect

The primary manifestation of oral herpes in most cases occurs in the form of severe flare-ups. Symptoms include tingling, burning, or itching that occurs in the area where the blisters are located. Painful formations burst or crust over, and then heal within two weeks.

The herpes virus penetrates from the skin into the blood and nerve cells immediately after infection, remaining in the body for life. The disease can proceed in a latent form and manifest itself only after exposure to predisposing factors on the body.Over time, outbreaks of oral herpes become less frequent and less intense.

Risk factors

You can get the herpes virus from an infected person. If you have an oral herpes virus in your body, predisposing factors such as stress, fatigue, colds, fever, overheating in the sun, menstruation, pregnancy, cuts, or surgery can trigger an outbreak.


Oral herpes virus is found in the body of almost every person.With the help of the conducted studies, it was found that by the age of 50, 9 out of 10 people are infected with oral herpes.

Preventive measures

If an adult or a young child develops tingling, burning or sores on the face after kissing or using personal hygiene items, then measures should be taken to prevent the development of the disease.

As a preventive measure, boiling towels, strict adherence to personal hygiene, refusal of oral sex and the use of cotton swabs to treat herpes sores can be distinguished.


When symptoms of oral herpes appear, it is recommended to use special gels and ointments containing zinc. If pain is present, it is recommended to take medications such as acetaminophen or ibuprofen. The severity and frequency of outbreaks can be reduced with antiviral drugs.

It is more advisable to start treatment at the very beginning of an outbreak of oral herpes with the following drugs:

  • Acyclovir;
  • Famciclovir;
  • Valacyclovir.

What to do yourself?

  • Wash ulcers with antiseptic soap and water;
  • Use L-lysine and anesthesin for treatment;
  • Drink plenty of fluids;
  • Do not overcool;
  • Avoid sunlight and stress.

When to see a doctor?

An ambulance should be called when a fever develops and large areas of redness are spread. It is recommended to go to the doctor’s office when characteristic discomfort and sores appear that do not heal for 10 days or more.With a strong decrease in immunity and the presence of cancer or AIDS, oral herpes is a serious reason to see a doctor.

It is necessary to visit a specialist if sores spread to the eyes and there is severe pain in the area of ​​the affected skin. In children, oral herpes can cause dehydration, so it is recommended that you monitor your urine output if you have an infection.

What to ask a doctor?

  1. How to prevent the spread of oral herpes?
  2. Which medicine should I use?
  3. What to expect in the future?


Oral herpes is diagnosed by visual examination.To confirm the diagnosis, a sample is taken from the area of ​​the affected skin. In the absence of symptoms of infection, it can be confirmed by a blood test.

How is it aggravated?

Abrasions, scrapes, stress, colds, heat, sunburn, menstruation, pregnancy, cuts or surgery.

90,000 Herpes virus in pigeons. Columbid Herpesvirus

The pigeon herpes virus is spread throughout the world. It was first noted in 1945, and already in 1967 it was found in pigeons in many countries of the world.

This virus belongs to the Herpesviridae family and is called Columbid Herpesvirus. In terms of physicochemical and morphological properties, it is identical to the simple herpes virus.

Pigeons are a natural carrier of this virus. Budgerigars and cockatiels (nymphs) can also be infected with this virus. Canaries, ducks and chickens are resistant to this viral infection. According to unconfirmed laboratory data, based on similar clinical signs, an outbreak of a similar disease in domestic swifts was recorded in different cities.Usually fatal.

Pigeons become infected by contact with a sick infected bird. Most pigeons are latent carriers of the virus. They shed the virus from the pharynx during mating and while feeding young pigeons. Young pigeons are protected from disease by antibodies obtained from the mother through the egg yolk. At initial infection, they are asymptomatic carriers of the herpes virus. Infected birds, 24 hours after infection, begin to shed the virus.Typical lesions can be observed 1-3 days after infection.

Herpes virus entering the bird’s body in the upper respiratory tract, digestive tract and throughout the body (trachea, spleen, liver, kidneys and brain) due to viremia, in frequent cases with reduced immunity in pigeons.

Clinical signs.
The acute form occurs with signs of conjunctivitis, pigeons often sneeze, the nasal passages are closed with nasal mucus and secretions.White coruncles usually turn yellow-gray.

The chronic form is characterized by the presence of severe shortness of breath and sinusitis, especially if the primary viral infection is complicated by Trichomonas columbae or secondary mycoplasmic, bacterial agents (Mycoplasma columbinum, Mycoplasma columborale, Pasteurella multocida, Pasteurella hemolitic colica, Escherlopichia hemaphytica) …
In the cavity of the pharynx and larynx, there is stagnation of blood, in severe cases, foci of necrosis and small ulcers.The pharynx may become covered with diphtheria membranes. With viremia (generalization of a viral infection), foci of necrosis may appear in the liver. With a bacterial complication, the trachea can be clogged with caseous material, aerosaculitis and pericarditis can be observed.

Columbid Herpesvirus is isolated from chick embryo fibroblast cultures from pharyngeal swabs of infected pigeons. It can also be isolated from internal organs, trachea, lungs and liver, but with great difficulty, using immunofluorescence.Serologically, by viral neutralization reaction or by indirect immunofluorescence. Antibodies can be determined by the method of countercurrent (counter) immunoelectrophoresis.

The final diagnosis is made by virus isolation and serology. It is recommended to use both methods, as the latent carrier may lack seroconversion. It is recommended to examine several birds from one dovecote.
Differential diagnosis.

Severe Herpes Viral Disease Difficult to Distinguish Newcastle Disease Virus (see Table: Strains of Lentogenic Pneumotropic Paramyxovirus).

In case of bacterial complication, it is necessary to distinguish it from the diphtheria form of smallpox virus infection.
Treatment is not beneficial in preventing further spread of the virus by infected poultry. Vaccination can prevent re-shedding of the virus and control its spread.

Take care and love your feathered pets and they will reciprocate you.
Veterinary ornithologist
Chuguevsky V.V.
Veterinary clinic Bambi.

The article uses materials from the book: Diseases of poultry and farm birds. edited by B. U. Kalnek Moscow “Aquarium” 2003

Gingivostomatitis in children

This is the most common infection of the oral mucosa in children caused by the Herpes simplex virus. The virus is very widespread in nature; many healthy people are its carriers. The contagiousness of the virus is small, but often the disease proceeds in the form of small epidemic outbreaks in nurseries and kindergartens.Infection occurs by airborne droplets, through toys, it is possible for a child to become infected from an adult carrier of a virus or suffering from recurrent herpes. The incubation period often lasts from 2 to 6 days, but can last up to 17 days.

Clinical presentation of acute herpetic gingivostomatitis in children.

Acute herpetic gingivostomatitis usually affects toddlers and toddlers, most often from 1 to 3 years of age. In recent years, there has been an increase in the incidence of illness in children 6-10 months old who are artificially fed from the first months of life.The generalized form of herpes is possible in a child born to a mother who does not have antibodies to the herpes simplex virus. Infection of such a child, who has not received passive immunity from the mother, leads to the development of a severe septic disease with damage to the serous membranes of the brain and internal organs. Extensive necrosis occurs in the oral cavity; most children die.

According to the clinical course, it is customary to distinguish between mild, moderate-severe and severe forms of acute herpetic gingivostomatitis.


With a mild form of acute herpetic gingvostomatitis, the general condition of the child is slightly disturbed, the body temperature is subfebrile, less often normal, the prodromal period is not always pronounced. The first clinical sign is pain when eating. On examination, the doctor discovers hyperemia and swelling of the oral mucosa and separate, usually not merging, round erosion with a diameter of 1 – 5 mm, covered with fibrinous plaque.The rash is usually single, new elements do not appear on the following days, the duration of the disease is 4-5 days.


Moderate and even severe acute herpetic gingivostomatitis is more often diagnosed in children. The onset of the disease is acute, as in most other infectious diseases, the body temperature is above 38 ° C, and in severe cases it can reach 40 ° C, intoxication is expressed: the child is lethargic, capricious, does not sleep well, complains of headache, appetite is significantly reduced even before the appearance erosion in the mouth.Some children experience nausea, vomiting, and stool disorders. Then catarrhal phenomena often join: runny nose, cough, conjunctivitis. Usually during this period the child is examined by a pediatrician and in most cases diagnoses an acute respiratory illness. However, with a careful examination of the maxillofacial region, the pediatrician can detect enlarged, painful submandibular, chin, cervical lymph nodes and the initial signs of catarrhal gingivitis; the gingival margin is brighter in color than the rest of the oral mucosa, the tops of the interdental gingival papillae are not sharp, as in normal conditions, but rounded.

On the 2nd, 3rd or (less often) on the 4th day of the disease on the mucous membrane of the mouth, and often on the red border of the lips and skin of the face, rashes of separate and grouped vesicles with a diameter of 1 – 3 mm appear. On the skin and the red border of the lips, the stage of the bubble is easily determined, at first the bubbles have a transparent content, after 1 – 3 days their content becomes cloudy, then shrinks into a crust. If the lining of the bubble is damaged, erosion of the skin forms. On the oral mucosa, intraepithelial vesicles quickly open up and the doctor sees round-shaped erosion – aphthae.Aphthae are sharply painful, they are localized on the tongue, mucous membrane of the lips, cheeks, less often on the palate, arches, gums. With a massive rash, the aphthae merge with each other, form extensive erosion of various shapes. The mucous membrane of the mouth, free from erosion, is edematous, hyperemic, the tongue is coated. The gingival margin is also swollen, hyperemic, erosion is often formed along the edges of the gums. Salivation increases, but the saliva is viscous with an unpleasant odor.

The period of the rash lasts 2 – 4 days, the child’s condition remains serious, some children refuse not only food, but also drink, which increases intoxication.Of great importance in the pathogenesis of the disease is secondary infection of erosions with endogenous mixed, primarily coccal, microflora of the oral cavity, which becomes pathogenic in a child weakened by a viral infection. In some children with a severe form of the disease, a deep ulcerative necrotic lesion of the oral mucosa develops.

The duration of the disease depends on its severity and the effectiveness of treatment and lasts 7-15 days, aphthae heal without scarring, gingivitis persists longer.The disease does not recur if strong immunity is developed. In recent years, many children have experienced relapses of the disease.

Acute herpetic gingivostomatitis should be distinguished from drug-induced stomatitis, exudative erythema multiforme and similar syndromes, from diphtheria and other stomatitis in acute infectious diseases.


Pospisill described a severe form of severe herpetic gingvostomatitis in children debilitated by infectious diseases.