There are two types of HSV: herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2). The majority of oral herpes cases are caused by HSV-1 and the majority of genital herpes cases are caused by HSV-2; however, type-1 or type-2 can occur in either the genital or oral area.
If you suffer from cold sores, fever blisters around the mouth, nose or lips, HSV-1 is the main cause. If the sores and blisters are around the groin, legs or genitals, then this is most likely due to an infection with HSV-2.
Infections are transmitted through contact with HSV in herpes lesions, mucosal surfaces, genital secretions, or oral secretions. HSV-1 and HSV-2 can be shed from normal appearing oral or genital mucosa or skin. Generally, a person can only get HSV-2 infection during genital contact with someone who has a genital HSV-2 infection. However, receiving oral sex from a person with an oral HSV-1 infection can result in getting a genital HSV-1 infection. Transmission commonly occurs from contact with an infected partner who does not have visible lesions and who may not be aware that he or she is infected.
After contracting the virus normally a week or more will pass before the symptoms become apparent. The first episode may include the following symptoms:
- Small blisters near or on the genitals – The blisters erupt to form surface deep but painful ulcers. These sores form a scab and heal after one or two weeks.
- Flu-like symptoms – General malaise, pain in the spine and legs. There may or may not be enlarged glands present in the groin.
- A rash or redness in the genital area. This may be accompanied by pain and the inability to pass urine easily.
- The skin may itch, tingle, and develop small cracks.
The first outbreak of herpes is often associated with a longer duration of herpetic lesions, increased viral shedding (making HSV transmission more likely) and systemic symptoms including fever, body aches, swollen lymph nodes, or headache. Recurrent outbreaks of genital herpes are common, and many patients who recognize recurrences have prodromal symptoms, either localized genital pain, or tingling or shooting pains in the legs, hips or buttocks, which occur hours to days before the eruption of herpetic lesions.
It is possible for the herpes virus to cause infections in other parts of the body, including the brain, kidneys, liver, eyes and lungs.
Genital herpes may cause painful genital ulcers that can be severe and persistent in persons with suppressed immune systems, such as HIV-infected persons. Both HSV-1 and HSV-2 can also cause rare but serious complications such as aseptic meningitis (inflammation of the linings of the brain). Development of extragenital lesions (e.g. buttocks, groin, thigh, finger, or eye) may occur during the course of infection.
When the herpes virus affects the brain, it causes what is known as Herpes Encephalitis. This serious condition affects around 2 million people. Symptoms of Herpes Encephalitis include a sore throat, vomiting and a fever that can even cause a coma or death if you do not seek treatment.
For pregnant women, an infection with HSV-1 and HSV-2 is particularly dangerous. The fetus and unborn child can suffer from eye disease and severe brain damage if they become infected with HSV whilst in the womb. It is also possible for the child to become infected with HSV during labour if the mother is suffering from an outbreak of HSV.