Both HSV-1 and HSV-2 live in nerve cells, usually under the skin. Neither virus is always active. They often remain silent or inactive in these cells, sometimes for many years or even a lifetime. This is called “latency.” For reasons not entirely understood by researchers, the viruses can become active and cause symptoms, which include sores around the mouth or near the genitals. This is called “reactivation.” These symptoms can come and go in what is known as outbreaks, or “flare-ups.”
During a flare-up, the virus becomes active and causes a chain of events leading to a cluster of small bumps to form. The bumps may rupture, heal, and then disappear for an indefinite period of time.
What are the symptoms of herpes?
The symptoms of herpes depends on the site of disease:
Oral herpes (cold sores): Sores around the mouth and nostrils. They may itch or be painful. They might look like the sore in the picture above.
Genital herpes: Sores on the penis in males or near or in the vagina in women. Genital herpes can also cause sores near the anus, including the area between the anus and the genital (the perineum). Sometimes, genital herpes can cause pain when urinating or defecation. They might look like the sores in the picture below.
Transmission
Herpes is contracted through direct skin contact (not necessarily in the genital area) with an infected person, and less frequently by indirect contact (for instance, by sharing lip balm or a virus infested shared towel). The virus travels through tiny breaks in the skin (or mucous membranes in the mouth and genital areas), so, healthy skin and mucous membranes are normally an effective barrier to infection. However, in the case of mucous membranes, even microscopic abrasions are sufficient to expose the nerve endings into which the virus splices itself. This is why most herpes transmission happens in mucous membranes, or in areas of the body where mucous membranes and normal skin merge (e.g., the corners of the mouth).
Symptoms may not appear for up to a month or more after infection.
Transmission was thought to be most common during an active outbreak; however, in the early 1980s, it was found that the virus can be shed from the skin in the absence of symptoms.
It is estimated that between 50% and 80% of new HSV-2 cases are from asymptomatic viral shedding.
|
