There are two different strains of herpes simplex viruses. Herpes simplex virus type 1 (HSV-1) is usually associated with infections of the lips, mouth, and face. It is the most common herpes simplex virus among the general population and is usually acquired in childhood. It often causes lesions inside the mouth such as cold sores or feverblisters and is transmitted by contact with infected saliva. By adulthood, up to 90% of individuals will have antibodies to HSV-1.

Herpes simplex virus 2 (HSV-2) is sexually transmitted and is usually associated with genital ulcers or sores -- however individuals may harbor HSV-2 and not have developed any symptoms. Up to 20-30% of U.S. adults have antibodies against HSV-2. Cross-infection of type 1 and 2 viruses may occur from oral-genital contact.

In addition to oral and genital lesions, the virus can also lead to complications such as meningoencephalitis (infection of the lining of the brain and the brain itself) or cause an infection of the eye -- in particular the conjunctiva, and cornea. A finger infection, called herpetic whitlow is another form of herpes infection -- usually affecting health care providers (because of exposure to oral secretions during procedures) and young children. The herpes virus may also infect the fetus and cause congenital abnormalities. Herpes viruses can be transmitted to a newborn during vaginal delivery in mothers infected with herpes viruses (especially if the mother has active infection at the time of delivery, yet transmission may still occur at a lower rate without visible lesions).

The virus may be transmitted even in the absence of symptoms or visible lesions. Once the virus is acquired, it spreads to nerve cells and remains dormant. It may intermittently reactivate and cause symptoms (flares). Recurrences may be precipitated by overexposure to sunlight, fever, stress, acute illness and medications or conditions that weaken the immune system (such as cancer, HIV/AIDS, and use of corticosteroids).

• mouth sores
• genital lesions (male) -- may be preceded by burning or tingling sensation
• genital lesions (female) -- may be preceded by burning or tingling sensation
• blisters and/or ulcers -- most frequent on the mouth, lips and gums or genitalia
• fever blisters
• fever -- may be present especially during the first episode
• enlargement of lymph nodes in the neck or groin

• meningitis
• encephalitis
• eczema herpetiform (widespread herpes across the skin)
• infection of the eye -- keratoconjunctivitis
• prolonged, severe infection in immunosuppressed individuals
• pneumonia
• infection of the trachea

Call your health care provider if you develop symptoms which appear to be herpes infection as there are many different conditions which can cause similar lesions (particularly in the genital area).

If you have a history of herpes infection and you develop similar lesions, notify your health care provider if they do not resolve after 7-10 days, or if you have a condition that weakens your immune system.

Prevention is difficult since the virus can be spread to others when the infected person has no evidence of a current outbreak; however, avoiding direct contact with an open lesion will lower the risk of infection. People with genital herpes should avoid sexual contact when active lesions are present. Safer sex behaviors including the use of condoms may also lower the risk of infection.

Individuals with active herpetic lesions should also avoid contact with newborns, children with eczema or immunosuppressed individuals as these groups are at higher risk for more severe disease.

In pregnant women with active herpes simplex infection at the time of delivery, a cesarean delivery (C-section) is recommended to decrease the risk of infecting the newborn.