Herpes simplex virus, known as herpes or HSV has two types. The first type is HSV-1, known as oral herpes. The second type is HSV-2, known as genital herpes. Although HSV-1 can also cause genital lesions, it mostly causes mouth sores. These mouth sores are also called cold sores or fever blisters. HSV-2 affects the genitals, causing painful sores to appear on them or in the anal area. Herpes simplex virus type 1 is a very prevalent disease, and around 67% of the population of the US live with it. On the other hand, HSV-2 is a global burden, affecting an estimated 417 million people in the world. 

What are the routes of transmission for HSV-1 and HSV-2?

The route of transmission for HSV-1 is through oral secretions or skin sores. Therefore, a person can transmit or acquire the virus through kissing or sharing objects used for the hygiene of the mouth. HSV-2 is transmissible through sexual contact with an infected person. Therefore, HSV-2 is a sexually transmitted disease (STD). It is significant to note that both viruses are highly transmissible, even in the absence of profound lesions. In other words, you can acquire herpes even when the virus is in submission. Genital herpes can also pass from a mother to her child during labor. 

What triggers herpes outbreaks?

HSV types 1 and 2 can be in remission, or dormant, for years. However, some factors act as triggers for a new symptomatic outbreak. People with herpes, usually experience attacks under physiological or emotional stress. Another example could be a chronic illness or fatigue. Other triggers for herpes outbreaks include immunosuppression, menstruation, or mechanical trauma in the genitals. A herpes attack is the timing that the viral infection becomes symptomatic. Most of the time, this is the only way for a person to find out they have HSV. Genital herpes doesn't exclude HSV-1. Therefore, anyone with genital herpes should test for both strains, to find out which one is responsible. A highly accurate method to do that at home is with an STD rapid kit combo test that covers both HSV-1 and HSV-2. 

Symptoms of herpes simplex

Symptoms of herpes simplex begin with one or multiple blisters on the mouth, genitals, or anus of the infected individual. After a few days, the blisters will erupt and transform into painful small sores, called ulcers. A newly acquired HSV infection might present with fever, swollen lymph nodes, and muscle pain. However, the intensity of the consecutive outbreaks decreases over time. Some people with HSV-2 might experience a symptomatic aura some days before the beginning of an eruption, with muscle pain in the thighs and buttocks. 

What are the complications of herpes infection?

  • HSV-2 and HIV seem to interact with each other. Research suggests that HSV-2-positive individuals have three times more chances to acquire an HIV infection. Also, people with both are more likely to transmit the disease to others. Keep in mind that HSV-2 is the most common infection in people living with HIV. In late HIV stages, HSV-2 can lead to severe and life-threatening complications. 
  • Women with HSV-2 may pass the infection to their children during delivery, leading to neonatal herpes. It is an uncommon condition that can cause severe neurological disabilities or even lead to death. The risk of HSV-2 increases if the woman acquires the infection in her late stages of gestation. 
  • The disease can significantly affect the psychological status of an individual. In the beginning, herpes has a broad impact on the private and sex life of the infected person. However, most people learn how to live with herpes, manage their symptoms, and avoid the trigger factors.

How to diagnose herpes simplex?

Herpes simplex is a disease that is very typical during an outbreak. Your doctor will perform a physical examination and will inspect the signs of the illness and their location. As mentioned previously, the site of the infection is crucial to differentiate between the two types of herpes infection. Your doctor can also take a sample from your sores or your blood and test it. However, you cannot find out who gave you the infection of for how long you live with it. Another method to find out whether you have HSV or not is to get tested with an STD rapid kit test at home. It is a fast and accurate way for you and your partner to establish the diagnosis alone. 

How do you treat herpes simplex?

Herpes simplex infection is not curable. The treatment's goal is to lower the severity and the frequency of outbreaks and to reach the healing process sooner. People with genital herpes experience pain, which is manageable with warm baths. The most commonly used drugs against HSV infection are the following:

  • acyclovir
  • famciclovir
  • valacyclovir

Is it possible to prevent herpes simplex infection?

People with an established HSV-1 infection should avoid oral contact with other individuals during the outbreaks. However, as mentioned previously, the virus is transmissible upon remission, too, but with less success. Using a condom or dental dams would also decrease your chances of acquiring genital herpes from an HSV-1-positive individual. 

HSV-2 is transmissible through sexual activity and is highly contagious during the outbreaks. Therefore, infected individuals should abstain from sex during those periods. The correct and systematic use of condoms will significantly decrease the risk of transmission. Pregnant women with herpes simplex should inform and consult their doctor for further information and medical support. Finally, circumcision in men is partially protective against HSV-2, HPV, and HIV.

Some general measures against getting infected with herpes simplex are the following:

  • Being monogamous
  • Having as a partner a monogamous person without STDs (only testing and negative results can assure you about the lack of STDs in an individual)
  • Using latex condoms
  • Do frequent screening
  • Taking medication against herpes, if you are infected
  • Abstaining from any sexual activity when your partner has a herpes outbreak

In conclusion, herpes is a common condition that is transmissible even when asymptomatic. It has no cure and is the most common infection in HIV-positive individuals. You can prevent its transmission with easy and small changes in your lifestyle. You can accurately test yourself for herpes simplex alone at home, with an STD rapid kit test. Also, if you live with HSV, you can try and learn how to avoid the trigger factors which lead to herpes attacks.