Herpes Simplex Virus (HSV): Causes, Symptoms, Diagnosis

Herpes simplex virus (HSV) is commonly known as herpes. Herpes is categorised into two categories:

• Herpes Simplex Virus 1 (HSV-1)

• Herpes Simplex Virus 2 (HSV-2)

One of the main symptoms is a rash of blisters that doctors sometimes refer to as a herpes rash.

Herpes is a highly contagious infection, and once the herpes virus enters your body, the herpes virus stays in your body for the rest of your life.

While there is no cure for herpes, some anti-viral medications are highly effective in suppressing the virus, treating an outbreak of cold sores, and even preventing or minimizing future episodes of recurring.

What are HSV-1 and HSV-2?

In a nutshell, HSV 1 is mainly associated with oral herpes, whereas HSV 2 is commonly linked to genital herpes.

1. Herpes Simplex Type 1 (HSV-1)

Herpes simplex type 1 (HSV-1) is mainly associated with oral herpes that causes infection, such as cold sores or fever blisters around the mouth and lips. However, a portion of the HSV-1 can cause genital herpes.

In most cases, HSV-1 oral herpes is acquired during childhood and leads to lifetime infection. 

HSV-1 oral infection is also called orolabial, oral-labial, or oral-facial herpes.

The statistics of Herpes simplex type 1 (HSV-1)

Based on WHO statistics, in 2016, an estimated 3.7 billion people under 50, or 67% of the population, had HSV-1 infection (both oral and genital) globally. 

Genital HSV-1 infection had approximately affected between 122 million to 192 million people aged 15-49-years in that same year.

A study shows that in Singapore Herpes simplex virus type 1 is responsible for about 30% of initial genital infections. Approximately 16% of penile ulcers containing pus in Singapore are associated with genital herpes infection.

2. Herpes Simplex Type 2 (HSV-2)

Herpes simplex type 2 (HSV-2) is commonly transmitted sexually; it is one of the most common Sexually Transmitted Infections (STIs) causing genital herpes symptoms around the genitals or rectum. However, in some cases, genital herpes is caused by HSV-1 and not HSV-2.

The statistics of Herpes simplex type 2 (HSV-2)

A WHO study shows that in 2016, Genital herpes caused by HSV-2 has an estimated 491 million (13%) people aged 15 to 49 years globally living with the infection.

An estimated 313 million women and 178 million men lived with the infection. In other words, the sexual transmission of HSV is more efficient from men to women than from women to men.

What are the Common STIs in Singapore

Based on the Department of Sexually Transmitted Infections Control (Singapore) in 2018, there were about 8000 STD cases in Singapore.

The common STDs in Singapore were:

What are the Causes of Herpes Infection?

Herpes is a contagious virus. At its most infectious stage, anyone with herpes can develop cold sores and blisters on the mouth area or the genital area. 

The Causes of Herpes simplex type 1 (HSV-1)

People with HSV-1 can transmit the virus via their saliva, oral-to-oral contact, oral-to-genital secretion, or exposing their sore and blisters secretions by:

• Kissing

• Sharing of toothbrush

• Sharing Shaver

• Sharing of lip balm or lipstick

• Sharing of eating utensils

• Oral-genital contact (causing genital herpes)

The Causes of Herpes simplex type 2 (HSV-2)

People with HSV-2 can transmit the virus sexually through:

• Close skin-to-skin contact, 

• Contact with herpes sore, blisters, fluid of someone infected,

• The skin inside the mouth, vaginal, rectum, and penis around

What are the Symptoms of Herpes?

Symptoms of Oral Herpes

Most commonly, the initial infection of oral herpes can have some of these severe symptoms:

• Flu-like symptoms

• Headache

• Swollen lymph nodes

• The blisters will leak fluid and become sores

• Painful, fluid-filled blisters or sore on the lips or inside or around the mouth

• Muscle aches

However, some people may have very mild symptoms unnoticed or mistake them for other skin conditions.

Most individuals infected with herpes are asymptomatic. However, even when asymptomatic, they can still transmit the virus to others.

Symptoms of Genital Herpes

Most people infected with HSV don't know they have been infected because there are no signs or symptoms (asymptomatic).

Some of the common symptoms of genital herpes are:

• Pain or itching

• Small red bumps or tiny white blisters

• Ulcers

• Scabs

• Flu-like symptoms

• Headache

• Swollen lymph nodes on the groin

Herpes sore and blister can appears on the:

• Buttocks and thighs

• Anus

• Mouth

• Urethra

• Vaginal area

• External genitals

• Cervix

• Penis

• Scrotum

After the first genital herpes outbreak, some signs and symptoms will reappear. Recurrences are common and will become less frequent over time.

How Can I prevent Herpes infection?

Unlike HPV (human papillomavirus), one of the common STIs causes genital warts. There is HPV vaccination available to reduce the risk of HPV infection. Unfortunately, there is no available vaccine that prevents Herpes infection.

There are ways to protect yourself and others from contracting herpes.

These include:

• Keep a strong immune system through regular exercise, proper nutrition, and rest

• Inform your partner immediately if you have genital herpes

• Not sharing food and utensils with others who have cold sores or ulcers

• Prevent close, physical contact with infected persons

• Practising safe sex

Recurrence of Genital Herpes

Some people may feel burning, tingling, and itching where the infection first entered your body and pain in your lower back, buttocks, and legs during the recurrences.

Outbreaks of genital herpes may be triggered by:

• Stress

• Menstruation

• Illness

• Surgery

• Suppressed immune system medications

Suppressed immune system medications are such as steroids or chemotherapy, or infections caused by the human immunodeficiency virus (HIV) 

Signs and symptoms of genital herpes may recur for years. While some people may experience numerous episodes each year, the outbreaks usually get less frequent as time passes.

Herpes suppressive therapy reduces the frequency of genital herpes recurrence.

What are the Complications of Herpes?

The complications of herpes are severe, and it may cause:

• Eye infection and scarring of the eye without immediate medical attention

• Seizures, brain damage, blindness, or even death of a newborn if the mother has herpes

• Anal Fissure

What is the Incubation Period of Herpes?

The typical incubation period of oral herpes is about 2-12 days.

You may not experience the symptoms immediately after being infected. However, symptoms may appear days, weeks, or even years after being infected with herpes.

How to Diagnose Herpes?

1. Herpes Swab Test

When you have Herpes (HSV-1) or Herpes (HSV-2) symptoms, our doctor will do a physical examination and perform a Herpes Swab Test collect a sample from your sore and blister on the infected area to test for the herpes virus.

2. Herpes Blood Test

Herpes blood test can detect the antibodies of the herpes virus in your systems. It is suitable for both asymptomatic and symptomatic cases. 

3. Herpes Test for HSV-1 and HSV-2

This STD Test can help determine which HSV type is present in your systems.

What is the Treatment for Herpes?

There’s no cure for genital herpes, but we can treat it. 

If you do have it, your doctor can help you manage it. Some drugs can shorten or prevent outbreaks, ease symptoms, and lower your sex partners' chances of getting it.

Herpes Simplex Virus testing, screening, and treatment are available at all PULSE clinics. If you have any concerns please contact our STD clinic, or make an appointment online.