Herpes refers to a sexually transmitted, double-stranded DNA virus, called herpes simplex virus (HSV) type 2 (also known as human herpesvirus 2, or HHV2). This virus is closely related to herpes simplex virus type 1 (HSV-1 or HHV1), which is the cause of common nonsexually transmitted cold sores.

Two strains of herpes simplex viruses:

1. Herpes simplex virus type 1 (HSV-1)
   Usually associated with infections of the lips, mouth, and face. It is the most common herpes simplex virus and most people develop it in childhood. HSV-1 often causes lesions inside the mouth, such as cold sores (fever blisters). It is transmitted by contact with infected saliva. By adulthood, up to 90% of people will have antibodies to HSV-1.
   
   
2. Herpes simplex virus type 2 (HSV-2)
   Is sexually transmitted. Symptoms include genital ulcers or sores. In addition to oral and genital sores, the virus can also lead to complications such as infection of the lining of the brain and the brain itself (meningoencephalitis) or infection of the eye (especially the conjunctiva and cornea). However, some people have HSV-2 but do not show symptoms. Up to 30% of U.S. adults have antibodies against HSV-2. Cross-infection of type 1 and 2 viruses may occur from oral-genital contact.

Transmission:
Herpes can be contracted through direct skin contact with an infected person. The virus travels through tiny breaks in the skin or mucous membranes in the mouth (HSV-1) and genital areas.

Outbreak triggers:
Physical or psychological stress can trigger an outbreak. Local injury to the face, lips, eyes or mouth, as through trauma, surgery, or sunburns are well established triggers of recurrent herpes simplex virus type 1 (HSV-1). Similarly, intercurrent infections, such as upper respiratory viral infections or other febrile. Diseases, can cause outbreaks, hence the historic terms "cold sore" and "fever blister".
Generalized psychological stress and anxiety are also triggers.

Symptoms

• Mouth sores genital lesions -- there may first be a burning or tingling sensation.
  
• Blisters or ulcers -- most often on the mouth, lips and gums. Genitals fever blisters occur during the first outbreak.
  
• Enlarged lymph nodes in the neck or groin.
  

Exams and Tests

Many times, doctors can tell whether you have a herpes-simplex infection simply by looking at the lesions. However, certain tests may be ordered to be sure of the diagnosis. These tests include:

• Blood test
  
• Direct fluorescent antibody (DFA) test
  

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