Human Herpesvirus 1 (HHV-1), commonly known as Herpes Simplex Virus type 1 (HSV-1), is a highly prevalent virus. It is a common cause of oral herpes, often referred to as cold sores or fever blisters. Once acquired, the virus remains in the body for life, often lying dormant in nerve cells.
How HHV1 Spreads
HHV-1 primarily spreads through direct skin-to-skin contact, particularly with active sores or saliva. This includes intimate contact such as kissing or oral sex. While the risk of transmission is highest when visible sores are present, HHV-1 can also spread even when no symptoms are apparent, a phenomenon known as asymptomatic shedding.
Asymptomatic shedding means the virus reactivates and replicates on the skin surface without causing noticeable blisters or sores. This silent shedding can still lead to transmission through direct contact with infected oral or skin surfaces that appear normal. HHV-1 is not typically spread through casual contact with inanimate objects like sharing utensils or towels unless there is direct contact with infected saliva or sores.
Recognizing HHV1
Oral herpes, known as cold sores or fever blisters, is the most common manifestation of HHV-1 infection. These typically appear as tiny, fluid-filled blisters on and around the lips, though they can also form around the nose or cheeks, or less commonly, inside the mouth. A cold sore usually begins with a tingling, itching, or burning sensation in the affected area, often a day or so before visible signs appear.
Small, red bumps then develop into fluid-filled blisters that may merge and eventually burst, leaving shallow, open sores. After several days, the sores dry out and crust over, typically healing completely within 2 to 3 weeks without scarring. The initial infection can sometimes be more severe, causing flu-like symptoms such as fever, headache, muscle aches, and swollen lymph nodes.
Less common manifestations of HHV-1 infection include ocular herpes, also known as herpes keratitis, which affects the eye. This can lead to eye pain, light sensitivity, and discharge. Another less frequent manifestation is herpetic whitlow, which presents as painful, deep-seated vesicles on the fingers, often accompanied by swelling and discoloration around the fingernail.
Managing HHV1
Diagnosis
Diagnosis of HHV-1 involves clinical evaluation and laboratory tests. A healthcare professional may visually inspect characteristic blisters or ulcers during an active outbreak. Laboratory tests include viral culture, which isolates the virus from a lesion, and Polymerase Chain Reaction (PCR) testing. PCR is a more sensitive and rapid method for diagnosing HHV-1, detecting viral DNA in samples from lesions and identifying the specific type of herpes simplex virus (HSV-1 or HSV-2). Antibody tests can also detect HHV-1 antibodies in the blood, indicating a past or current infection.
Treatment
Treatment for HHV-1 outbreaks primarily involves antiviral medications that reduce the severity and duration of symptoms. These oral medications are most effective when started within 24 to 48 hours of the first signs of an outbreak, such as tingling or itching. They can also be used as suppressive therapy to reduce the frequency of recurrent outbreaks.
Self-Care
Self-care measures can help manage symptoms at home. Applying a cold, damp cloth to sores can ease pain and reduce swelling. Over-the-counter pain relievers can alleviate discomfort. Keeping the affected area clean and avoiding touching sores can prevent spreading the virus to other body parts or to others.
Prevention
To prevent HHV-1 transmission, avoid direct contact, such as kissing or oral sex, during active outbreaks. Sharing personal items that come into contact with sores, like toothbrushes or lip balm, should also be avoided. Consistent handwashing, especially after touching a sore, is an important preventive measure.