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What is HSV 2?

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Introduction to HSV 2 - Herpes Simplex 2 - and what the difference is between HSV 1 and HSV 2.

Herpes (also known as Herpes Simplex Virus, or HSV) is a viral condition that affects millions of people in the US and around the world. A study by the Imperial College in London estimated that as many as 536 million people have been infected with some type of herpes across the globe, with 23.6 million new cases every year.

Herpes is a sexually transmitted disease. It is generally spread through unprotected sex, contact with open sores, and kissing. It can also be spread through childbirth, and may on rare occasions be spread through contact with open wounds.

Herpes is not a deadly virus. But it does come with severe social stigma and cause painful and itchy outbreaks. It is also extremely contagious.

Symptoms of Herpes

Herpes symptoms can be painful, embarrassing, and irritating. The clearest symptom of herpes is the formation of lesions around the infected area.

These lesions are often described as blisters and generally appear around the mouth and genitals. It is also possible, although unlikely, to get herpes around the eyes. Most of these blisters scab over before they eventually disappear.

The primary herpes infection (when you first catch the virus) is often the worst, with subsequent outbreaks becoming lighter and less frequent over time.

Similarly, the primary herpes outbreak may also be accompanied by additional symptoms, including flu-like symptoms such as:

  • Nausea
  • Fever
  • Headache
  • Muscle Fatigue
  • Enlarged lymph nodes

Roughly 80% of those suffering from their first herpes outbreak will develop one or all of these additional symptoms. Despite the frequency of these symptoms during primary outbreaks, some never experience any type of clear outbreak, and some never experience any symptoms at all.

Thus, while rare, it's possible to catch the herpes virus and not show any sign of herpes being present.

How is Herpes Spread?

Herpes is spread through unprotected contact with someone currently shedding the virus. Generally, this occurs through kissing or unprotected sex.

During an outbreak the infection is at its most contagious, however, it is possible for herpes to be spread when no outbreak appears to be present or during the "prodromal" period, where the skin tingles as though developing an outbreak, but no outbreak occurs.

Because herpes can recur with minimal to no symptoms, it's possible to spread the virus even when someone does not currently have an outbreak, so it is important to continue to use protection and precautions when in sexual contact with someone with herpes. Nevertheless, herpes is less contagious in between outbreaks.

What is the Difference Between HSV 1 and HSV 2?

There is more than one type of herpes, and yet most people refer to them interchangeably. That is because both have very similar profiles and cause very similar symptoms, yet are technically different viruses.

  • HSV-1 is the herpes virus that has adapted to affect the mouth.
  • HSV-2 is the herpes virus that has adapted to affect the genitals.

Despite these differences, both herpes simplex viruses can affect either the mouth or the genitals. The difference tends to be the way the virus manifests itself.

Herpes simplex 2 is stronger and more contagious around the genitals, so those with HSV-2 are more likely to have had genital contact with someone that also has HSV-2.

However, if you have oral contact with someone with HSV-2 during an outbreak, you are likely to get HSV-2 around your mouth. Similarly, those with HSV-1 are more likely to spread HSV-1 through kissing or another mouth to mouth behavior but may spread HSV-1 to genitals if they provide oral sex.

When you have HSV-1 of the genitals or HSV-2 of the mouth, you are still contagious, and can still spread the virus either to the mouth or genitals of someone else.

How Does the Adaptation Come Into Play?

Because herpes simplex 1 has adapted to the mouth, and herpes simplex 2 has adapted to the genitals, that is where they cause the most symptoms and are most contagious.

Those with HSV-2 of the mouth are less likely to be contagious, may have reduced symptoms, and may have fewer outbreaks. They can still spread the virus to both the mouth and the genitals, but they are more likely to experience less severe outbreaks than those with HSV-1 of the mouth.

Those with HSV-1 of the genitals are also less likely to have as many recurrent outbreaks and less likely to spread the virus. But spreading the virus is still a risk, so protection is necessary to protect against further infection.

Are There Any Other Differences Between HSV 1 and HSV 2?

While herpes simplex 2 differs from HSV 1, both viruses are almost identical. The American Social Health Association has researched the two viruses and found that they share as much as 50% of their DNA.

Most people believe that oral herpes is a different virus than genital herpes, and while the risk of infection may be greater if you have HSV-1 in the mouth and HSV-2 in the genitals, your oral herpes may be actually HSV-2. Direct testing is needed to discover the difference.

In society, most people see HSV-2 as a sexually transmitted disease and refer to HSV-1 as simply "cold sores," but this is not necessarily accurate for the reasons specified above. Similarly, preliminary research has shown that HSV-1 may actually be more dangerous than HSV-2 for long-term health, as well as the health of a child.

HSV-1 is also more likely to affect the eyes, which may lead to blindness.

HSV-2, despite the stigma of affecting the genitals, is far less likely to lead to any complications such as eye herpes.

Spreading HSV-2 and Social Stigma

Both forms of herpes tend to have more recurring outbreaks after the initial spreading of the virus, and these outbreaks decrease over time.

HSV-1 is most likely spread as a child, sometimes on a child as young as an infant. As a result, by the time the child reaches adulthood, they are highly unlikely to have a breakout.

On the other hand, HSV-2 is generally spread through sexual contact that occurs later in life, generally during the teens and mid-'20s. Research has shown that after the initial outbreak, most people experience a recurrence in HSV-2 roughly 4 to 6 more times during the year, and then fewer and fewer times over the next several years.

That is one of the primary reasons that HSV-2 is seen with more of a negative social stigma – because it occurs and is spread at a later age and most people have outbreaks solely on the genitals.

Additional Information on HSV 2

  • The CDC estimates that 16.2% of the population between the ages of 14 and 49 have genital HSV 2.
  • Women are more likely to catch HSV 2 than men, with 1 out of 4 women and 1 out of 8 men infected.
  • Herpes creates open sores, which may make someone more susceptible to other sexually transmitted diseases, such as HIV.
  • 70% of those that get herpes got it from a partner when there was no sign of an outbreak.
  • Condoms create very effective barriers against HSV-2, but will not protect unprotected skin that may not be covered by the condom.
  • Several drugs have been shown to reduce "viral shedding"  (the contagious period) of HSV-2 by as much as 80%.
  • HSV-2 cannot cause ocular herpes or blindness. Only HSV-1 (traditionally oral herpes/cold sores) can cause ocular herpes.
  • 2/3rds of those infected with HSV-2 do not know they're infected.
  • HSV-2 symptoms have no cure, but can be managed with both medicinal and natural treatments.
  • Herpes cannot be transmitted via objects because the virus dies upon contact with air.


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