The average incubation period of HSV-1 is 4 days with a range from 2 to 12 days.
Primary HSV-1 infection typically manifests with gingivostomatitis and pharyngitis. This usually happens in young children between 1 and 3 years of age. When the lesions appear a person experiences fever, sore throat malaise, itching, burning sensations, myalgias, inability to eat, irritability, cervical adenopathy, and mucosal edema. Tingling and pain may precede the occurrence of sores.
Vesicular rash which looks like small blisters is distributed on the hard palate, the tongue, the gingiva, and around the lips. These lesions, also known as fever blisters or cold sores tend to rupture, leaving gray-white ulcers. The disease lasts from 10 to 21 days.
The virus may be found in oral secretions from 7 to 10 days as well as in the stool.
When the disease recurs the pain, burning, tingling or itching sensations precede the development of the orofacial lesions.Within 24-48 hours afterwards the painful vesicles appear, typically on the border of the lip. From 3 to 4 days later the vesicles crust and after 8-10 days the lesions disappear.
The incubation period of primary genital herpes may last from 2 to 12 days. Primary genital herpes tends to have a prolonged symptom duration.
The first episode of genital herpes manifests with fever, headache, general malaise, and muscular pain. Pain, itching, dysuria, vaginal and urethral discharge, and the painful enlargement of the local lymph nodes are characteristic. These symptoms occur between day 7 and 11 of the illness.
Widely spaced bilateral lesions on the genitalia are observed on examination, including vesicles, pustules, painful erythematous ulcers, and crusting. The lesions persist for approximately 21 days. However, in males the lesions heal faster.
A clear mucoid discharge and dysuria (painful urination) may also be present. The cervix and urethra are involved in more than 80% of women with first-episode HSV. Women are likely to experience more severe
In males the lesions typically are observed on the glans, or shaft, of the penis. In females the labia minora, labia majora, and perineum are the most frequently affected.
HSV-1 infection of the finger is known as herpetic whitlow. It occurs when the broken skin of the hand is exposed to the virus. An infected finger swells and becomes reddish acutely, it becomes tender and painful. Vesicles or pustular lesions are detected on the fingertip.
Herpes gladiatorum (mat herpes) is common for wrestlers and other sportsmen involved in high-contact sports. This type of HSV 1 infection develops due to the traumas of the mucosa and the skin as the virus penetrates through the injured epithelium. It may affect almost every part of the body.
Herpetic encephalitis and meningitis
The virus may spread into the brain via the ganglia and results in HSV encephalitis. HSV encephalitis presents with headache, fever, altered consciousness, seizures, memory loss, anosmia (absence of the smell perception), olfactory hallucinations, speech disorders, and behavioral disturbances.
HSV meningitis is usually associated with genital herpes.
HSV causes keratitis – an inflammation of the cornea. It manifests with pain, blurred vision, and chemosis. Characteristic dendritic lesions of the cornea are detected. Blepharitis and follicular conjunctivitis may also occur.
HSV esophagitis causes odynophagia (pain while swallowing), dysphagia, substernal pain, and weight loss. The distal part of the esophagus is usually affected.
HSV hepatitis may be seen in individuals with the suppressed immune system. Hepatitis manifests with the sudden increase of bilirubin and aminotranspherase levels and fever.
- disease localized to the skin, eye (chorioretinitis), and/or mouth (45% of cases);
- encephalitis, with or without SEM involvement (30% of cases);
- disseminated infection when multiple organs (the CNS, lung, gastrointestinal tract, liver, adrenals, skin, eye, and/or mouth) are involved (25% of cases).
Read more: Neonatal herpes