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Oral Herpes Risks & Complications

How is oral herpes spread?

Herpes is a virus with multiple strains; two of these strains, HSV-1 and HSV-2, cause both oral and genital herpes. Herpes viruses infect the skin and/or mucous membranes. Oral herpes presents itself as cold sore or fever blisters that affect the lips or area near the mouth. Oral herpes is most often caused by the HSV-1 strain, but oral herpes can also be caused by the HSV-2 strain. Approximately 80 percent of oral herpes cases are caused by HSV-1, while the remaining 20 percent are caused by HSV-2, and 75%-80% of Americans carry at least one Herpes Simplex Virus (Type 1 or 2).

Herpes 1 and 2 can be contracted during vaginal, anal or oral sex. The initial outbreak of either virus strain can result in flu-like symptoms, including fever, swollen lymph nodes and body aches.

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Oral herpes can be transmitted by kissing, sharing eating utensils or drinks, or during sex. Since oral herpes can be contracted from both Type 1 and Type 2 strains of the Herpes Simplex Virus, our doctors recommend getting tested for both of these HSV strains at the same time.

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What causes oral herpes?

Oral herpes is most commonly transmitted by kissing or sharing drinks or utensils, but can also be contracted from a partner who has genital herpes during oral sex. HSV-1 can be contracted from infected bodily fluids, including semen, vaginal fluid, saliva, or herpes lesions, sores or blister fluid. Upon entering a cell, the infection often does not cause any symptoms. If the virus destroys the host cell during replication, sores or blisters filled with fluid appear. Scabs form over the sores or blisters once the fluid is absorbed, then the scabs disappear without scarring.

The herpes virus goes through dormant phases where it becomes inactive for indeterminable periods of time and reactivate unpredictably. Herpes can be transmitted even when signs or symptoms are not present. This process is known as “shedding,” and occurs when cells that have the active virus are dropped or shed from the skin. Approximately one- third to half of all shedding occurrences are asymptomatic.

How can I prevent getting or spreading oral herpes?

There are many ways to prevent getting or spreading oral herpes, but getting tested first is the only way to know for certain that you are not a carrier of HSV-1 or HSV-2. You can also help prevent contracting oral herpes by not kissing or having oral sex with anyone with cold sores or genital sores, or sharing creams, medicines, makeup and other fluids that may have come in contact with the virus. Avoid sharing drinks, straws and eating utensils also.

Who is at risk for oral herpes?

Men and women who come in contact with HSV-1 or HSV-2 infections are at risk of contracting oral herpes. Since oral herpes is transmitted through skin-to-skin contact including kissing and oral sex, anyone engaged in oral-genital or genital-genital sex may also be at risk. HSV-1 and HSV-2 do not always show symptoms and can lie dormant in your body for many years before being triggered.

Other conditions linked to oral herpes

Oral herpes is not typically a serious condition. Having herpes may cause personal discomfort, stress and inconvenience such as making it difficult or painful to drink fluids or swallow food.

In rare cases, HSV-1 can recur spontaneously in the eye, a condition known as ocular herpes. Ocular herpes can be serious and can even lead to blindness in some cases.

Herpes simplex virus encephalitis is a rare, but serious condition mainly caused by HSV-1. HSV encephalitis causes inflammation of the brain.

Herpes viruses have also been linked to Recurrent Lymphocytic Meningitis (Mollaret’s meningitis), which is characterized by sudden attacks of meningitis symptoms that last for 2-7 days and are separated by symptom-free (latent) intervals lasting for weeks, months or years.

  1. "Herpes Fast Facts." American Sexual Health Association. http://www.ashasexualhealth.org/stdsstis/herpes/fast-facts-and-faqs/
  2. Kallio-Laine, Katariina, Mikko Seppänen, Hannu Kautiainen, Marja Liisa Lokki, Maija Lappalainen, Ville Valtonen, Markus Färkkilä, and Eija Kalso. "Recurrent Lymphocytic Meningitis Positive for Herpes Simplex Virus Type 2." Emerging Infectious Diseases. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2744243/
  3. Al-Dujaili, Lena J., Patrick P. Clerkin, Christian Clement, Harris E. McFerrin, Partha S. Bhattacharjee, Emily D. Varnell, Herbert E. Kaufman, and James M. Hill. "Ocular Herpes Simplex Virus: How Are Latency, Reactivation, Recurrent Disease and Therapy Interrelated?" Future Microbiology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3403814/
  4. "The Straight Dope on Herpes Statistics." Project Accept. http://projectaccept.org/straight-dope-herpes-statistics/

Medically Reviewed by on Jun 18, 2019

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