Two forms of herpes exist: one is the “good herpes” and the other the “bad herpes.” These subjective monikers reflect social perceptions associated with herpes. Unfortunately, these perceptions and the stigma they produce are not based on facts, and they cause unnecessary pain and suffering for people who have genital herpes. To set the facts straight, people should know the real difference between HSV1 and HSV2, between oral and genital herpes, and the causes and symptoms of each kind of infection.
To begin with, the herpes simplex virus (HSV) is the microorganism that causes herpes. There are two major subtypes of HSV, and these are HSV-1 (type 1) and HSV-2 (type 2). HSV-1 is mainly responsible for causing oral herpes, while HSV-2 mainly causes genital herpes. The qualifier “mainly” is there because in some cases (about 20% of all reported cases of herpes), HSV-1 causes genital herpes, and HSV-2 causes oral herpes. This uncharacteristic causation is often the result of oral sex. ( sex with herpes )
How are HSV1 & HSV2 the same?
Both the herpes simplex type 1 and the herpes simplex type 2 viruses infect the body’s mucous membranes (usually the mouth or genitals, but there are also mucous membranes located in the nose, eyes, and ears). Once infected, they establish latency (lie dormant) in the nervous system.
When the viruses become reactivated due to physical or emotional stimuli, they replicate and then travel the nerve pathways to the surface of the skin – sometimes that results in a physical outbreak, other times, it results in viral shedding. That is why both strains can recur and then be transmitted to others even when there are no noticeable symptoms present.
Clinically, HSV1 & HSV2 present identically, meaning, you can’t differentiate between one strain of the virus or the other by the severity of the initial outbreak or how the lesions look alone. The physical symptoms of HSV1 & HSV2 are indistinguishable.
For both HSV1 & HSV2, it is thought that at least two-thirds of infected people experience no symptoms at all or symptoms that are too mild to notice. As a result, it’s estimated that as many as the same amount (two-thirds) of people are entirely unaware they are infected.
How are HSV1 and HSV2 different?
HSV-1 and its associated infection, oral herpes, is referred to as the “good herpes” chiefly because it is transmitted non-sexually. Even young children can have oral herpes, and the infection is taken lightly as merely “cold sores” and “fever blisters.” Oral herpes appears as sores usually on the mouth, lips or gums, and sometimes on the tongue, the roof of the mouth, inside the cheeks, or on the face and neck. The sores may be accompanied by flu-like symptoms such as fever, swollen lymph nodes, painful muscles and joints, fatigue and irritability. Over-the-counter medications are used for the fever and pain, and after a few days, the sores heal on their own. They may recur a few weeks, months or years later, and succeeding recurrences are usually less severe than the first outbreak. Over the years, these recurrences decrease in number. Thus, oral herpes is generally benign and not a cause of much worry, although it is highly contagious and non-curable.
More or less the same is true of genital herpes. The main difference between HSV1 and HSV2, and between oral and genital herpes, is the area where the sores appear. HSV-1 sores appear generally on the mouth region, while HSV-2 sores appear mainly on the genital area. Again, it must be made clear that sometimes HSV-1 causes genital sores, and HSV-2 sometimes causes oral sores as well. This only goes to show that the two subtypes are not that different. They also produce the same symptoms during an outbreak: painful or itchy sores, fever, muscle pain and tiredness.
However, social perceptions of oral and genital herpes diverge widely. While people tend to dismiss oral herpes as merely “cold sores,” they generally perceive genital herpes as an altogether different matter. Because it is a sexually transmitted disease (STD), genital herpes is often considered as something bad, “unclean” and a cause for shame and embarrassment. This opinion is unwarranted, given that there is not much difference between HSV1 and HSV2, or between oral and genital herpes, apart from their common infection sites on the human body. The erroneous public perception concerning genital herpes needs to be corrected, so that persons with the disease will not be needlessly tormented by shame or embarrassment nor unfairly treated.
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