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Infectious Diseases

Herpes simplex one & two



What is the major difference between herpes simplex one and herpes simplex two, especially in children under the age of five?.


Despite being given different numbers, herpes simplex virus-1 (HSV-1) and herpes simplex virus-2 (HSV-2) can present with similar symptoms in all patients. As a general rule, HSV-1 infection is more likely to produce symptoms of the mouth, lips and face (e.g., a "cold sore" or "fever blister"), whereas HSV-2 is more likely to be associated with genitalia and sexual contact. However, HSV-1 can be associated with genital infection and HSV-2 can be associated with mouth, lips and facial infections.

As another general rule, infection with herpes simplex viruses may result in recurrent symptoms and disease over a number a years; HSV-1 is more likely to be associated with recurrent "cold sores" if facial infection is present compared to facial infection with HSV-2, and HSV-2 is more likely to be associated with recurrent genital lesions when compared to HSV-1 genital infections.

For children under the age of 5, there can be a broad spectrum of symptoms and diseases associated with the herpes simplex viruses, but, with the exception of newborns, the most common presentation is a "cold sore" or "fever blister" or other infection of the mouth, lips and face.

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Response by:

Stephen   Kralovic, MD Stephen Kralovic, MD
Associate Professor
College of Medicine
University of Cincinnati