Epidemiology of herpes simplex virus type 1 infection
- Robyn S Klein, MD, PhD
Robyn S Klein, MD, PhD
- Associate Professor of Medicine
- Washington University School of Medicine
Herpes simplex virus type 1 (HSV-1) infections are frequently asymptomatic but can produce a variety of signs and symptoms. These include oral or perioral lesions, ocular infections, nongenital skin lesions, genital skin or mucous membrane lesions, and serious systemic illnesses such as encephalitis and neonatal disease. (See "Clinical manifestations and diagnosis of herpes simplex virus type 1 infection".)
HSV-1 is transmitted from person-to-person via infected oral secretions during close contact. Infection occurs worldwide, equally between the sexes, and without seasonal variation. In the United States, there are estimated to be approximately 500,000 primary infections per annum . The incubation period of oral infections ranges from 1 to 26 days (median 6 to 8 days) and lesions range from 1 to 8 days in duration [2,3]. While infection is lifelong, it is rarely fatal in the immunocompetent host, producing either asymptomatic or mild clinical disease.
Herpetic keratitis continues to be the leading cause of blindness in industrialized countries, with the predominant disease being of the stromal type . Over the past 20 years, the prevalence of the disease has decreased in most developed countries. (See "Herpes simplex keratitis".)
Contact with herpetic lesions or oral secretions can produce infection with HSV-1 . The viral titer is 100 to 1000 times greater when lesions are present ; as a result, transmission is much more likely when the patient is symptomatic . Following primary infection, HSV can also sometimes be recovered from the stool .
In various series, HSV was obtained from 81 to 88 percent of vesicles, 34 percent of ulcers or crusts, and from the saliva in 3.6 to 25 percent of patients with a positive history or serology [2,6,7].
- Scott DA, Coulter WA, Lamey PJ. Oral shedding of herpes simplex virus type 1: a review. J Oral Pathol Med 1997; 26:441.
- Douglas RG Jr, Couch RB. A prospective study of chronic herpes simplex virus infection and recurrent herpes labialis in humans. J Immunol 1970; 104:289.
- Corey L, Spear PG. Infections with herpes simplex viruses (1). N Engl J Med 1986; 314:686.
- Claoué C, De Cock R. The spectrum of herpes simplex virus disease of the anterior segment in the 1990s. Acta Ophthalmol Scand 1996; 74:407.
- BUDDINGH GJ, SCHRUM DI, LANIER JC, GUIDRY DJ. Studies of the natural history of herpes simplex infections. Pediatrics 1953; 11:595.
- Spruance SL, Overall JC Jr, Kern ER, et al. The natural history of recurrent herpes simplex labialis: implications for antiviral therapy. N Engl J Med 1977; 297:69.
- Young SK, Rowe NH, Buchanan RA. A clinical study for the control of facial mucocutaneous herpes virus infections. I. Characterization of natural history in a professional school population. Oral Surg Oral Med Oral Pathol 1976; 41:498.
- Brandt BM, Mandleblatt J, Asbell PA. Risk factors for herpes simplex-induced keratitis: a case-control study. Ann Ophthalmol 1994; 26:12.
- Remeijer L, Maertzdorf J, Doornenbal P, et al. Herpes simplex virus 1 transmission through corneal transplantation. Lancet 2001; 357:442.
- Roberts CM, Pfister JR, Spear SJ. Increasing proportion of herpes simplex virus type 1 as a cause of genital herpes infection in college students. Sex Transm Dis 2003; 30:797.
- Roberts C. Genital herpes in young adults: changing sexual behaviours, epidemiology and management. Herpes 2005; 12:10.
- Bernstein DI, Bellamy AR, Hook EW 3rd, et al. Epidemiology, clinical presentation, and antibody response to primary infection with herpes simplex virus type 1 and type 2 in young women. Clin Infect Dis 2013; 56:344.
- Xu F, Sternberg MR, Kottiri BJ, et al. Trends in herpes simplex virus type 1 and type 2 seroprevalence in the United States. JAMA 2006; 296:964.
- Malvy D, Halioua B, Lançon F, et al. Epidemiology of genital herpes simplex virus infections in a community-based sample in France: results of the HERPIMAX study. Sex Transm Dis 2005; 32:499.
- Horowitz R, Aierstuck S, Williams EA, Melby B. Herpes simplex virus infection in a university health population: clinical manifestations, epidemiology, and implications. J Am Coll Health 2010; 59:69.
- Langenberg AG, Corey L, Ashley RL, et al. A prospective study of new infections with herpes simplex virus type 1 and type 2. Chiron HSV Vaccine Study Group. N Engl J Med 1999; 341:1432.
- Whitley RJ, Kimberlin DW, Roizman B. Herpes simplex viruses. Clin Infect Dis 1998; 26:541.
- Blackwelder WC, Dolin R, Mittal KK, et al. A population study of herpesvirus infections and HLA antigens. Am J Epidemiol 1982; 115:569.
- Belongia EA, Goodman JL, Holland EJ, et al. An outbreak of herpes gladiatorum at a high-school wrestling camp. N Engl J Med 1991; 325:906.
- Nahmias AJ, Roizman B. Infection with herpes-simplex viruses 1 and 2. 3. N Engl J Med 1973; 289:781.
- Perl TM, Haugen TH, Pfaller MA, et al. Transmission of herpes simplex virus type 1 infection in an intensive care unit. Ann Intern Med 1992; 117:584.
- Buchman TG, Roizman B, Adams G, Stover BH. Restriction endonuclease fingerprinting of herpes simplex virus DNA: a novel epidemiological tool applied to a nosocomial outbreak. J Infect Dis 1978; 138:488.
- Brown ZA, Selke S, Zeh J, et al. The acquisition of herpes simplex virus during pregnancy. N Engl J Med 1997; 337:509.
- Hashido M, Lee FK, Nahmias AJ, Kawana T. Prevalence of herpes simplex virus type 1- and 2- specific antibodies among the acute, recurrent, and provoked types of female genital herpes. Microbiol Immunol 1997; 41:823.
- Sullivan-Bolyai J, Hull HF, Wilson C, Corey L. Neonatal herpes simplex virus infection in King County, Washington. Increasing incidence and epidemiologic correlates. JAMA 1983; 250:3059.
- Ship, H, Morris, AL, Durocher, RT, Burker, LW. Recurrent aphthous ulcerations and recurrent herpes labialis in a professional school student population. Oral Surg 1960; 13:1191.
- Cook SD. Herpes simplex virus in the eye. Br J Ophthalmol 1992; 76:365.
- Lafferty WE, Coombs RW, Benedetti J, et al. Recurrences after oral and genital herpes simplex virus infection. Influence of site of infection and viral type. N Engl J Med 1987; 316:1444.
- Reis MA, Costa RS, Ferraz AS. Causes of death in renal transplant recipients: a study of 102 autopsies from 1968 to 1991. J R Soc Med 1995; 88:24.
- Naraqi S, Jackson GG, Jonasson O, Yamashiroya HM. Prospective study of prevalence, incidence, and source of herpesvirus infections in patients with renal allografts. J Infect Dis 1977; 136:531.
- Djuric M, Pavlica D, Jankovic L, et al. Presence of herpes simplex virus on the oral mucosa in patients undergoing chemotherapy. Scott Med J 2007; 52:28.
- Meyers JD, Flournoy N, Thomas ED. Infection with herpes simplex virus and cell-mediated immunity after marrow transplant. J Infect Dis 1980; 142:338.
- Itin PH, Lautenschlager S. Viral lesions of the mouth in HIV-infected patients. Dermatology 1997; 194:1.
- Hodge WG, Margolis TP. Herpes simplex virus keratitis among patients who are positive or negative for human immunodeficiency virus: an epidemiologic study. Ophthalmology 1997; 104:120.