Symptoms of herpes usually develop within 2 to 20 days after contact with
the virus, although it could take longer. These symptoms may last up to
several weeks, varying from one person to the next. In many people, the first
infection is so mild that it goes unnoticed. In others, the first attack
causes visible sores. Even so, subsequent recurrences of the disease may cause
lesions. When the sores are completely healed, the active phase of infection
is over. Healing of the skin usually leaves no scars. In either case, the
virus retreats into the nervous system and lies dormant.
Typical symptoms
The virus starts to multiply when it gets into the skin cells. The skin
becomes red and sensitive, and soon afterward, one or more blisters or bumps
appear. The blisters first open, and then heal as new skin tissue forms.
During a first outbreak, the area is usually painful and may itch, burn or
tingle. Flu-like symptoms are also common. These include swollen glands,
headache, muscle ache or fever. Herpes may also infect the urethra, and
urinating may cause a burning sensation.
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The Disease Process
When HSV enters the body, the infection process typically takes place as
follows:
The virus penetrates vulnerable cells in the lower layers of skin tissue and
attempts to replicate itself in the cell nuclei. Scientists are close to
decoding the genetic structure of HSV and to discovering how the virus works
its way into specific cells. Researchers have also isolated proteins that may
facilitate the entry of HSV into healthy cells. For example, protein receptors
on cells called nectin 1 and 2 may bind to some subtypes of HSV and promote
the transmission of the infection from cell to cell.
Even after it has penetrated the cells, in many, if not most, cases, the
virus never causes symptoms.
However, if the HSV's replication process destroys the host cells, symptoms
erupt in the form of inflammation and fluid-filled blisters or ulcers. Once
the fluid is absorbed, scabs form and the blisters disappear without scarring.
After the initial replication, the viral particles are carried from the skin
through branches of nerve cells to clusters at the nerve-cell ends, the
ganglia.
Here, the virus persists in an inactive ( latent) form, in which complete
viral replication does not occur but both the host cells and the virus
survive. Infection is not apparent during these periods.
In many cases, the virus begins multiplying again, and in symptomatic
patients, skin lesions often recur.
