Oral herpes, also known as cold sores or fever blisters, is an incurable infection caused by herpes simplex virus type 1. According to the American Social Health Association, 50 percent of Americans are infected by the age of 20. Oral herpes is highly contagious, so it's important to recognize the signs of infection as soon as they begin.
Prodrome
According to a 2008 article in the "Archives of Internal Medicine," an outbreak of oral herpes is frequently preceded by a prodrome, or precursor phase, which foreshadows the full-blown disease. During the prodrome, the infected person may report tingling, itching, burning, stinging, hypersensitivity or some combination of these symptoms in the area where lesions later appear. Careful observation may reveal blanching, redness or mild swelling in the same sites.
Constitutional Symptoms
According to the American Dental Association, the onset of flu- or cold-like symptoms may be another clue that a herpes outbreak is impending. Common complaints include low-grade fever, malaise, headache, muscle or joint pain, poor appetite and swollen lymph nodes around the neck or throat. Notably absent, however, are the characteristic respiratory symptoms of flu and colds, such as cough or runny nose.
Lesions
The single most recognizable sign of oral herpes is the lesion itself. In a first-time outbreak, look for shallow, red lesions with well-defined borders---frequently described as punch-outs---inside the mouth and at the back of throat. Both initial and recurrent outbreaks, according to "Harrison's Principles of Internal Medicine," tend to feature lesions on the lips and skin near the mouth. At the beginning of the outbreak, these lesions characteristically appear as tiny (1 to 2 mm) bumps or blisters. After a few days, they spontaneously rupture and look like yellow, granular scabs.
References
- "Harrison's Principles of Internal Medicine"; A.S. Fauci, et al. (Eds.); 2008
- American Dental Association: Canker Sores, Cold Sores & Common Mouth Sores
- "Archives of Internal Medicine"; The Treatment of Herpes Simplex: An Evidence-Based Review; C. Cernik, K. Gallina and R.T. Brodell; June 2008
