According to MedlinePlus, a patient information service of the U.S. National Library of Medicine and the National Institutes of Health, herpes is an infection caused by the herpes simplex virus. Oral herpes causes cold sores, also called fever blisters, around the mouth or on other parts of the face. Genital herpes affects the genitals, buttocks or anal area. Most outbreaks of herpes begin with a "prodrome" or early phase of symptoms.
Flu-Like Illness
According to a 2005 report in the journal American Family Physician, about 80 percent of people with herpes report constitutional symptoms such as fever, headache, muscle or joint pain, lack of appetite and malaise at the beginning of an outbreak. Often these symptoms are mistaken for the flu or the common cold; however ,characteristic respiratory symptoms of flu and cold such as cough and runny nose are notably absent. Fever, according to Dr. Raphael Dolin in "Harrison's Principles of Internal Medicine," may persist for two to seven days. Other constitutional symptoms are more durable, lasting three to 14 days, according to Dr. Dolin. Constitutional symptoms are worst during the first outbreak and become progressively less severe in recurrent outbreaks or they may not recur at all, especially for oral herpes.
Pain, Tingling and Burning
Prodromal symptoms of herpes also include pain, tingling and/or burning in the area where lesions later appear. Occasionally, the area will also appear slightly red or swollen. According to the CDC, these symptoms may last anywhere from two to 24 hours. The American Social Health Association says slightly longer--one to two days. For the first outbreak, patients are usually unaware that they have been infected with herpes and these prodromal symptoms are rarely recognized as such.
Small Red Bumps
According to a 2008 article in the Archives of Internal Medicine, the 1-2 mm, fluid-filled blisters classically associated with herpes actually begin as small bumps on a red base. However, these precursor lesions last only a few hours and are often missed. In fact, both the bumps and subsequent lesions, notes the American Social Health Association, are frequently confused with pimples, insect bites, abrasions, yeast infections and other conditions, which may explain why up to 90 percent of people with herpes do not know they have the disease.
References
- "American Family Physician": Genital Herpes: A Review; J.G. Beauman; Oct. 15, 2005
- Herpes Simplex Viruses (Chapter); L. Corey; In: "Harrison's Principles of Internal Medicine, 17th edition"; A.S. Fauci, E. Braunwald, D.L. Kasper, S.L. Hauser, D.L. Longer, J.L. Jameson and J. Loscalzo (eds.); 2008
- Archives of Internal Medicine: The Treatment of Herpes Simplex: An Evidence-Based Review; C. Cernik, K. Gallina, and R.T. Brodell; June 2008
