Highest incidence of HSV-1 occurs in children aged 6 months to 3 years. Many primary infections are asymptomatic. Antibody production develops, and infection becomes latent in the sensory ganglia. Recurrent lesions are common. Physical examination and symptoms vary depending on location of the lesions.
Infection begins a chronological development of symptoms.
First, the prodrome occurs, then lesions appear along with constitutional signs and symptoms. Lesions coalesce, and tender bilateral lymphadenopathy develops. Lesions usually heal over the next several weeks. Lesions usually are vesicular or ulcerative on an erythematous base and are very painful. HSV-1 is transmitted through direct contact with infected saliva or direct contact with contaminated utensils.