Herpes Simplex Virus

           A.    WHAT IS HERPES SIMPLEX?

Classification:

Famili              :  Herpesviridae

Subfamili         :  Alphaherpesvirinae

Genus               :  Simplexvirus

Spesies        : Herpes Simplex Virus Type 1 (HSV-1) and Herpes Simplex Virus Type 2 (HSV-2)

          Herpes simplex is an infection caused by herpes simplex virus (HSV) types 1 and 2. Both HSV-1 and HSV-2 can cause genital herpes infections, but HSV-1 more commonly causes infections of the mouth and lips (blister-like sores in the mouth and around the lips and on tissues that are in contact with the mouth, such as a sucked thumb or finger). Herpes simplex infects skin and mucous membrane which is caused by humanist virus herpes simplex. The infection of herpes can cause many serious implications if the onset is on the eyes, cervix periphery, newborn babies, or immune defficiency. Herpes simplex is latent infectious agent on the nerve cell, and usually has recrudescence. The infection is lifelong and can reappear at various times in a person’s life.

Herpes Simplex Virus (HSV) is included in Herpesviridae (DNA Virus) and only infects humans. The infection is worldwide. About 10% of the infection is symptomatic primer infection. Most of HSV-1 infection happen in preschool years and about 70-90% adult world population has antibody from the previous infections. HVS-2 infection commonly happens on sexual activity, 20% of adults have a high antibody level in multi sex partner and low sosio-economy category. Males and females of all ages are at risk. The incubation period is 5 days (about 2-12 days).

           B.     SYMPTOMS

Many people have mild or no symptoms. Painful assembled vesicles may appear after the primer contact with the virus. Primary infection maybe occur no matter where on the skin. It causes severe blister on the skin. Symptoms may include fever; irritability; headache; tender, swollen lymph nodes; and small, painful fluid-filled blisters in the mouth, on the gums or lips, or on sex organs or the anus. Blisters progress to open sores that crust over and heal within two to four weeks. Symptoms generally appear between two days and two weeks.

  

           C.    SPREAD

HSV-1 is primarily spread by direct contact through kissing and contact with open sores or by contact with saliva (example: from mouthed toys). HSV-2 is usually spread through sexual contact. Both types 1 and 2 may be spread by vaginal, oral or anal sex; contact with an infected person’s sores; or from an infected mother to her newborn. Most herpes simplex infections are spread from an infected person who does not have a visible sore.

Pic. Newborn infection

Newborn infections are caused by HSV-2. To avoid the infection to the baby, surgery or caesarean is needed for expectant mother with genital herpes lessions. Herpesneonatal infections are more regular  to be symptomatic. Mortality number from the infections without treatment is 50%.

Indirect contanct through stuff which used by the infected person, because HSV-2 has envelope. Thus, HSV-2 can live outside of human body until about 30 minutes.

             D.    INFECTION PERIOD

During the first infection, people shed the virus and can spread the disease for at least a week and occasionally for several weeks after signs or symptoms appear. After that first infection, the virus may be shed off and on for years and possibly lifelong. People with repeated infections shed the virus for up to five days after signs or symptoms appear. Infected individuals who have no signs or symptoms may shed lower levels of virus.

           E.     DIAGNOSE

A health-care provider can diagnose herpes simplex by visual inspection or by taking a sample from the sore and testing it in a laboratory. Blood tests may be used, but the results are not always clear-cut.

            F.     PREVENTION AND TREATMENT

Oral herpes simplex infections are common among children who are in child care or school. Most of these infections do not result in symptoms. Only children with a first infection and symptoms and who do not have control of oral secretions should be excluded from child care. Children with cold sores and recurrent infection do not have to be excluded from child care or school. Children with uncovered sores on exposed surfaces pose a small risk to contacts. If children are certified by a physician to have recurrent infection, covering the sores when they attend child care or school is sufficient.

To prevent the spread of herpes simplex, exercise careful and frequent hand washing, avoid kissing or nuzzling children when a cold sore is present, do not share food or drinks with children or staff, do not touch sores, and avoid the sharing of respiratory secretions through contact with objects.

There is no treatment that can cure herpes simplex; infection is lifelong. Antiviral medications can shorten and prevent repeated infections during the period of time the person takes the medication.

There are generic medicines to help curing HSV infection, such as Acyclovir, Vidarabin, Idoksuridin topical (for eye membrane), and Trifluridin. They treat genital Herpes Simplex Virus, herpes labialis, herpes zoster, HSV encephalitis, neonatal HSV mucocutaneous HSV in patients who have a weakened immune response (immunocompromised), varicella-zoster.

Herpes simplex treatment by acyclovir: 200 mg (400 mg in patients who have a weakened immune response / immunocompromised or if absorption impaired) 5 times a day, for 5 days. For children under 2 years are given half the adult dose. Over 2 years given the adult dose. Prevention of recurrent herpes simplex, 200 mg 4 times daily or 400 mg 2 times a day, can be reduced to 200 mg 3 times daily 2 and interruptions every 6-12 months. Prevention of herpes simplex in immunocompromised patients, 200-400 mg 4 times daily. Children under 2 years half adult dose. Same dose over 2 years with an adult dose.

There are some simple and conventional treatments which are cheaper, easier, and more trusted for some people to relieve pain, such as:

1.      Bath salts

Salt water (example: Epsom salt) can be used to wash the infected area and help clean, soothe and heal wounds. Use 1 tea spoon of salt in 600 ml of water or about a handful of salt in the tub. Swimming in the sea also shall have the same effect.

2.      A common pain reliever

Simple analgesics can be consumed such as aspirin and paracetamol. Ice can help if applied directly to the wound.

3.      Pants in a loose

Wearing loose-fitting clothing made ​​of cotton (not nylon) during an outbreak can help reduce discomfort and aid recovery.

4.      Relieve pain during urination

For anyone who experienced severe pain during urination, it could be reduced if done in a cold shower and it is important to remember to drink plenty of fluids as this dilutes the urine.

5.      Controlled temperature

We can use hair dryer or ice to relief the pain, but it cannot stop the infection by the virus . If using a hair dryer in the lower rule, it can relieve the pain. Ice can be comforting if wrapped in a towel and applied directly to the wound.

6.      Help emotionally 

   Flower remedies (example: Bach flower remedies) can be used to reduce the emotional stress caused by herpes. On the other hand, they have contra-indications with some medications, so please check with your doctor or health provider before taking.

REFERENCES

American Academy of Pediatrics. [Section 3, Summaries of Infectious Diseases]. In: Pickering LK, ed. Red Book: 2003 Report of the Committee on Infectious Diseases. 26th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2003:[page 344].

http://www.ndhealth.gov/disease/Documents/faqs/Herpes%20Simplex.pdf

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