Cause of herpes simplex virus infection,herbal medicines vietnam,natural medicine for cold sore,herpes simplex 2 research guide - 2016 Feature

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Pregnant women who are infected with either herpes simplex virus 2 (HSV-2) or herpes simplex virus 1 (HSV-1) genital herpes have a higher risk for miscarriage, premature labor, retarded fetal growth, or transmission of the herpes infection to the infant while in the uterus or at the time of delivery.. During a first infection, the virus is shed for longer periods, and more viral particles are excreted. An infection that first occurs in the late term does not allow the mother to develop antibodies that would help her baby fight off the infection at the time of delivery. The risk for transmission also increases if infants with infected mothers are born prematurely, if there is invasive monitoring, or if instruments are required during vaginal delivery. Very rarely, the virus is transmitted across the placenta, a form of the infection known as congenital herpes. Infants may acquire congenital herpes from a mother with an active herpes infection at the time of birth. Unfortunately, only 5% of infected pregnant women have a history of symptoms, so in many cases herpes infection is not suspected, or symptoms are missed, at the time of delivery. Obtaining routine herpes cultures on all women during the prenatal period is not recommended.
Performing chorionic vilus sampling, amniocentesis, and percutaneous fetal blood draws can safely be performed during pregnancy. If lesions in the genital area are present at the time of birth, Cesarean section is usually recommended.
If lesions erupt shortly before the baby is due then samples must be taken and sent to the laboratory.
Some doctors recommend anti-viral medication for pregnant women who are infected with HSV-2. Herpes infection in a newborn can cause a range of symptoms, including skin rash, fevers, mouth sores, and eye infections. Herpes meningitis, an inflammation of the membranes that line the brain and spinal cord, occurs in up to 10% of cases of primary genital HSV-2. Iridocyclitis is another serious complication of ocular herpes, in which the iris and the area around it become inflamed. Herpes simplex is particularly devastating when it occurs in immunocompromised patients and, unfortunately, coinfection is common. The majority of patients with HIV are co-infected with HSV-2 and are particularly vulnerable to its complications. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. HERPES SIMPLEX VIRUS is a virus that can cause an infection on the skin, mucus membranes and nerve. Sexually transmitted diseases such as Herpes are more prevalent among adolescent women than men.
Patient information: See related handout on cold sores, written by the authors of this article. Nongenital herpes simplex virus type 1 (HSV-1) is a common infection that most often involves the oral mucosa or lips (herpes labialis). A cross-sectional study of herpes simplex virus types 1 and 2 in college students: occurrence and determinants of infection. Longitudinal evaluation of herpes simplex virus DNA load during episodes of herpes labialis. The natural history of recurrent herpes simplex labialis: implications for antiviral therapy. Comparison of Chemicon SimulFluor direct fluorescent antibody staining with cell culture and shell vial direct immunoperoxidase staining for detection of herpes simplex virus and with cytospin direct immunofluorescence staining for detection of varicellazoster virus. Acute herpetic gingivostomatitis in adults: a review of 13 cases, including diagnosis and management.
Treatment of herpes simplex gingivostomatitis with aciclovir in children: a randomised double blind placebo controlled study.
Interventions for the prevention and treatment of herpes simplex virus in patients being treated for cancer. Single-dose, patient-initiated famciclovir: a randomized, double-blind, placebo-controlled trial for episodic treatment of herpes labialis. Valacyclovir and topical clobetasol gel for the episodic treatment of herpes labialis: a patient-initiated, double-blind, placebo-controlled pilot trial. Clinical efficacy of topical docosanol 10% cream for herpes simplex labialis: a multi-center, randomized, placebo-controlled trial.
Herpes simplex virus (HSV) reactivation within the geniculate ganglion with subsequent inflammation and entrapment of the nerve at the meatal foramen has been proposed to be the pathogenetic mechanism. Bell’s palsy is a disorder in which a nerve that controls the facial muscles becomes dysfunctional, resulting in weakness or paralysis of one side, or more rarely, both sides of the face. In order for the virus to attack our facial nerve and cause Bell’s palsy, it would be necessary for it to be reactivated. The role of Herpes Simplex Virus Type 1 (HSV-I) in Bell’s Palsy was evaluated according to clinical symptomatology and serologic findings in a series of 41 patients seen over two years period. Bell’s palsy is a form of temporary facial paralysis resulting from damage or trauma to one of the two facial nerves. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Possible ComplicationsThe severity of symptoms depends on where and how the virus enters the body. Although about 25 - 30% of pregnant women have genital herpes, less than 0.1% of babies are born with neonatal herpes.
Transmission can occur if the amniotic membrane of an infected woman ruptures prematurely, or as the infant passes through an infected birth canal. Also rarely, newborns may contract herpes during the first weeks of life from being kissed by someone with a herpes cold sore.
Aggressive treatment with antiviral medication is required, but may not help systemic herpes.
If there is evidence of an active outbreak, doctors usually advise a Cesarean section to prevent the baby contacting the virus in the birth canal during delivery. Samples are cultured to detect the virus at 3 - 5-day intervals prior to delivery to determine whether viral shedding is occurring. Recent studies indicate that acyclovir (Zovirax) or valacyclovir (Valtrex) or famciclovir (Famvir)Valtrex can help reduce the recurrence of genital herpes and the need for Cesarean sections.
It is important to treat babies quickly, before the infection spreads to the brain and other organs. In most cases, ocular herpes causes inflammation and sores on the lids or outside of the cornea that go away in a few days. In children, this is often caused by thumbsucking or finger sucking while they have a cold sore. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Transmission from an infected male to his female partner is more likely than from an infected female to her male partner.
The primary oral infection may range from asymptomatic to very painful, leading to poor oral intake and dehydration.
The virus travels from the skin during contact to the sensory dorsal root ganglion, where latency is established.
The mouth lesions (herpetic gingivostomatitis) consist of painful vesicles on a red, swollen base that occur on the lips, gingiva, oral palate, or tongue. However, if the pattern of the lesions is not specific to HSV, its diagnosis can be made by viral culture, PCR, serology, direct fluorescent antibody testing, or Tzanck test. In one randomized controlled trial (RCT), children receiving acyclovir had oral lesions for a shorter time than children receiving placebo (median of four versus 10 days). Herpes viruses, specifically herpes simplex virus type 1 and herpes zoster virus, which causes chickenpox, are thought to be involved in a substantial proportion of cases (Holland 2004; Zandian 2014). There can be other causes of facial nerve palsy, but it is believed that the herpes simplex virus is commonly implicated.
Three of the 8 human herpes virus typesherpes simplex virus type 1 (HSV-1) , HSV-2, and varicella zoster virusestablish latency in the peripheral sensory ganglia and persist in the host for a lifetime.
Most scientists believe that a viral infection such as viral meningitis or the common cold sore virusherpes simplexcauses the disorder when the facial nerve swells and becomes inflamed in reaction to the infection.
HSV-1 can also cause genital herpes. Herpes simplex virus 2 (HSV-2) is the most common cause of genital herpes, but it can also cause oral herpes. Except in very rare instances and in special circumstances, the disease is not life threatening, although it can be very debilitating and cause great emotional distress. The baby is at greatest risk from an asymptomatic infection during a vaginal delivery in women who acquired the virus for the first time late in the pregnancy. This increased risk is present if the woman is having or has recently had an active herpes outbreak in the genital area. If no lesions are present and cultures indicate no viral shedding, a vaginal delivery can be performed and the newborn is examined and cultured after delivery. Women begin to take the drug on a daily basis beginning in the 36th week of pregnancy (last trimester).
Neonatal herpes can spread to the brain and central nervous system causing encephalitis and meningitis and leading to mental retardation, cerebral palsy, and death. Scarring and corneal thinning develop, which may cause the eye's globe to rupture, resulting in blindness.
It can also occur in adult health care workers, such as dentists, because of increased exposure to the herpes virus. HSV-2 infection increases HIV levels in the genital tract, which makes it easier for the HIV virus to be spread to sexual partners. Because of this, genital HSV-2 infection is more common in women (approximately one out of five women aged 14 to 49 years) than in men (about one out of nine men aged 14 to 49 years).As mentioned earlier while most herpes infections do not cause serious complications, infections in infants and in people with weakened immune systems or herpes infections that affect the eyes can be life threatening. The diagnosis of an infection with herpes simplex virus type 1 is usually made by the appearance of the lesions (grouped vesicles or ulcers on an erythematous base) and patient history.
Oral HSV-1 infections reactivate from the trigeminal sensory ganglia, affecting the facial, oral, labial, oropharyngeal, and ocular mucosa.Primary infection appears two to 20 days after contact with an infected person. Although it has been argued that the presence of detectable viral DNA in the geniculate ganglia of most humans cannot explain the annual incidence of Bell palsy of 20 to 30 per 100000, there has been increasing acceptance of HSV-1 and varicella zoster virus as the cause of Bell palsy. Varicella-zoster virus (VZV) and herpes simplex virus (HSV) are considered to be the major causes of acute peripheral facial palsy (APFP).
Trends in HSV Types and Genital HerpesGenital herpes can be caused by either HSV-2 or HSV-1. Fortunately, rapid diagnostic tests and treatment with acyclovir have both significantly improved survival rates and reduced complication rates. Fortunately, herpes meningitis usually resolves without complications, lasting for up to a week, although recurrences have been reported.
Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. However, if uncertain, the diagnosis of herpes labialis can be made by viral culture, polymerase chain reaction, serology, direct fluorescent antibody testing, or Tzanck test. The vesicle should be unroofed with a scalpel or sterile needle, and a swab should be used to soak up the fluid and to scrape the base.
Although the herpes simplex virus has been suspected since 1972 to be a cause of this disorder, definitive evidence for its involvement has been difficult to obtain. The prevalence of antibodies to HSV among patients with Bell’s palsy was significantly higher than the prevalence among those with VZV reactivation (Ramsay Hunt syndrome or zoster sine herpete).
Recurring herpes and a first infection that is acquired early in the pregnancy pose a much lower risk to the infant. For those who recover, nearly all suffer some impairment, ranging from very mild neurological changes to paralysis. You may be infected with HSV-1 or HSV-2 but not show any symptomsUsually, HSV causes mild and self-limited outbreak on the mouth and lips or at genital sites.However, on occasion, the disease can be life-threatening such is the case with neonatal HSV infection and HSV infections of the central nervous system.
Other nonoral herpes simplex virus type 1 infections include herpetic keratitis, herpetic whitlow, herpes gladiatorum, and herpetic sycosis of the beard area. The swab should be sent in special viral transport media directly to the laboratory (or placed on ice if transport will be delayed).


Bell’s palsy is more common in patients with diabetes, and although it can affect persons of any age, incidence peaks in the 40s.
In recent years, HSV-1 has become a significant cause in developed countries, including the United States. The best chances for a favorable outcome occur in patients who are treated with acyclovir within 2 days of becoming ill. Any duplication or distribution of the information contained herein is strictly prohibited. Furthermore, in the immunocompromised host, severe infection has been encountered and is a source of morbidity. The differential diagnosis of nongenital herpes simplex virus infection includes aphthous ulcers, acute paronychia, varicellazoster virus infection, herpangina, herpes gestationis (pemphigoid gestationis), pemphigus vulgaris, and BehA┬žet syndrome. There were more aborted lesions in the valacyclovirclobetasol group compared with the placebo-placebo group (50 versus 15.8 percent). Infection by herpes simplex virus type 1 (which causes mouth infections, such as cold sores).
Oral acyclovir suspension is an effective treatment for children with primary herpetic gingivostomatitis. Usatine, MDFigure 2.Primary herpetic gingivostomatitis caused by herpes simplex virus type 1 shown in (A) a four-year-old girl with lower lip ulcers and crusting on the upper lip, and (B) a two-year-old girl with ulcers on the lower lip and tongue. Direct fluorescent antibody testing may be performed from air-dried specimens, and can detect 80 percent of true HSV-positive cases compared with culture results.10 Immunoglobulin G antibodies that are type-specific to HSV develop the first several weeks after infection and persist indefinitely. For example, it is thought that the herpes simplex virus has a coat protein called UL6, which is similar to proteins found in the human cornea. In between herpes outbreaks, the virus lies dormant (as if it is hibernating or sleeping) in nerve cells. Oral acyclovir, valacyclovir, and famciclovir are effective in treating acute recurrence of herpes labialis (cold sores). A Tzanck test is difficult to perform correctly without specific training in its use, but it may be done in the office setting by scraping the floor of the herpetic vesicle, staining the specimen, and looking for multinucleated giant cells. ABSTRACT The possible association of some viral infections with the onset of Bell’s palsy was examined in a study of 142 patients.
The risk of infection is highest during outbreak periods when there are visible sores and lesions.
Recurrences of herpes labialis may be diminished with daily oral acyclovir or valacyclovir.
Usatine, MDIn recurrent herpes labialis, symptoms of tingling, pain, paresthesias, itching, and burning precede the lesions in 60 percent of persons.5 The lesions then appear as clusters of vesicles on the lip or vermilion border (Figure 1). They applied penciclovir cream or placebo within one hour of the first sign or symptom of a recurrence, and then every two hours while awake for four days. The number of probable recent viral infections, as judged by increase in antibody titers or presence of IgM antibodies, did not differ statistically from that found in a sex- and age-matched control group. Topical acyclovir, penciclovir, and docosanol are optional treatments for recurrent herpes labialis, but they are less effective than oral treatment. Resolution of symptoms occurred more rapidly in the penciclovir group regardless of whether the medication was applied in the early or late stage.
SymptomsWhen genital herpes symptoms do appear, they are usually worse during the first outbreak than during recurring attacks.
Usatine, MDFigure 3.(A) Ulcers that form after the vesicles break, as shown in an adult women with herpes labialis.
Herpes, Pregnancy, and Newborn InfantsHerpes can pose serious risks for a pregnant woman and her baby. The risk is greatest for mothers with a first-time infection, because the virus can be transmitted to the infant during childbirth.
Guidelines from the American Academy of Pediatrics recommend using specific diagnostic tests for women in labor to determine the risk of transmission.
Common symptoms are eye pain, light sensitivity, and discharge with gritty sensation in the eye.
Babies born to mothers infected with genital herpes are often treated with the antiviral drug acyclovir, which can help suppress the virus. Fluorescein stain with a ultraviolet light may show a classic dendritic ulcer on the cornea (Figure 47).
Herpes viruses include human herpes virus 8 (the cause of Kaposi sarcoma) and varicella-zoster virus (also known as herpes zoster, the virus responsible for shingles and chickenpox).
The word "herpes" comes from the Greek word "herpein," meaning "to creep." This refers to the unique characteristic pattern of all herpes viruses to creep along local nerve pathways to the nerve clusters at the end, where they remain in an inactive (dormant) state for variable periods of time. The usual cause of oral herpes (herpes labialis), which are commonly called cold sores or fever blisters. HSV-1 can also cause genital herpes, which is a sexually transmitted disease (STD). Herpes simplex virus 2 (HSV-2).
Usatine, MDHerpetic whitlow is a vesicular lesion found on the hands or digits (Figures 68 and 7). It occurs in children who suck their thumbs or medical and dental workers exposed to HSV-1 while not wearing gloves. Herpes gladiatorum is often seen in athletes who wrestle, which may put them in close physical contact with an infected person. Until recently, the general rule was to assume that HSV-1 caused oral herpes and HSV-2 caused genital herpes. Vesicular eruptions are often seen on the torso, but can occur in any location where skin-to-skin contact has occurred. It is now clear, however, that either type of herpes virus can be found in the genital or oral areas (or other sites). Herpetic sycosis is a follicular infection with HSV that causes vesiculopapular lesions in the beard area.
In fact, HSV-1 is now responsible for more than half of all new cases of genital herpes in developed countries. The Disease ProcessHerpes is transmitted through close skin-to-skin contact. To infect people, the herpes simplex viruses (both HSV-1 and HSV-2) must get into the body through tiny injuries in the skin or through a mucous membrane, such as inside the mouth or on the genital or anal areas.
The risk for infection is highest with direct contact of blisters or sores during an outbreak. But the infection can also develop from contact with an infected partner who does not have visible sores or other symptoms. Once the virus has contact with the mucous membranes or skin wounds, it enters the nuclei of skin tissue cells and begins to replicate. The virus is then transported from the nerve endings of the skin to clusters of nerve cells (ganglia) where it remains inactive (latent) for some period of time. However, at some point, the virus wakes up and travels along nerve pathways to the surface the skin where it begins to multiply again. During this time, the virus can infect other people if it is passed along in body fluids or secretions.
Viral shedding may be accompanied by noticeable symptoms (outbreak) but it can also occur without causing symptoms (asymptomatic shedding).
In either case, a person is infectious during periods of viral shedding. Symptoms may appear as multiple small red bumps or patches that develop blisters. Usatine, MDHSV infection is one of the most common causes of erythema multiforme (Figure 8), which some patients have with a recurrent HSV infection.
Certain triggers can wake up the virus from its dormant state and cause it to become active again. In general, recurrent episodes of herpes cause less severe symptoms than the primary outbreak.
Usatine, MDFigure 9.Vesicles on a red base of the wrist in a woman with herpes gestationis after the loss of a pregnancy. HSV-1 is the most prevalent form of herpes simplex virus, and infection is most likely to occur during preschool years.
In addition, because HSV-1 can be passed in saliva, people should also avoid sharing toothbrushes or eating utensils. Transmission of Genital Herpes Genital herpes is transmitted through sexual activity. People can get HSV-2 through genital contact or HSV-1 through mouth-to-genital contact with an infected partner. People with active symptoms of genital herpes are at very high risk for transmitting the infection. Unfortunately, most cases of genital herpes infections occur when the virus is shedding but producing no symptoms.
Most people either have no symptoms or do not recognize them when they appear. In the past, genital herpes was mostly caused by HSV-2, but HSV-1 genital infection is increasing.
There is also evidence that children today are less likely to get cold sores and become exposed to HSV-1 during childhood. Centers for Disease Control and Prevention (CDC), about 1 in 6 Americans ages 14 to 49 years have genital herpes. While HSV-2 remains the main cause of genital herpes, HSV-1 has significantly increased as a cause, most likely because of oral-genital sex. African-American women are at particularly high risk. People with compromised immune systems, such as those who have HIV, are at very high risk for genital herpes.
Drugs that suppress the immune system, and organ transplantation, can also weaken the immune system and increase the risk for contracting genital herpes. It is almost impossible to defend against the transmission of oral herpes, because it can be transmitted by very casual contact, including kissing. Still, you can help reduce the risk of transmitting oral herpes by not sharing objects that touch the mouth, such as eating and drinking utensils, toothbrushes, and towels. It is best to refrain from any type of sex (vaginal, anal, or oral) during periods of active outbreak. However, herpes can also be transmitted when symptoms are not present (asymptomatic shedding). Although condoms may not provide 100% protection, they are proven to significantly reduce the risk of sexual disease transmission, including herpes. Natural condoms made from animal skin do NOT protect against HSV infection because herpes viruses can pass through them. Use a water-based lubricant. Lubricants can help prevent friction during sex, which can irritate the skin and increase the risk for outbreaks. Only water-based lubricants (K-Y Jelly, Astroglide, AquaLube, and glycerin) should be used. However, it is best not to use condoms pre-lubricated with spermicides. Do not use spermicides for protection against herpes. Nonoxynol-9 can cause irritation around the genital areas, which makes it easier for herpes and other STDs to be transmitted. Use a dental dam or condom for oral sex. If you have any symptoms of oral herpes, it is best not to perform oral sex on a partner until any visible sores or blisters have healed. Limit the number of sexual partners. The more sexual partners you have, the greater your chances of becoming infected or infecting others. It is very unlikely to transmit or contract genital herpes from a toilet seat or bath towel. Studies suggest that male circumcision may help reduce the risk of HSV-2, as well as human papillomavirus (HPV) and HIV infections. However, herpes can cause significant and widespread complications in people who don't have a fully functioning immune system. The CDC recommends that all people diagnosed with herpes simplex virus 2 (HSV-2) get tested for HIV. Most people with HIV are co-infected with HSV-2 and are particularly vulnerable to its complications.
HSV-2 infection increases HIV levels in the genital tract, which makes it easier for the HIV virus to be spread to sexual partners. Herpes and PregnancyPregnant women who have genital herpes due to either HSV-2 or HSV-1 have an increased risk for miscarriage, premature labor, inhibited fetal growth, or transmission of the herpes infection to the infant in the uterus or at the time of delivery.
Herpes in newborn babies (herpes neonatalis) can be a very serious condition. Fortunately, neonatal herpes is rare. Although about 25 to 30% of pregnant women have genital herpes, less than 0.1% of babies are born with neonatal herpes. The baby is at greatest risk during a vaginal delivery, especially if the mother has an asymptomatic infection that was first introduced late in the pregnancy. The risk for transmission also increases if infants with infected mothers are born prematurely, there is invasive monitoring, or instruments are used during vaginal delivery.
This risk is increased if the woman is having or has recently had an active herpes outbreak in the genital area. Very rarely, the virus is transmitted across the placenta, a form of the infection known as congenital herpes. Also rarely, newborns may contract herpes during the first weeks of life from being kissed by someone with a herpes cold sore. Infants may get congenital herpes from a mother with an active herpes infection at the time of birth.


Aggressive treatment with antiviral medication is required. Most infected pregnant women do not have a history of symptoms, so herpes infection is often not suspected or detected at the time of delivery. Fortunately, if a woman does have genital lesions, rapid diagnostic blood tests can quickly determine her chances of transmitting the virus to her baby during delivery. Some women with new or recurrent herpes may also be prescribed antiviral medication during pregnancy. A woman with herpes can usually safely breastfeed her baby, as long as she does not have a lesion on her breast or nipple.
Neonatal herpes can spread to the brain and central nervous system, causing encephalitis and meningitis. Herpes can also spread to internal organs, such as the liver and lungs. Infants infected with herpes are treated with acyclovir, an antiviral drug. They usually receive several weeks of intravenous acyclovir treatment, often followed by several months of oral acyclovir. Fortunately, rapid diagnostic tests and treatment with acyclovir have significantly improved survival rates and reduced complication rates. Nearly all who recover have some impairment, ranging from very mild neurological changes to paralysis.
Like encephalitis, meningitis symptoms include headache, fever, stiff neck, vomiting, and sensitivity to light. Fortunately, herpes meningitis usually resolves after about a week without complications, although symptoms can recur. Herpes Eye ComplicationsOcular herpes is a recurrent infection that affects the eyes. Ocular herpes is usually a simple infection that clears up in a few days, but in its more serious forms, and in severe cases, it can cause blindness.
It only affects the upper layer (epithelium) of the cornea and heals with scarring. Stromal Keratitis. Herpes Skin ComplicationsEczema Herpeticum A rare form of herpes infection called eczema herpeticum, also known as Kaposi varicelliform eruption, can affect people with skin disorders and those with a weakened immune system. Untreated, this condition can be extremely serious and possibly fatal. Gingivostomatiti Oral herpes can cause multiple painful ulcers on the gums and mucus membranes of the mouth, a condition called gingivostomatitis.
Children with gingivostomatitis commonly develop herpetic whitlow (herpes of the fingers). Herpetic Whitlow A herpetic whitlow is an infection of the herpes virus involving the finger, often around the fingernail.
In children, this is often caused by thumb sucking or finger sucking while they have a cold sore.
The use of latex or polyurethane gloves prevents herpes whitlow in health care workers. SymptomsHerpes symptoms vary depending on whether the outbreak is initial or recurrent.
The primary outbreak is usually worse than recurrent outbreaks, with more severe and prolonged symptoms.
In fact, studies indicate that 10 to 25% of people infected with HSV-2 are unaware that they have genital herpes.
The first signs are a tingling sensation in the affected areas (genitalia, buttocks, and thighs) and groups of small red bumps that develop into blisters. The sores may sometimes itch, but itching decreases as they heal. About 40% of men and 70% of women develop other symptoms during initial outbreaks of genital herpes, such as flu-like discomfort, headache, muscle aches, and fever. Some women may have difficulty urinating and may, occasionally, require a urinary catheter. Women may also experience vaginal discharge. Recurrent Genital Herpes Outbreak In general, recurrences are much milder than the initial outbreak.
The virus sheds for a much shorter period of time (about 3 days) compared to an initial outbreak of 3 weeks.
Women may have only minor itching, and the symptoms may be even milder in men. On average, people have about four recurrences during the first year, although this varies widely.
There are some differences in frequency of recurrence depending on whether HSV-2 or HSV-1 caused genital herpes.
HSV-2 genital infection is more likely to cause recurrences than HSV-1. Symptoms of Oral HerpesOral herpes (herpes labialis) is most often caused by HSV-1, but it can also be caused by HSV-2. It usually affects the lips and, in some primary attacks, the mucus membranes in the mouth.
A herpes infection may occur on the cheeks or in the nose, but facial herpes is very uncommon. Primary Oral Herpes Infection If the primary (initial) oral infection causes symptoms, they can be very painful, particularly in children. The sores last 10 to 14 days and can be very uncomfortable. Blisters that may be preceded or accompanied by sore throat, fever, swollen glands, and painful swallowing. Recurrent Oral Herpes Infection A recurrent oral herpes infection is much milder than the primary outbreak.
It usually manifests as a single sore, commonly called a cold sore or fever blister (because it may arise during a bout of cold or flu). The sore usually shows up on the outer edge of the lips and rarely affects the gums or throat. Recurrences of genital herpes are more likely with HSV-2 infection than with HSV-1 infection. The outbreak of infection is often preceded by a prodrome, an early group of symptoms that may include itchy skin, pain, or an abnormal tingling sensation at the site of infection. Recurrent outbreaks feature most of the same symptoms at the same sites as the primary attack, but they tend to be milder and briefer. Occasionally, the symptoms may not resemble those of the primary episode, but appear as fissures and scrapes in the skin or as general inflammation around the affected area. They include sunlight, wind, fever, physical injury, surgery, menstruation, suppression of the immune system, and emotional stress.
Oral herpes can be triggered within about 3 days of intense dental work, particularly root canal or tooth extraction. Timing of Recurrences Recurrent outbreaks may occur at intervals of days, weeks, or years. For most people, outbreaks recur with more frequency during the first year after an initial attack.
The good news is that in most healthy people, recurring infections tend to become progressively less frequent, and less severe, over time.
However, other conditions can resemble herpes, and doctors cannot base a herpes diagnosis on visual inspection alone.
These tests include: Virologic tests (viral culture of the lesion) Serologic tests (blood tests that detect antibodies) The CDC recommends that both virologic and serologic tests be used for diagnosing genital herpes. People diagnosed with genital herpes should also be tested for other sexually transmitted diseases. At this time, experts do not recommend screening for HSV-1 or HSV-2 in the general population. Genital herpes can be caused by either HSV-1 or HSV-2. It is important to determine which virus is involved, as the type of herpes infection influences prognosis and treatment recommendations. Recurrences of genital herpes, and viral shedding without overt symptoms, are much less frequent with HSV-1 infection than with HSV-2. False-negative (testing negative when herpes infection is actually present) or false-positive (testing positive when herpes infection is not actually present) results can occur.
Your health care provider may recommend that you have a test repeated. Virologic TestsViral culture tests are made by taking a fluid sample, or culture, from the lesions as early as possible, ideally within the first 48 hours of the outbreak. PCR tests are much faster and more accurate than viral cultures, and the CDC recommends PCR for detecting herpes in spinal fluid when diagnosing herpes encephalitis.
PCR can make many copies of the virus' DNA, so that even small amounts of DNA in the sample can be detected. However, many labs now use PCR for herpes testing because it is highly accurate. An older type of virologic testing, the Tzanck smear test, uses scrapings from herpes lesions.
The scrapings are stained and examined under a microscope for the presence of giant cells with many nuclei or distinctive particles that carry the virus (called inclusion bodies). The Tzanck test is not reliable for providing a conclusive diagnosis of herpes infection and is not recommended by the CDC. Serologic TestsSerologic (blood) tests can identify antibodies that are specific for either HSV-1 or HSV-2.
When the herpes virus infects you, your body's immune system produces specific antibodies to fight off the infection.
If a blood test detects antibodies to herpes, it is evidence that you have been infected with the virus, even if the virus is in a non-active (dormant) state. The presence of antibodies to herpes also indicates that you are a carrier of the virus and might transmit it to others. Serologic tests can be especially useful for people who do not have active symptoms, but who have other risk factors for herpes (such as other STDs, multiple sex partners, or a monogamous partner who has genital herpes).
Although glycoprotein (gG) type-specific tests have been available for many years, many of the older nontype-specific tests that cannot distinguish HSV-1 from HSV-2 are still on the market. Canker sores frequently crop up singly or in groups on the inside of the mouth, or on or underneath the tongue.
The drugs are used initially to treat a first attack of herpes, and then afterward to either treat recurrent outbreaks (episodic therapy) or reduce frequency of recurrences (suppressive therapy).
Drugs can, however, reduce the severity of symptoms, improve healing times, and prevent recurrences. If people experience very severe disease or complications, they need to be hospitalized and receive an antiviral drug intravenously. Your health care provider will prescribe one of the three antiviral medications, which you will take for 7 to 10 days. You should begin the medication as soon as you notice any signs or symptoms of herpes, preferably during the prodrome stage that precedes the outbreak of lesions.
If taken during prodrome, episodic therapy may help prevent an outbreak from occurring or reduce its severity.
Valacyclovir is taken once a day. Suppressive treatment can reduce the frequency of outbreak recurrences by 70 to 80%. It is generally recommended for people who have frequent recurrences (6 or more outbreaks per year).
Because herpes recurrences often diminish over time, you should discuss annually with your health care provider whether you should stay with drug therapy or discontinue it.
While taking any suppressive therapy for genital herpes, it is still important to regularly use latex condoms and to avoid any sexual activity during recurrences.
A new form of acyclovir (Sitavig) is administered orally as an adhesive tablet; it is applied to the gum region of the mouth, where it dissolves during the course of the day. In addition, acyclovir is available in topical form, as is the related drug penciclovir (Denavir). Topical TreatmentsThese ointments or creams can help shorten healing time and duration of symptoms. However, none are truly effective at eliminating outbreaks. Penciclovir (Denavir) heals HSV-1 sores on average about half a day faster than without treatment, stops viral shedding, and reduces the duration of pain. Ideally, you should apply the cream within the first hour of symptoms, although the medication can still help if applied later.
Apply the cream 5 times a day, beginning at the first sign of tingling or pain. Over-the-counter topical ointments may provide modest relief. They include Anbesol gel, Blistex lip ointment, Campho-phenique, Herpecin-L, Viractin, and Zilactin. Some contain a topical anesthetic such as benzocaine, tetracaine, or phenol. Lip balm that contains sunblock, or sunscreen applied around the lips may help prevent sun-triggered outbreaks. Herbs and SupplementsGenerally, manufacturers of herbal remedies and dietary supplements do not need FDA approval to sell their products. Just like a drug, herbs and supplements can affect the body's chemistry, and therefore have the potential to produce side effects that may be harmful. There have been several reported cases of serious and even lethal side effects from herbal products. Always check with your provider before using any herbal remedies or dietary supplements. Many herbal and dietary supplement products claim to help fight herpes infection by boosting the immune system. There has been little research on these products, and little evidence to show that they really work.
Epidemiology, clinical presentation, and antibody response to primary infection with herpes simplex virus type 1 and type 2 in young women. Seroprevalence of herpes simplex virus type 2 among persons aged 14 - 49 years -- United States, 2005-2008.
Guidance on management of asymptomatic neonates born to women with active genital herpes lesions.
Genital shedding of herpes simplex virus among symptomatic and asymptomatic persons with HSV-2 infection.



Cold sore cure progress
Side effects herpes if left untreated 4x4


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