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Learn about genital herpes causes (hsv-1, hsv-2), symptoms, signs, information and treatment.
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Neil Walsh at Bangor University, he found that the oft-cited advice that a sick athlete should not engage in high intensity training as it is thought to suppress immune function (and thereby increase the duration of the illness) is misguided.
Note that the application of acyclovir may develop acute renal failure due to precipitate formation of crystals of acyclovir, which is especially likely during rapid IV introduction, the simultaneous use of nephrotoxic drugs in patients with impaired renal function and lack of water stress.
Will H1N1 influenza vaccine ever be available for healthy people age 25 years and older (who are not in targeted groups)? The age limitation is due to clinical data that showed reduced immunity in persons age 50 and over. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. 13 Reporting can assist local, state, and national authorities to recognize outbreaks and to implement control measures to reduce future infections. Dambaugh T, Beisel C, Hummel M, King W, Fennewald S, Cheung A, Heller M, Raab-Traub N, Kieff E. Once public health authorities at the local level determine that the H1N1 influenza vaccine demand for the five target groups has been met, providers will be notified that they can administer the vaccine to healthy people ages 25 through 64 years.
At this time, state and local public health officials recommend that students can — and should — continue to go to school, as long as they are not sick and do not have flu symptoms. 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. Stimulate new cell growth has an ugly medical the tricky part is separating the egg white from the yolk. When you manage to keep your skin clean and dry, the healing process of the canker sore ulcer will take place much faster.
Not only is it cold-and-flu season for everyone else, but we are gearing up to do some of our hardest training of the year, a period that leaves us more susceptible to illness. 936 There’s indisputable evidence referring to herpes treatment is that it scopes out more herpes hand rash; 8%[4] and 11%[5] found amongst children. Most patients with non-neuroinvasive WNV disease or WNV meningitis recover completely, but fatigue, malaise, and weakness can linger for weeks or months. Biologic and antigenic characteristics of Epstein-Barr virus-related Herpesviruses of chimpanzees and baboons. Federal health experts agree that the H1N1 (Swine) flu shot should be as safe as the shot for the seasonal flu.
Trends in HSV Types and Genital HerpesGenital herpes can be caused by either HSV-2 or HSV-1. What Are The Best Vitamins For Herpes Drugs used to treat herpes medication with youtube herpes.
La forme est grave chez les sujets dont l’etat general est deficient (sida, leucemie, traitement immunosuppresseur, utilisation de la cortisone). One infant who apparently acquired WNV infection through breastfeeding remained asymptomatic. Since the condition is otherwise entirely benign, no treatment is indicated and the patient should be reassured that it is a common variance of the normal appearance of the tongue. CDC expects that any side effects following vaccination with the 2009 H1N1 influenza vaccine would be rare. It is believed that the virus remains latent in the brain and reactivates under periods of stress, causing cumulative neuronal damage that ultimately leads to Alzheimer’s disease.
I know there are swimmers out there that will go to practice regardless of how they are feeling (there was one such gentleman at the YMCA yesterday, who I overheard unleashing mucus tornadoes into the water), and there are also coaches who won’t accept anything short of a missing limb as an excuse to miss a workout. Users that click on the e-mail are at risk of having malicious code installed on their computers. The inactivated seasonal and live H1N1 influenza vaccines together or at any time before or after each other.
Hematologic metabolic disorders (including diabetes mellitus) and immunosuppression (including immunosuppression caused by medications or by human immunodeficiency virus).
In addition, symptoms of H1N1 flu include: runny nose, stuffy nose, headache, body aches, feeling very tired and sometimes vomiting or diarrhea.
If side effects occur, they will likely be similar to those experienced following seasonal influenza vaccine. In recent years, HSV-1 has become a significant cause in developed countries, including the United States. The health benefits on the skin become treatment that involves scrubbing or resurfacing methods such as dermabrasion.
You need to understand that the repetition of the virus will be greatly reduced when you can lower the temperature. The DNA consists of two domains of largely unique sequence complexity, a segment US of 9 x 10(6) daltons and a segment UL of 88 x 10(6) daltons. Otc Herpes Remedies MeSH WNV encephalitis is a more severe clinical syndrome that usually manifests with fever and altered mental status, seizures, focal neurologic deficits, or movement disorders such as tremor or parkinsonism. The live seasonal and inactivated H1N1 influenza vaccines together or at any time before or after each other. Swine flu has infected more than 20,000 Massachusetts children and adults since the virus first appeared five months ago. We follow the HIPAA Privacy Rule, which gives you complete control over who has access to your personal information.
Hal ini akan menyebabkan pemulihan yang lebih lambat dan berakhir dengan synkinesis, yaitu gerakan atau respon involunter pada bagian tubuh tertentu, saat tubuh berusaha menggerakkan bagian tubuh yang lain. For a field of the dead rushes red on my sight, And the clans of Culloden herpes simplex virus emedicine are scattered in fight. Administering both the live attenuated seasonal and the live attenuated H1N1 influenza vaccines at the same visit is NOT recommended because of concerns about competition between vaccine viruses. Overwhelming evidence, including an Institute of Medicine review, indicates that thimerosal has not been associated with any adverse effects. Southcoast Hospitals Group has updated its visitors policy to limit visitor access to maternity and pediatric units at the three hospitals to protect the patients most at-risk. Salah satu sisi wajah tampak “jatuh”, berbicara bisa cadel, nyeri hebat pada daerah leher, telinga atau kepala.
The symptoms of influenza (flu-like illnesses) are similar to those caused by many other viruses.
With simultaneous use of acyclovir with other nephrotoxic drugs increases the risk of nephrotoxicity (especially in patients with impaired renal function).
The type of flu vaccine that is sprayed into your nose (nasal spray) does not contain thimerosal or other preservatives.
Persons with chronic medical conditions between the age of 25 to 64 years — conditions such as heart disease, lung disease, asthma, diabetes or persons with weakened immune systems.
The CDC states that the human influenza viruses generally can survive on surfaces such as doorknobs, desks, computer keyboards and phones between 2 and 8 hours, in some cases as long as 48 hours. DPH projects in the coming weeks and months Massachusetts will begin seeing more widespread cases similar to what the South is experiencing now. The risk of infection is highest during outbreak periods when there are visible sores and lesions. The virus tends to grow whenever you get sick, stressed or when your immune system is very weak.
Sometimes there is a large central furrow, with smaller fissures branching perpendicularly. Current testing (rapid flu test) for H1N1 is not accurate enough to confirm the specific flu strain (Flu Fact #10). It is also generally believed that viruses survive for longer periods on nonporous surfaces (plastic, metal or wood) than porous surfaces (fabric or paper). Sindrom Ramsay Hunt terjadi akibat reaktivasi virus varicella zoster, yang melibatkan ganglion genikulatum N. Following are some of recommended about 6 body shop aloe night cream acne weeks now I have stopped treatment, you certainly need to know some effective treatments of home remedy. Therefore, even if you believe you had the 2009 H1N1 virus, it is still recommended, and not harmful, to receive the vaccine. In order to receive the H1N1 nasal mist vaccine, persons must be less than 50 years of age and in generally good health. The best way to stop germs: washing hands frequently with soap and water or alcohol-based hand sanitizer and wiping down surfaces with soap and water or a disinfectant wipe. Patients and people entering the hospital with cold or flu symptoms are asked to wear surgical masks that will be provided by hospital staff. SymptomsWhen genital herpes symptoms do appear, they are usually worse during the first outbreak than during recurring attacks.
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. Babies born to mothers infected with genital herpes are often treated with the antiviral drug acyclovir, which can help suppress the virus.
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). Until recently, the general rule was to assume that HSV-1 caused oral herpes and HSV-2 caused genital herpes. It is now clear, however, that either type of herpes virus can be found in the genital or oral areas (or other sites). 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. 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.
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. Transmission can occur if the amniotic membrane of an infected woman ruptures prematurely, or as the infant passes through an infected birth canal. 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. It is important to treat babies quickly, before the infection spreads to the brain and other organs. 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. Iridocyclitis is another serious complication of ocular herpes, in which the iris and the area around it become inflamed. 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. It can also occur in adult health care workers, such as dentists, because of increased exposure to the herpes virus.


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.



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