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Signs herpes outbreak is coming

At least 85% of the world population have serological evidence of having had a herpes simplex infection. Herpes simplex infections can be primary- the first infection in a previously seronegative patient – or recurrent. Follows direct contact with an infected individual, either with active disease or shedding viral particles during a latent phase. Trigger factors include minor trauma, febrile illnesses, ultraviolet light and possibly stress. Complications include: Erythema multiforme (65% of attacks are triggered by a herpes simplex recurrence within the preceding two weeks), eczema herpeticum, persistent ulceration in the immunocompromised and keratoconjuctivitis.
These are transmitted sexually, and begin to appear at puberty or are spread from a mother’s genital tract infection to a newborn child.


The median recurrence rate is about one attack every 3 months for HSV-2 infections (and far less often for genital HSV-1 infections). Prevention is difficult because the virus is ubiquitous and spread by people with no obvious active infection. Those looking after patients with atopic eczema should stay away if they have cold sores because eczema herpeticum is so serious. Suppressive long-term antiviral therapy may be needed for particularly frequent or severe relapses.
The decision to use oral antiviral therapy for recurrent facial herpes simplex depends on the frequency and severity of relapses and the damage being done to the quality of life. Long-term suppressive therapy can be considered in genital herpes relapsing more than 5 times per year.


By age 30, 50% of adults of high economic status in the US are seropositive to HSV-1, in contrast to 80% of those of lower status.
The introduction of aciclovir (DNA polymeras inhibitor) was a milestone although it does not eradicate the virus.
They are closely related but differ in their epidemiology, although both are spread by close personal contact. Regular use of condoms helps prevent genital herpes and a high protection factor sunscreen helps to prevent recurrent facial lesions.



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