HERPES

HERPES Infection
Viruses have been a causative agent for many infections and diseases since long time! Viruses exhibit a wide range in their diseases – influenza virus, coronavirus, herpes, hepatitis and many others.
Viral infections are not limited to respiratory infections. Some viral infections primarily affect the skin.
Multiple small pimples like painful lesions on skin, usually on face or genital areas might be a sign of herpes infection.

Causative virus
Herpes Simplex Virus – 1 (HSV 1) and Herpes Simplex Virus -2 (HSV 2)
HERPES virus is a DNA virus with an icosahedral symmetry. These group of viruses typically have characteristics of latency, and can remain latent in any of the organs and re-activate later in life.

Mode of spread
Direct contact with lesion
Sexual mode of transmission

Herpes virus is of 2 types type1 and type 2
Type 1 (HSV-1) is the cause of lesions located above the waist and spread through direct contact with the lesion. This is responsible for causing symptoms such as – herpes labialis, encephalitis, meningitis, whitlow, herpes gladiatorum
Type 2 (HSV-2) is cause of lesions which spread through sexual route. This is responsible for causing Genital Herpes, Neonatal Herpes.

Signs and symptoms-
After entering the body, herpes virus may directly show symptoms or may remain in body for inactivated form and show symptoms later in life. Herpes virus can show symptoms in any part of the body.
In any regions which Herpes infects, the lesions have certain fixed characteristics-
Multiple small vesicles (small pimple like)
highly painful lesions
tender lesions
The lesions seen in a herpes infection mostly follow a specific cycle of life!
Initially these form a vesicle. This vesicle then breaks to form a painful ulcer. Over time this ulcer forms a crust and then undergoes healing.
Sites
As discussed above, herpes can infect many areas of skin. But not just skin, in some cases it can also spread to brain and related organs and cause unpleasant symptoms.
Some common manifestations of herpes include-
Gingivo-Stomatitis
Pharyngitis
Herpes Labialis
painful lesions near the lips. Especially near the corners of lip
Encephalitis
Herpes virus is the most common cause of sporadic viral encephalitis
Meningitis
Infection of meninges around brain
Known as Mollaret’s meningitis
Transverse Myelitis
Guillain-Barre syndrome
Hepatic Whitlow
seen in health care workers –
doctors, dentists, and nurses
who come in contact with the infected patients.
Herpes Gladiatorum
Seen in sports which involve skin to skin contacts such as wrestling
Eyes
Kerato-conjunctivitis
Recurrent infection can lead to formation of typical dendritic ulcers on cornea
Genital lesions
Visceral and Disseminated herpes
Herpes virus spreads to various organs and affects them
This typically occurs in –
People with compromised immunity
Neonatal herpes
Such patients show the above mentioned effects plus any of these effects-
Pneumonitis
Tracheobronchitis
Hepatitis

GENITAL HERPES
As discussed above, herpes virus has a propensity to affect Genital and Sexual organs. This is due to the Herpes Simplex Virus type 2 (HSV 2).

Causes of genital herpes-
HSV 2 virus resides in the Genital organs of the infected person. They can transfer from one person to another through sexual intercourse with the infected person even if the person may or may not show symptoms.
There are high chances that the virus may transfer from ‘Person A’ to ‘Person B’ during sexual intercourse. And ‘Person A’ will show symptoms a few days after the sexual intercourse.
Hence, people who have frequent changing in sexual partners are at more risk of developing genital herpes.

SYMPTOMS of Genital Herpes-
The lesions seen in Genital herpes are very similar to those that are seen in any other organs or area. The lesion in such case develop around the sexual organs and are painful, multiple tiny vesicular ulcers.
In males, these lesions are present on penis and skin around it.
In females, these are present on vulva. This is the areas surrounding the vaginal orifice.
There may also be presence of fever and swelling of Lymph Nodes.

PREVENTION of Genital Herpes
The best way is to maintain a constant sexual partner. Or else use a barrier method of contraception such as a CONDOM at the time of maintaining sexual relationship.
And as soon as one has symptoms of herpes infection or of any other sexually transmitted disease, it is advisable to start treatment as soon as possible and also inform your sexual partner about your disease. This will help the person in starting prophylaxis treatment of the partner.

NEONATAL HERPES
1 in 6000-20,000 babes born might be affected by Herpes. Herpes infection can remain persistent in the urinary tract and Genital areas for long time.
Pregnant females with Herpes infections, especially those associated with Genital symptoms, can transmit the infection to their children. In a Pregnant female with Herpes disease there are 75% to 90% chance that she will transfer this disease to her child during the process of normal vaginal delivery!!
This is mostly due to Herpes Simplex Virus type 2 (HSV 2).
Babies born to a infected female may lead to developmental detects in child such as-
Generalised skin lesions
Eye lesions
Encephalitis
Disseminated lesions affecting various organs

Diagnosis of herpes
For diagnosis, a swab sample is taken from the base of the site of lesion.
This is then processed through molecular methods such as PCR.

Treatment of Herpes
The treatment of herpes infection must be started soon and the course must be completed in order to eliminate the virus completely from the body.
It is advisable that even the partner visits the physician for check-up and to start the prophylaxis if needed.

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