Coping with HERPETIC INFECTIONS
Herpes is a group of viruses that cause infections throughout the body
The eight herpes virus species include Herpes simplex type 1 (HSV-1)
& 2 (HSV-2), Varicella-Zoster virus (VZV), Cytomegalovirus (CMV) and Epstein Barr virus (EBV).
HSV-1 is transmitted in saliva, causing cold sores, keratoconjunctivitis and encephalitis, while HSV-2 generally is transmitted sexually, causing genital herpes, neonatal encephalitis and aseptic meningitis. However, there is some crossover of types and both cause a rash called erythema multiforme.
HSV-1 is commonest in children, causing fever, irritability and lip blisters, which heal spontaneously in two to three weeks. HSV-1 affecting the eye can be severe, with corneal ulcers, scarring, blindness and, rarely, encephalitis. HSV-2 causes recurrent painful genital blisters, fever and swollen glands, but can be carried asymptomatically around the cervix, urethra and prostate. Neonatal herpes is transmitted during vaginal delivery. HSV diagnosis is made clinically, or by taking cell samples or blood tests.
HSV treatment is by antiviral drugs including aciclovir, as local creams or oral tablets. These shorten the lesion duration, suppress recurrences and reduce viral shedding, but aren’t a cure. Preventing spread depends on avoiding oral or genital contact, and caesarean section if you carry active HSV-2 lesions in pregnancy.
VZV primarily causes chickenpox,
passed by respiratory droplets with a classic blistering rash and fever seven to 14 days later. Usually seen in children where it’s milder, it’s often severe in previously unexposed adults. Usually, antivirals are only offered to adults or immunocompromised children. Vaccination is available where appropriate, such as in unexposed health workers.
VZV stays within the body, reactivating as shingles – the virus travels down one nerve causing a painful blistering rash, usually in the elderly as a result of other
illness triggers. Antiviral medication will reduce the risk of long-term neuralgia pain. Shingles vaccination is now routinely offered to the over-70s.
CMV is transmitted by bodily fluid contact, is common in children and adolescents, and often asymptomatic. It can be serious in the immunocompromised and if contracted during pregnancy.
EBV (aka glandular fever or infectious mononucleosis), caught through bodily fluid contact, classically kissing, causes a relapsing fever, sweats, with sore throat, fatigue and swollen glands. Diagnosis is confirmed on blood tests. There’s no vaccine or specific treatment, only symptom relief.