Over 80 known viruses exist within the Herpes family..

Out of these 80 strains of the virus in the herpes family, 8 are known to cause disease in humans, the most common being Herpes simplex virus 1 and 2. The herpes virus causes or is associated with a whole spectrum of diseases ranging from infectious mononucleosis to malignancies and mental retardation and have the ability to cause more than one kind of disease.

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Human Herpes Viruses HHV

Herpes simplex virus

Human cytomegalovirus

Herpes Zoster (Varicella-Zoster virus)

Epstein-Barr Virus

Herpes simplex encephalitis

Neonatal herpes

Herpes whitlow

Herpes keratitis

Herpes gladiatorum

 

Herpes Simplex Virus (HSV)

HSV-1 and HSV-2 look identical under the microscope, and either type can infect the mouth or genitals.  HSV-1 usually  occurs above the waist, and HSV-2 below the waist.

Herpes Simplex Virus 1

Cold sores – herpes labalis – oral herpes – fever blisters

  • primarily affects the mouth and facial area
  • affects the skin and mucous membranes
  • is transmitted by oral and respiratory secretions
  • It is estimated 80% of people have HSV1

The virus produces highly infectious open sores that crust over before healing. Although less probable, HSV-1 can also cause genital herpes

Herpes Simplex Virus 2

HSV2 – Genital herpes – Herpes genitalis

  • primarily affects the genital area
  • Is generally a more virulent form of the virus
  • is transmitted by sexual contact, with cross-infection possible from oral to genital sex

Approximately 85% of all HSV infections are sub-clinical, the others produce localized lesions and systemic reactions.

After the first infection of both HSV1 & HSV2, a patient is susceptible to recurrent infections brought on by:

  • fever
  • heat and/or cold
  • menses
  • stress

In recurrent infections there may be no constitutional signs and symptoms.  Herpes occurs equally in males and females.

Herpes triggers

 

Herpes Zoster

Shingles – varicella-zoster

Herpes Zoster (Shingles) is an acute unilateral and segmental inflammation of the dorsal root ganglia caused by infection with the herpes virus, varicella-zoster, which also causes chicken pox.

Herpes Zoster usually occurs in adults producing:

  • localized vesicular skin lesions confined to a dermatome
  • severe neuralgic pain in peripheral areas especially  the nerves arising in the inflamed root ganglia

Prognosis

Unless the infection spreads to the brain eventually most patients recover completely, except for possible scarring and, in corneal damage, visual impairment.  However, in some cases neuralgia may persist for months or years.

Herpes zoster results from reactivation of the varicella virus that has lain dormant in the cerebral ganglia or the ganglia of posterior nerve roots after infection from chicken pox.

The virus is thought to multiply as it is reactivated and  is neutralized by antibodies remaining from the initial infection. However, the virus continues to multiply in the ganglia, destroys the host neuron, and spreads down the sensory nerves to the skin if effective antibodies are not present.

Herpes zoster is found primarily in adults over 50 and seldom recurs.

Onset of herpes zoster is characterized by:

  • fever
  • malaise

Within 2-4 days, severe deep, continuous pain may develop

Other herpes zoster symptoms may include:

  • hyperesthesia (abnormally increased sensitivity to stimuli)
  • paresthesia (an abnormal or perverted sensation, such as burning or tingling due to disorder of the sensory nervous system)
  • pruritus (itching)

This usually occurs on the trunk and occasionally on the arms and legs lasting from 1-4 weeks.

Small red nodular skin lesions can continue to erupt on the painful areas up to 2 weeks after the first symptoms.

 

Human Cytomegalovirus

Infection by the cytomegalovirus (DNA, ether sensitive virus belonging to the herpes family) occurs worldwide and is transmitted by human contact.

About 4 out of 5 people over the age of 35 have been infected with cytomegalovirus usually during childhood or early adulthood. In most of these people, the disease is so mild that it is sometimes overlooked.

CMV infection during pregnancy can be hazardous to the fetus, possibly leading to:

  • brain damage
  • neonatal illness.
  • other birth defects
  • stillbirth

Cytomegalovirus has been found in:

  • blood
  • breast milk
  • cervical secretions
  • feces
  • saliva
  • semen
  • urine
  • vaginal secretions

Transmission usually occurs through contact with the infected secretions, which harbor the virus for months or even years.

Immunodeficient patients

AIDS patients or those who have received transplanted organs are a high risk for contracting CMV infection.

Immunodeficient patients and those receiving immuno-suppressives may develop pneumonia or other secondary infections.

Recipients of blood transfusions

Recipients of blood transfusions from donors with positive CMV antibodies are at some risk.

Cytomegalovirus is thought to be spread through the body in lymphocytes or mononuclear cells to the lungs, liver, and central nervous system where it often produces inflammatory reactions. The disease usually runs a self-limiting course.

 

Epstein-Barr Virus (EBV)

Infectious mononucleosis

Infectious mononucleosis is an acute infectious disease caused by the Epstein-Barr virus (EBV), a member of the herpes group which usually  affects young adults and children.

Infectious mononucleosis  produces:

  • an increase in lymphocytes and monocytes
  • cervical lymphodenopathy
  • development of heterophil antibodies
  • fatigue
  • fever
  • headaches
  • hepatic dysfunction
  • malaise
  • sore throat
  • temperature fluctuations

Recovery prospects are excellent.

Other infectious diseases with symptoms similar to mononucleosis include:

  • Cervical lymphodenopathy
  • Hepatitis
  • Rubella
  • Toxoplasmosis

Symptoms usually subside about 6-10 days after onset of the disease but may persist for weeks.

 

HSV-1 and HSV-2 can cause other diseases including:

 

Herpes Simplex Encephalitis

  • A rare but potentially fatal herpetic infection of the brain.

Neonatal Herpes

  • A rare but potentially severe HSV infection in a newborn.
  • Is caused by transmission of the virus from  mother to  baby during delivery.

Herpes Whitlow

  • A HSV infection of the finger.
  • Caused from transfer of the infection from another part of the body or from direct contact with another.
  • Is more prevalent amongst health care workers.

Herpes Keratitis

  • An HSV infection of the eye.
  • Can cause blindness.

Herpes Gladiatorum

  • A HSV infection, usually of the skin, acquired during wrestling.
  • Skin can become abraded or scraped, during a wrestling match, allowing a herpes virus to enter the body and establish an infection.

 

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