Herpes simplex is a virus that causes an infection  that mainly affects the mouth or genital area.

 


Causes of Herpes Simplex Infection

There are different strains of herpes simplex virus:
The type 1 (HSV-1) is associated with infections of the lips, mouth and face. This type of herpes simplex is one that infects people more often and usually develops in childhood.

HSV-1 usually causes sores (lesions) inside the mouth, such as cold sores or infection to the eye (especially the conjunctiva  and cornea). It can also cause an infection of the outer membrane of the brain (meningitis).
It is transmitted by contact with infected saliva.

The  herpes simplex virus type 2  or genital herpes (HSV-2) is sexually transmitted.
Signs and symptoms include genital and sore ulcers .
However, some people with HSV-2 do not have symptoms.
A finger infection called herpetic panicle is another form of herpes simplex infection.
It usually affects health care professionals who are exposed to saliva during surgery or during work (dentists).
Sometimes even small children can get sick.
HSV can infect a fetus and cause abnormalities.
A mother who is infected with HSV can pass the virus to the baby during vaginal delivery, especially if the mother has an active infection at the time of delivery, even if it is asymptomatic.
It is possible that the virus is transmitted even if there are no visible symptoms or lesions.
HSV is never removed from the body, but remains dormant and can be reactivated causing symptoms.

 

The eight types of herpes virus

Viruses are identified with numbers from 1 to 8 (HHV1-HSV8).

Herpes simplex virus type 1
Generally, the Herpes virus 1 (HSV1) is the cause of cold sores around the mouth. HSV 1 can also cause an infection in the genital area that causes  genital herpes , the infection usually occurs with oral-genital contact, such as during sexual intercourse.
It usually affects the lips and mucous membranes of the mouth. Herpes infection can occur in the face or nose, but herpes facial is very rare.
HSV1 infections are contagious and are usually transmitted by skin-to-skin contact with an infected person through small wounds or the mucosa.
The HSV1 virus can spread most likely through shared objects such as utensils that are used for eating, razors and towels used by a person with an active outbreak.

Type 2
herpes virus Generally, human herpes virus type 2 (HSV-2) causes genital herpes, a sexually transmitted infection .
However, it can also cause cold sores in the face area. Like HSV1, HSV2 infection is contagious and transmitted by skin-to-skin contact. The main route of transmission is sexual contact, even if the virus does not survive long outside the body.

 

Herpes Zoster (or copper)

Herpes simplex virus type 3
The varicella virus or herpes zostercan cause chickenpox or (chickenpox) the herpes zoster infection that is called shingles or shingles.
Herpes Zoster occurs when the dormant varicella virus reactivates after an initial attack.
Herpes zoster infects skin cells and nerve cells. This virus itself can also be found along the path of nerve fibers, causing the blisters where the nerve ends in the skin.
Herpes zoster vesicles (blisters) follow the course of the nerve, if the sciatica is affected they can be found along the leg, but if they become infected other nerves can be seen in the arm, breasts, feet, etc.
Shingles is usually much more severe than the recurrence of herpes simplex because it often affects a whole group of nerve cells.
Blisters usually have a stripe-like disposition, occur on one side of the body and are often accompanied by itching , tingling,  or unilateral pain.
The healing usually occurs in 3-4 weeks, but the scars may remain.
Post-herpetic neuralgia is a herpes zoster complication associated with pain that can persist for months and even years.
Most people who suffer from shingles once do not have a relapse.

Herpes simplex virus type 4
Herpes simplex virus type  4 is also known as the Epstein Barr virus that is the main cause of infectious mononucleosis or kiss disease.
Mmononucleosis is a contagious infection that is transmitted through saliva. The transmission of the virus occurs through coughing , sneezing or sharing cutlery and glasses with an infected person.

Herpes simplex virus type 5
Cytomegalovirus (CMV) may not cause any symptoms to people with healthy immune systems. The virus can be transmitted sexually and can cause problems for children, for example it can cause hepatitis .
Cytomegalovirus can be transmitted through sexual contact, breastfeeding, blood transfusions, and organ transplants. CMV infection is one of the complications of AIDS.
Cytomegalovirus symptoms include: diarrhea , severe vision problems, infection of the stomach or intestine, and even death.

Herpes simplex virus type 6
The human herpes virus 6 causes sudden rash or sixth disease and usually affects young children.
Symptoms are high fever and a rash (roseola), but can also cause seizures.
Therapy for the virus does not exist, but you can relieve the symptoms, for example in case of bacterial infections, your doctor may prescribe antibiotics .

Herpes simplex virus type 7
Herpes simplex virus 7 is very similar to the HSV6 virus, affects virtually all children up to 3 years.
The HSV7 virus can cause roseola, but it is not clear whether it can cause other symptoms.
Transmission occurs with saliva.

Type 8 herpes
virus HSV8 virus has recently been isolated from Kaposi’s sarcoma (KS), a tumor that usually affects the skin, mucous membranes and the gastrointestinal tract.
SK affects people with AIDS, it is very rare in other people.
Kaposi’s sarcoma causes purplish-colored tumors on the skin and other tissues of some people with AIDS.
It is very difficult to deal with the medication.
HSV8 can also cause other cancers, including lymphoma (cancer of the lymph nodes) associated with AIDS.
The fact that these tumors are caused by a virus may explain why it affects people with AIDS when the immune system is compromised.

Symptoms

Sintomas da herpes Oral

Usually oral herpes (cold sores) is caused by herpes simplex virus 1 (HSV-1), but it can also be caused by type 2.
Primary (initial) oral infection can be very painful, especially in young children.
The blisters form on the lips, and sometimes on the tongue, they rarely reach the nose or eyes.
When the bubbles burst, there remain open wounds that develop a yellowish membrane before it heals.
Wounds disappear in 2 weeks.
You may notice increased salivation and bad breath .
Rarely, the infection can be accompanied by difficulty in swallowing, chills , muscle pain or hearing loss.
In children, the infection usually occurs in the mouth. In adolescents, primary infection is more frequent in the upper throat and causes pain.
During pregnancy , it is possible to have a relapse of cold sores, usually not a danger to the child because if the mother transmits the virus to the child, she also passes the antibodies to treat it.
If you are taking medication, ointment should be spread only on site as this can cause harm to the child.

The symptoms of genital herpes

For patients with symptoms, the first outbreak usually occurs in the genital area 1-2 weeks after exposure to the virus.
The first signs are a tingling sensation in the affected areas (for example, the genitals, anus, buttocks and thighs) and groups of red blisters.
In the next 2-3 weeks, the blisters can burst creating some open and painful wounds.
The lesions eventually dry out and are replaced by a crust.
The scars heal quickly without leaving a scar. Wet bubbles heal more slowly than in other areas.
The lesions can cause itchiness that decreases as you heal.
About 40% of men and 70% of women have other symptoms with the initial outbreak of genital herpes, such as flu disorders, headache , muscle aches, fever and swollen lymph nodes . (The glands in the groin and neck may swell). Some patients may have difficulty urinating and women may notice vaginal discharge .
During pregnancy, if the mother has a reactivation of genital herpes can infect the child at the time of delivery, then you have to talk to the doctor to evaluate the intake of antiviral drugs.

 

Herpes diagnosis

Many times, doctors can tell if there is HSV infection just by looking at the lips. However, some tests may be prescribed to make sure the diagnosis.
These tests are as follows:

  • Blood tests for antibodies such as HSV (serology)
  • Direct immunofluorescence (DFA) test of cells from a bubble
  • The viral culture of bubbles

 

Treatment and medicines for herpes virus

Some cases are mild and do not need treatment.
People with severe or prolonged outbreaks have problems with the immune system or with frequent relapses may benefit from antiviral drugs such as acyclovir, famciclovir or valaciclovir.

People with severe or frequent relapses of oral herpes or genital herpes may choose to continue to take antiviral medications to reduce the frequency and severity of the outbreaks.
The cortisone is not a suitable remedy for treating herpes virus.
Natural remedies include physical therapy that may help in the case of shingles (type 3) in fact, laser treatment reduces the time of healing of open wounds and the formation of scabs.

 

Natural Remedies for Herpes Viruses

One of the most effective home remedies for cold sores is to pour a few drops of lemon juice onto a cotton ball and keep it in contact with the blisters of the herpes.
For disinfection toothpaste can be applied to the lips.
Applying honey directly onto the affected area with herpes can reduce healing time and symptoms.
Among the effective ointments to reduce the cicatrization time there is a cream with lemon balm extract.
Tea tree oil gel  is another topical treatment for curing the Herpes virus.

How long does it last?

Oral or genital herpes simplex lesions heal spontaneously in 7-10 days. The infection can be severe and last longer in patients with compromised immune systems.
When the infection occurs, the virus spreads to nerve cells and stays in the body for the rest of a person’s life. It may return over time and cause symptoms or blisters.
Relapses can be triggered by excessive sunlight, fever, stress , an acute illness, drugs or diseases that weaken the immune system (such as cancer, HIV / AIDS or taking cortisone).

 

When is it contagious?

Infection is always possible, even in the asymptomatic phase, but is much more likely to transmit the virus to another person during the period when there are no open blisters.

Possible Complications of Herpes Virus

  • Dermatitis herpetiformis (herpes spread through the skin)
  • Encephalitis
  • Infection of the eye – (ocular herpes)
  • Tracheal infection
  • Meningitis
  • Pneumonia
  • Prolonged and severe infection in immunocompromised individuals

 

Prevention

Prevention of HSV is difficult because people can spread the virus even when they do not have symptoms of an active outbreak.
Avoiding direct contact with the open lesion reduces the risk of infection.
Behaviors of safe sex, including condom use, reduce the risk of infection.
People with active HSV lesions should avoid contact with newborns, children with eczema or people with compromised immune systems because these groups are most at risk.
To reduce the risk of infecting the newborn, cesarean section may be recommended for pregnant women who have active HSV infection at the time of delivery.
References
Whitley RJ. Herpes simplex virus. In: Goldman L, Ausiello D, eds. Cecil Medicina. E 23a. Filadélfia, Pa: Saunders Elsevier., 2007: cap 397.

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