Most of the time, when the herpes simplex virus or HSV infects a person, there are no symptoms. In fact, it also usually moves from one person to another in the absence of symptoms, so it can therefore it can move through a population silently. Once in a while, though, it can cause symptoms, and typically those are in the form of skin and mucous membrane lesions which can be divided into infections “above the waist”—mostly involving the mouth and tongue, and those “below the waist”—involving the genitals.
There are two types of herpes simplex
viruses—HSV1 and HSV2—both of which are part of a larger family of enveloped double-stranded
DNA viruses: the herpesviridae family. Generally speaking, HSV1 tends to cause
infections above the waist and HSV2 tends to cause infections below the waist, but there are a lot of crossovers because both viruses can cause both types of
infections. Although herpes is most contagious when there are virus-filled
lesions present, it can also spread by asymptomatic shedding which means that
herpes viruses can be in saliva or genital secretions even when there are no
signs of a cold sore or genital lesion.
Typically, when the herpes virus lands on a new host, in other words, a person that’s never had herpes before, it dives into small cracks in the skin or mucosa and binds to epithelial cell receptors, which trigger those cells to internalize the virus. Once inside, the virus starts up the lytic cycle, which is where its DNA gets transcribed and translated by cellular enzymes which help to form viral proteins which are packaged into new herpes viruses which can leave to go off and infect neighboring epithelial cells. HSV1 and HSV2 also infect nearby sensory neurons, and travel up their axon to the neuron's cell body to start up the latent cycle. The sensory neurons of the face have their cell bodies in the trigeminal nuclei and those around the genitalia are located in the sacral nuclei.
So that’s ultimately where the
herpes virus settles in—for life! You see the sensory neurons aren’t destroyed,
instead, they become a permanent home for the herpes virus, and from time to
time, the herpes virus makes a few viral copies of itself and sends those virus
particles back down the axon so they can get released and infect epithelial
cells. Since the trigeminal and sacral nuclei serve just one side of the face
or body, herpes vesicles and ulcers develop on the ipsilateral or the same side as
the affected nuclei. This can happen over and over again throughout a person’s
lifetime, with classic triggers being things like stress, skin damage, and
viral illnesses. Recurrent episodes are usually less severe than the primary
infection, and sometimes there are no symptoms at all. When there are symptoms,
there might be a characteristic tingling or burning sensation, called a
prodrome, one or two days before the blisters appear.
In oral and genital herpes, the primary infection is most often asymptomatic. Having said that, oral herpes when it does cause symptoms usually affects children and it causes lesions on the palate, gums, tongue, lip, and facial area, as well as a fever and enlarged lymph nodes. The lesions themselves are typically clusters of small, painful, fluid-filled blisters, which ooze and ulcerate, and then eventually heal after a few weeks. In older children and adults, a common symptom is pharyngitis. Most of the time, like primary infection, reactivation doesn’t cause any symptoms, but when it does, the most common pattern is having a handful of blisters at the vermillion border—the border of the lip—on one side of the face. These blisters are typically smaller and heal over a week. With genital herpes, primary infection can cause symptoms like ulcers and pustules which form on the labia majora, labia minora, mons pubis, vaginal mucosa, and cervix in women and on the shaft of the penis in men. Like oral herpes, most of the time reactivation doesn’t cause any symptoms, but when it does, the most common pattern is to have a few blisters that resolve rapidly in about a week.
In addition to oral and genital infections, HSV can also affect other areas. When it affects the fingertip or nail bed, it’s called herpetic whitlow, and this might happen if the finger rubs up against an active lesion around the mouth or genital area. Once it affects the fingertip, it’s also easy for it to get carried over to other areas of the body to spread the infection—a process called autoinoculation. HSV can sometimes involve the trunk, extremities, or head—a pattern that’s common among wrestlers because they have a lot of skin-to-skin contacts; and is therefore called herpes gladiatorum. Finally, individuals with burn injuries or with atopic dermatitis can have really serious herpes infections in those areas, the latter even has a specific name—eczema herpeticum. HSV can also affect the eye causing keratoconjunctivitis, which is inflammation of both the cornea and conjunctiva. In addition to symptoms of conjunctivitis which are pain, redness, tearing, and sensitivity to light, there can be some classic signs of corneal involvement like blurry vision and a branching dendritic lesion that looks a bit like the tree-like dendrites of a neuron, which happens on the cornea itself, and this pattern is classic for herpes infection.
In rare cases, herpes viruses can
spread to the central nervous system and cause meningitis or encephalitis,
typically affecting the temporal lobe, in individuals of all ages. These can happen
from a primary infection, but more commonly happen during reactivation when
some of the virus can escape into the bloodstream and reach the brain. When
there is brain involvement, a lumbar puncture often has specific findings like
an increase in red blood cells, an increase in white blood cells, and elevated
protein levels. There are also some CT, MRI, and EEG changes that can help to
make the diagnosis. HSV can also pass from a mother to a baby. Rather than
causing a congenital infection while the fetus is in the uterus, most of the
transmission happens at birth when the baby passes through infected maternal
vaginal secretions during delivery.
Neonatal HSV causes three different patterns of illness each occurring
about ⅓ of the time. The first is skin, eye, or mucous membrane infection,
where lesions pop up 1-2 weeks after delivery typically at sites of damaged
skin like the site where fetal scalp electrodes may have been attached. The
second is central nervous system infection which typically causes lethargy,
irritability, and even seizures 2-3 weeks after delivery and can cause some of
the same lumbar puncture, CT, MRI, and EEG findings as that in older children
and adults with HSV encephalitis. If not treated, both the first and second
types can transition into the third type which is disseminated infection, where the herpes virus causes sepsis and failure of various organs including the heart
and brain.
HSV can cause unique symptoms in
immunocompromised individuals who tend to have more frequent reactivation, more
severe symptoms, and a wider range of symptoms, like lesions in the esophagus
or lungs. Herpes can usually be diagnosed based on how the skin or mucous
membrane lesions look and can be confirmed with tests looking for viral DNA,
like polymerase chain reaction, an antibody response to the virus, or by
growing the virus with a viral culture. Although infections typically resolve
without treatment within a couple of weeks, there are antiviral drugs like acyclovir,
famciclovir, and valacyclovir that can be used topically or systemically to
reduce pain and speed up healing. For recurring episodes, these treatments
usually work best if taken when the prodrome starts; in other words, before the
blisters develop, and high-dose intravenous antivirals may be given in more
severe, or life threatening situations.
Alright, as a quick recap, most of
the time, herpes simplex virus 1 and 2 cause asymptomatic latent infections
that set up in the trigeminal and sacral nuclei for life, but sometimes they
can cause symptoms like recurrent oral and genital lesions. They can also cause
more severe infections like HSV keratoconjunctivitis, meningitis, and
encephalitis, as well as neonatal infections which usually get transmitted when
a baby passes through infected vaginal secretions.
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ReplyDeleteHello, everyone! I,m here to explore blogs and forum about wonderful and most safe cure for (Herpes Virus).I was positive to the deadly virus called herpes and i lost hope because i was out casted and rejected even by my closet friends.i searched on-line to know and enquirer about cure for Herpes and i read someone testimony on how he was cured from Herpes so i decided to contact the same herbalist because i know that nature has the power to heal everything.i contacted him to know how he can help me and he told me never to worry that he will heal me with the natural herbs from God!after 2 days of contacting him, he told me that the cure has been ready and he sent it to me via DHL and it got to me after 3 days!i used the med as he instructed me (MORNING and EVENING) and i was cured!its really like a dream but i am so happy!thats the reason i decided to also add more comment of Him so that more can be saved just like me!and if you need his help, you can email him on nativehealthclinic@gmail.com, or whatsapp +2348140073965 I,m neme amber and you can get in touch with me via nemeamber@gmail.com..Contact him for help at Herpes virus HIV/AIDS CANCER COPD BRAIN TUMOR All kind of virus and disease Dr Emmanuel YouTube like at https://www.youtube.com/channel/UCpUsOO5kNWlqOYzaWgtQuHQ
ReplyDeleteHello, everyone! I,m here to explore blogs and forum about wonderful and most safe cure for (Herpes Virus).I was positive to the deadly virus called herpes and i lost hope because i was out casted and rejected even by my closet friends.i searched on-line to know and enquirer about cure for Herpes and i read someone testimony on how he was cured from Herpes so i decided to contact the same herbalist because i know that nature has the power to heal everything.i contacted him to know how he can help me and he told me never to worry that he will heal me with the natural herbs from God!after 2 days of contacting him, he told me that the cure has been ready and he sent it to me via DHL and it got to me after 3 days!i used the med as he instructed me (MORNING and EVENING) and i was cured!its really like a dream but i am so happy!thats the reason i decided to also add more comment of Him so that more can be saved just like me!and if you need his help, you can email him on nativehealthclinic@gmail.com, or whatsapp +2348140073965 I,m neme amber and you can get in touch with me via nemeamber@gmail.com..Contact him for help at Herpes virus HIV/AIDS CANCER COPD BRAIN TUMOR All kind of virus and disease Dr Emmanuel YouTube like at https://www.youtube.com/channel/UCpUsOO5kNWlqOYzaWgtQuHQ
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