Herpes simplex virus infection: what to look for. What to do!

Herpes simplex virus (HSV) is a ubiquitous microorganism that is highly prevalent in the general population. This prevalence and the oral manifestations put dentists, dental hygienists and dental patients at risk of being accidentally infected with HSV. This brief review highlights some of the basic properties of HSV, its transmission and pathogenesis. As well, common HSV oral infections are reviewed and suggestions are put forward to prevent the accidental transmission of HSV.

[Activation of a herpetic infection via corneal transplantation]. / Aktivatsiia gerpeticheskoi infektsii pri peresadke rogovoi obolochki.

Activation of herpes infection in keratoplasty was studied in 26 patients and found to be caused both by operative intervention and the corresponding corticosteroid therapy. The fluorescent antibody technique proved to be the most effective and rapid test for the detection of herpes infection. It is recommended to carry out laboratory control in transplantation of the cornea as well as topical antiviral therapy in the postoperation period not only in patients with herpetic keratitis but also in the subjects operated on for nonspecific leukoma and other diseases of the cornea.

Transmission of herpes simplex virus type 1 infection in rugby players.

Skin infections, both bacterial and viral, are endemic in contact sports such as wrestling and rugby football. In this report, we describe four cases of extensive cutaneous herpes simplex virus in players on a rugby team. All players had a prodrome of fever, malaise, and anorexia with a weight loss of 3.6 to 9.0 kg. Two players experienced ocular lesions associated with cutaneous vesicular lesions of the face. A third player, who had herpetic lesions on his lower extremity, experienced paresthesias, weakness, and intermittent urinary retention and constipation. All infected players on the team were forwards or members of the "scrum," which suggests a field-acquired infection analogous to the herpetic infections seen in wrestlers (herpes gladiatorum). Considering the serious sequelae of recurrent herpes simplex keratitis, the traumatic skin lesions in rugby football players should be cultured for herpes virus, and infected individuals should be restricted from playing until crusted lesions have disappeared.

Transmission of herpes simplex during CPR training.

Instruction in cardiopulmonary resuscitation (CPR) has become a standard part of training for medical personnel and is widely recommended for the lay public. We present a case report of two women, one of whom contracted herpes labialis and one of whom contracted ocular herpes simultaneously after participating as partners in a CPR training course. This case suggests that added precautions against the transmission of infectious disease should be taken by screening participants in CPR courses for signs of respiratory, oral, or facial cutaneous disease. In addition, this case underscores the crucial importance of adequately disinfecting mannequins between users and between training sessions. Specific recommendations are made.

Ocular herpes simplex infections in children.

A survey of "hospitalised" Herpes simplex infections in otherwise normal healthy children under the age of 13 years over a 15 year period between 1964 and 1979 at Princess Margaret Hospital for Children. This survey highlighted the unnecessarily high transference rate of Herpes simplex virus (HSV) infection to the under 3 year old within the home environment. There were three hundred and forty (340) cases of non-fatal "hospitalized" HSV infections in the under 3 year old of which sixty three (63) were ocular infections. Over all age groups one hundred and forty five (145) children were hospitalised on one or several occasions with ocular HSV infection. Of these children before reaching the age of 13 years, fifteen (15) developed intraocular HSV infection and twenty seven (27) had a permanent visual acuity of less than 6/12. As a result of this survey the Princess Margaret Hospital motto for the I.Y.D.P. is: "Cuddle but do not kiss your child when you have an acute coldsore"

Bacterial enzyme in viral infections: a new concept. The possible role of hyaluronidase in herpes simplex virus keratitis.

Data are presented to suggest that hyaluronidase can act as a virus spread factor in herpes simplex eye infection by both degrading tissue mucopolysaccharide and interfering with the antiviral effects of the interferon system. Most of herpes simplex eye infections are accompanied by contamination by various bacterial species capable of hyaluronidase production. Based on these data, a hypothetical model for the involvement of bacterial hyaluronidase in controlling the clinical course of ocular herpes simplex infection is suggested. The model can apply to other viral infections accompanied by bacterial contaminations, and provides a new therapeutic approach to such cases.

Chorioretinitis of the newborn with herpes simplex virus type 1. Report of a case.

A disseminated herpes simplex virus (HSV) infection involving the central nervous system and accompanied by chrioretinitis in a a 3-week-old girl is described. The aetiologic diagnosis was established on the basis of vrius isolated from skin vesicles, and a significant rise in complement fixing antibodies to HSV type 1. The mode of transmission of the virus to the infant apparently was direct contact with an oral lesion in the mother, that was present at the time of delivery. The patient survived but became blind and microcephalic, with severe neurological sequelae. The virus isolated was identified as HSV type 1, which is an infrequent finding in herpetic chorioretinitis of the newborn.

The portals of entry of herpes simplex virus infections.

In the present paper different possible portals of entry into the body for Herpes simplex Virus are examined. The possibility to infect the cornea with HsV without a preceding scarification was established. Scanning microscopy clearly showed the lesions of the infected cornea and a parallelity between the concentration of the inoculum and the spread of lesions. The i.c., i.m. and i.p. portals of entry are compared as to their capacity to produce encephalitis. The titration of virus may also be realized in the animal experiment. The intragastric portal of entry could be clearly demonstrated. So it is possible to explain herpes encephalitis in human newborns from mothers infected with Herpes virus.

Oculogenital transmission of type 2 herpes simplex virus in adults.

Type 2 (genital) herpes simplex virus (HSV-2) was isolated from three patients (two adults and an 11-year-old girl) with acute ocular infections. Two of these patients had acute blepharoconjunctivitis and one had acute keratoconjunctivitis. Genital herpes infections had preceded the eye infections in the two adults. This was not the case in the 11-year-old, but she had been in close contact with her sister who had apparently had the genital disease. The study strongly suggests transmission of HSV-2 from the genital site to the eye.