Transcript Herpes - KSU Faculty Member websites

History:
Herpes
The term Herpes Simplex appeared in Richard Boulton's A System of Rational
and Practical Chirurgery in 1713, where the terms Herpes miliaris and Herpes
exedens also appeared.
Herpes was not found to be a virus until the 1940s.
What is Herpes?
Herpes is a common infection generally
transmitted through skin-to-skin contact.
There are several strains of the herpes virus,
two of these strains commonly cause genital
herpes. You can have oral herpes (on the lips,
most often 'cold sores'), genital herpes (on
the genitals) or non-genital herpes (herpes
on other parts of the body; most often
'shingles'). Shingles is not sexually
transmitted. It is a secondary event long after
the initial infection with common 'chicken
pox'. Shingles is usually a one-off occurrence.
Herpes virus: 8 Types :
The herpes family of viruses includes 8 different viruses that affect human beings.
The viruses are known by numbers as human herpes virus 1 through 8 (HHV1 - HHV8).
Human herpes virus 1
Human herpes virus 1 (HHV1) is also known as herpes simplex virus 1 (HSV1). It is
typically the cause of cold sores around the mouth. HHV1 can also lead to infection in
the genital area causing genital herpes
Human herpes virus 2
Human herpes virus 2 (HHV2) is also called herpes simplex virus 2 (HSV2). It typically
causes genital herpes, a sexually transmitted infection. However, it can also cause cold
sores in the facial area.
Human herpes virus 3
Human herpes virus 3 (HHV3) is also called varicella-zoster virus. HHV3 causes
chickenpox. It can also cause a recurrent virus infection of the skin, which is called
herpes zoster or shingles.
Human herpes virus 4
Human herpes virus 4 (HHV4) is also known as the Epstein-Barr virus. It is the major
cause of infectious mononucleosis
Human herpes virus 5
Human herpes virus 5 (HHV5) is the official name of cytomegalovirus (CMV). CMV is
also a cause of mononucleosis.
Human herpes virus 6
Human herpes virus 6 (HHV6) is a recently observed agent found in the blood cells of a
few patients with a variety of diseases. It causes roseola (a viral disease causing high
fever and a skin rash in small children)
Human herpes virus 7
HHV7 can also cause roseola, but it is not clear what other clinical effects that this
virus causes.
Human herpes virus 8
Human herpes virus 8 (HHV8)
was recently discovered in the
tumors called Kaposi's Sarcoma
(KS). These tumors are found in
people with AIDS and are
otherwise very rare.
Classification
Group: Group I
( dsDNA )
Family:
Herpesviridae
Subfamily:
Alphaherpesvirinae
Genus:
Simplexvirus
Species:
Herpes simplex virus 1 ( HSV-1 )
Herpes simplex virus 2 ( HSV-2 )
HERPES VIRUS STRUCTURE - GENERAL
• Envelope
Herpes viruses are enveloped viruses. They bud from the inner nuclear
membrane which has been modified by the insertion of herpes
glycoproteins The viral membrane is quite fragile and a virus with a
damaged envelope is not infectious.
• Tegument
The space between the envelope and the capsid is the tegument. This contains
virally-encoded proteins and enzymes involved in the initiation of replication.
• Capsid
These viruses have a doughnut shaped capsomere of about 100-200 nm in
diameter with an icosahedral nucleo capsid .
• Genome
These viruses have double stranded DNA. The size of the genomes
differs with cytomegalovirus having the largest genome.
Condition
Description
Herpetic
gingivostomatitis
Initial presentation during the first herpes infection.
Herpes labialis
Infection occurs when the virus comes into contact with
oral mucosa or abraded skin.
Herpes genitalis
The typical manifestation of a primary HSV-1 or HSV-2
genital infection is clusters of inflamed papules and
vesicles on the outer surface of the genitals resembling
cold sores.
Herpetic whitlow
Herpes whitlow is a painful infection that typically affects
the fingers or thumbs. Occasionally infection occurs on
the toes or on the nail cuticle.
Individuals that participate in contact sports sometimes
acquire a this condition which presents as skin ulceration
Herpes gladiatorum
on the face, ears, and neck. It occasionally affects the
eyes or eyelids.
Primary infection typically presents as swelling of the
Herpetic
conjunctiva and eyelids accompanied by small white itchy
keratoconjunctivitis
lesions on the surface of the cornea.
Illustration
Condition
Description
A herpetic infection of the brain that is thought to be caused by the
retrograde transmission of virus from a peripheral site on the face
Herpesviral encephalitis
following HSV-1 reactivation. When infecting the brain, the virus shows
a preference for the temporal lobe
Herpesviral meningitis
HSV-2 is the most common cause of Mollaret's meningitis, a type of
recurrent viral meningitis.
Neonatal herpes simplex
Rare but serious condition,caused by vertical transmission of HSV from
mother to newborn.
Weakened immune system, herpes simplex can cause unusual lesions
During immunodeficiency in the skin. the appearance of clean linear erosions in skin creases,
with the appearance of a knife cut.
Herpetic sycosis
It is a recurrent or initial herpes simplex infection affecting primarily
the hair follicle.
Eczema herpeticum
Infection with herpesvirus in patients with chronic atopic dermatitis
may result in spread of herpes throughout the eczematous areas.
Herpes esophagitis
Symptoms may include painful swallowing (odynophagia) and difficulty
swallowing (dysphagia). It is often associated with impaired immune
function
Illustration
Diagnosis
Diagnosis for herpes affecting the face is usually made solely on the basis of the symptoms.
But in the case of suspected genital herpes, HSV affecting the eyes, or more severe skin
outbreaks, it can be useful to confirm the diagnosis by laboratory tests. Traditionally, tests
involve taking a swab from an active lesion, growing the virus in the laboratory, and using
colour-coded antibodies to pinpoint whether HSV-1 or HSV-2 is the culprit.
Another way, which is faster but yields less information, is to use an electron microscope to
look for viral particles in fluid collected from the blisters.
More recently, many laboratories have moved to using a highly accurate DNA test that can
rapidly pick up the virus in a sample, and at the same time tell whether it is HSV-1 or HSV-2.
Doctors also sometimes take a blood sample, particularly in people with a history of possible
herpes infection but no active lesions, to look for herpes antibodies.
There are currently no treatments capable of removing herpes virus DNA from the nerve cells
that carry it. Treatment focuses on reducing the intensity of a primary infection, and the
frequency and severity of subsequent viral reactivations.
• Real-time PCR with melting curve analysis of PCR products is a rapid procedure for
detecting and genotyping herpes simplex virus (HSV). When testing mucocutaneous
samples for HSV by a real-time PCR assay targeting the DNA polymerase gene, we found
that some PCR products had atypical melting curves that did not conform to the expected
melting temperatures for HSV type 1 or 2. Sequence analysis showed that these strains
had base-pair mismatches over the probe binding sites. An alternative assay is required to
type such atypical isolates.
Treatment
The introduction of 9-(2hydroxyethoxymethyl)guanine, AKA acyclovir, in
the late 1970s raised antiviral treatment another
notch and led to vidarabine vs. acyclovir trials in
the late 1980s.The lower toxicity and ease of
administration over vidarabine has led to acyclovir
becoming the drug of choice for herpes treatment
after it was licensed by the FDA in 1998.[83]
Another advantage in the treatment of neonatal
herpes included greater reductions in mortality
and morbidity with increased dosages, something
that did not occur when compared with increased
dosages of vidarabine.On the other side of the
equation, acyclovir seems to inhibit antibody
response and newborns on acyclovir antiviral
treatment experienced a slower rise in antibody
titer than those on vidarabine.
Prevention
The only surefire way to prevent genital herpes
is abstinenceabstinence. Teens who do have
sex must properly use a latex condom every
time they have any form of sexual intercourse
(vaginal, oral, or anal sex). Girls receiving oral
sex should have their partners use dental dams
as protection. These sheets of thin latex can be
purchased online or from many pharmacies.
If one partner has a herpes outbreak, avoid
sexual contact until all sores have healed.
Herpes can be passed sexually even if a
partner has no sores or other signs and
symptoms of an outbreak. Finally, one way to
lessen this risk is to take antiviral medication
even when no sores are present if you know
you have genital herpes.
Smallpox
History
For centuries, epidemics of smallpox — an infection caused by the variola virus —
affected people all over the globe, and the disease was often serious. But in 1796,
British doctor Edward Jenner discovered a way to protect people from getting
smallpox, which led to the development of the first smallpox vaccine.
What is Smallpox?
Smallpox is a very serious illness caused by a
virus called the variola (say: vair-ee-oh-luh)
virus. Smallpox gets its name from the pusfilled blisters (or pocks) that form during the
illness. Although the names may sound
alike, smallpox is not related to chickenpox,
which is a milder disease caused by a
different virus.
CLASSIFICATION OF THE SMALLPOX VIRUS
GENOME: Linear Double Stranded DNA
Family: Poxviridae
Subfamily: Chordopoxvirinae
Genus: Orthopoxvirus
Species: Variola
Structure
The smallpox virus consists of genetic
material (one molecule of double
stranded DNA) contained in a core. The
virus is tilted, showing the rounded
biconcave brick shape of the core, in
whose depressions nestle the "lateral
bodies". The function of the lateral
bodies is unknown. The virus includes
several layers of host cell membrane
added at various points in its life cycle.
The poxviruses are the most complicated
type of animal virus
How is smallpox spread?
Smallpox is contagious. That means the virus can spread to others. It spreads through
tiny drops of an infected person's saliva (spit) when the person coughs, talks, or
sneezes. Smallpox usually passes from person to person during close, face-to-face
contact.
How is it diagnosed?
If someone does get smallpox, a doctor can recognize the disease because it causes a
special kind of rash. The rash shows up as blisters on the skin that fill with fluid and
crust over. This might sound like chickenpox, but the blisters look different from the
blisters that chickenpox causes. The other symptoms of smallpox are like those of
many other less serious illnesses: fever, headache, backache, and feeling tired.
Treatment
There are no pills that can treat smallpox, but scientists are doing research to try to
develop medicine for the disease. If someone does become infected with the
smallpox virus, getting the vaccine within a few days of becoming infected can lessen
the disease's symptoms.
Vaccination
The vaccine worked so well that the United States stopped vaccinating the general
population against smallpox in 1972 because the disease was no longer a threat
(the last U.S. case of smallpox was in 1949).
The world's last known case of smallpox was reported in Africa in 1977. In 1980,
the World Health Organization (WHO) announced that smallpox was wiped out —
the first (and only) time in history that an infectious disease was declared
eliminated from the planet.
After the September 11, 2001, terrorist attacks
and the anthrax scare that same year, the U.S.
government took the precaution of asking several
companies to begin making smallpox vaccine again.
Today, there's enough vaccine on hand to protect the
American people in the event of a smallpox outbreak.
Public health officials have a rapid response plan
ready to vaccinate anyone exposed to the disease,
as well as people who come into contact with them.
So although a person doesn't need to get vaccinated
at the moment, the vaccine is there in case it's needed.
Given that the vaccine can stop the spread of the disease, experts believe it's
unlikely that terrorists will go to the trouble of producing and using smallpox as a
biological weapon — it would take too long and have little effect.
chickenpox
What is Chickenpox?
The disease known as chicken pox is a viral disease
caused by infection with the varicella-zoster virus,
which is a member of the herpes family of viruses.
This extremely contagious disease can affect a
person during any stage of life or age, however; it
usually affects children and is one of the most
common conditions during childhood. A lot of
children suffer from chickenpox infection during
their childhood; the infection results in the
formation of painful and itchy blisters on the skin.
The disease is highly communicable and can spread
very rapidly; the virus is transmitted through the air.
The illness can be communicated through the air by
droplets, the virus is released through actions like
coughing and sneezing, through direct contact with
secretions of the pox; and even activities such as
laughing with and talking to an infected individual is
sufficient to transmit the viral particles
PATH0L0GY
Chicken-pox is due to the reception of a specific poison, which after an incubation of about
thirteen days, shows itself by an eruption upon the skin.
1. Chicken-pox is characterized by the rapidity with which it runs through its stages.
2. The chicken-pox eruption attains complete development by the end of the third day.
3. In modified small-pox the premonitory symptoms are usually well-marked, often quite as
severe as in the natural disease.
4. The vesicles of chicken-pox are globular or ovoid in form, without any central
depression.
5. Small-pox is an inculpable affection; chicken-pox, according to reliable authority, is not.
6. When cases arise which all recognize to be modified smallpox, they are always
accompanied by others which are more severe.
7. Small-pox and vaccinia are often early followed,
in the same individual, say within two or
three years, by chicken-pox, and vice versa.
8. Chicken-pox, vaccinia, and small-pox
have been known to follow in immediate.
Symptoms
Chickenpox causes a red, itchy skin rash that usually appears first on the abdomen or
back and face, and then spreads to almost everywhere else on the body, including the
scalp, mouth, nose, ears, and genitals.
The rash begins as multiple small red bumps that look like pimples or insect bites.
They develop into thin-walled blisters filled with clear fluid, which becomes cloudy.
The blister wall breaks, leaving open sores, which finally crust over to become dry,
brown scabs.
Some kids have a fever, abdominal pain, sore throat, headache, or a vague sick feeling
a day or 2 before the rash appears. These symptoms may last for a few days, and
fever stays in the range of 100°-102° F (37.7°-38.8° C), though in rare cases may be
higher. Younger kids often have milder symptoms and fewer blisters than older
children or adults.
Contagiousness
Chickenpox is contagious from about 2 days
before the rash appears until all the blisters
are crusted over.
Chickenpox and Pregnancy
Pregnant women and anyone with immune system problems should not be near a
person with chickenpox. If a pregnant woman who hasn't had chickenpox in the past
contracts it (especially in the first 20 weeks of pregnancy), the fetus is at risk for birth
defects and she is at risk for more health complications than if she'd been infected
when she wasn't pregnant. If she develops chickenpox just before or after the child is
born, the newborn is at risk for serious health complications. There is no risk to the
developing baby if the woman develops shingles during the pregnancy.
If a pregnant woman has had chickenpox before the pregnancy, the baby will be
protected from infection for the first few months of life, since the mother's immunity
gets passed on to the baby through the placenta and breast milk
Prevention
Doctors recommend that kids receive the chickenpox vaccine when they're 12 to 15
months old and a booster shot at 4 to 6 years old. The vaccine is about 70% to 85%
effective at preventing mild infection, and more than 95% effective in preventing
moderate to severe forms of the infection. Therefore, although some kids who are
immunized still will get chickenpox, the symptoms are usually much milder than
those of kids who haven't had the vaccine and become infected.
Healthy kids who have had chickenpox do not need the vaccine — they usually have
lifelong protection against the illness.
Treatment
A virus causes chickenpox, so the doctor won't prescribe antibiotics. However,
antibiotics may be required if the sores become infected by bacteria. This is pretty
common among kids because they often scratch and pick at the blisters.
The antiviral medicine acyclovir may be prescribed for people with chickenpox who
are at risk for complications. The drug, which can make the infection less severe,
must be given within the first 24 hours after the rash appears. Acyclovir can have
significant side effects, so it is only given when necessary. Your doctor can tell you
if the medication is right for your child.
Vaccine
Not long ago, 3 million people got
chickenpox each year in the United
States. But now that kids receive the
shot, fewer and fewer people get
chickenpox.
Dealing With Discomfort
To help relieve the itchiness, fever, and discomfort of chickenpox:
•Use cool wet compresses or give baths in cool or lukewarm water for the first few
days. Oatmeal bath products can help to relieve itching. (Baths do not spread the
rash.)
•Don't rub the body dry.
•Put calamine lotion on itchy areas (Don’t use on face).
•Serve foods that are cold, soft, and bland .
•Ask your doctor or pharmacist about pain-relieving creams to apply to sores in the
genital area.
•Give your child acetaminophen regularly to help relieve pain if your child has
mouth blisters.
Never use aspirin to reduce pain or fever in kids with chickenpox because aspirin
has been associated with the serious disease Reye syndrome.
As much as possible, discourage kids from scratching. This can be difficult for them,
so consider putting mittens or socks on your child's hands to prevent scratching
during sleep. In addition, trim fingernails and keep them clean to help lessen the
effects of scratching, including broken blisters and infection.
Done By :
Fay Al-Khuredly
Rawan Al-Amer
Huda Al-Rubaie
Anisah Al-Yahya
Alreem Al-abdulwahid