Herpes Simplex Transmission

Herpes simplex is a viral infection caused by herpes simplex virus type I and II (HSV-I and HSV-II). HSV-I often attacks the area around the mouth (herpes labialis), while HSV-II is often on the genital area (genital herpes). However, because of oral sex or oro-genital sex then either HSV-I and HSV-II can about the area around the mouth or genitals. Forms of HSV attack on an individual can be a primary infection, non primary first episode, recurrent and asymptomatic.
The incidence of herpes simplex infection increases every year. Data in the United States said that found 1.5 million new cases are caused by HSV transmission through sexual intercourse, in which a woman infected with HSV can transmit to a partner by 4-5%, but if the man who infected the chances of transmitting HSV the spouse of 8-10%. HSV infection in neonates due to vertical transmission from mother to reach 1500-2000 new cases each year.
An individual may be exposed to HSV infection because of transmission from a seropositive individual, where transmission can take place both horizontally and vertically. The difference of the two transmission methods are as follows:

Herpes Simplex Test

Test for Herpes Simplex Virus (HSV) infection can be performed virology and serology, each instance of the investigation are as follows: 

Virology

1. Light microscope. Samples derived from cells at the base of the lesion, smears on the mucosal surface, or from a biopsy, may be found in internuclear inclusions (Lipschutz inclusion bodies). Infected cells may show an enlarged cells resembling balloons (ballooning) and found fusion. In the experiment Tzanck with Giemsa or Wright staining, can be found in many core datia cells and inclusion bodies intra nuclear.
2. Examination direct antigen (immunofluorescence). Cells of the specimens included in the frozen acetone. Then the examination is done by using light electrons (90% sensitivity, 90% specific) but, this examination can not be matched with viral culture.
3. PCR, polymer chain reaction test for HSV DNA is more sensitive than traditional viral culture (sensitivity> 95%, compared with a culture that only 75%). But its use in the diagnosis of HSV infection has not been conducted on a regular basis, most likely because the cost is expensive. This test is commonly used to diagnose HSV encephalitis because the results are faster than culture virus.6
4. The virus culture, viral culture of vesicle fluid in the lesion (+) for HSV is the best way because the most sensitive and specific than other methods. HSV can develop within 2 to 3 days. If the test is (+), almost 100% accurate, especially if the fluid comes from the primary vesicles rather than vesicles recurrence. Growth of virus in the cell indicated by the occurrence of cytoplasmic granulation, balloon degeneration and giant cell core a lot. Since the virus is difficult to develop, test results often (-). However, this method has the disadvantage due to a long examination time and expensive.

Serology

Herpes Simplex Fact : Neonatal HSV Infection

 Neonatal infection can be divided into 3 clinical types, namely: the spread of infection and generally attacks the liver, encephalitis and infections limited to skin, eyes and mouth. The first and second form often leads to death. Infections are usually caused by HSV 2 but infections caused by HSV1 is also common. The risk of infection in children depends on 2 main factors in the mother; the pad when the gestational age of pregnant women is generating HSV and depends also on whether the infection suffered by secondary infection or primary infection.
Only HSV excretion containing incurred during childbirth are dangerous for newborns with intrauterine infection although rare exceptions may occur. Primary infection in the mother can increase the risk of infection in infants from 3% to 30%, presumably because of immunity in the mother can provide protection.

Herpes Simplex Causes, Distribution and Incubation

Herpes Simplex Etiology
Causes Herpes simplex virus infection are included in the family herpesviridae, subfamily alphaherpesvirinae. HSV type 1 and type 2 can be distinguished immunologically (especially if you used a specific antibody or monoclonal antibody). And HSV type 1 and type 2 is also different when viewed from the growth pattern of the virus in cell culture, eggs and embryos in experimental animals.
Herpes Simplex Distribution
Scattered throughout the world. Hamapir 50% -90% of adults have antibodies to HSV 1. Initial infection of HSV 1 usually occurs before age 5 years, but now many primary infections are found occur in adults. Infection with HSV-2 usually starts because of sexual activity and rarely occur before adulthood, except in case of sexually abused children. HSV-2 antibody was found about 20% -30% of American adults. Prevalence of antibodies to HSV-2 increased (more than 60%) in lower socioeconomic groups and in people who have multiple sexual partners.
Reservoir - Humans serve as reservoirs.
Herpes Simplex Transmission

Herpes Simplex Encephalitis Patofisiology

HSE pathogenesis has not been understood. Part of the brain affected by ptekie very diffuse and scattered necrosis of the medial lobe asymmetry in the inferior temporal and frontal lobes. The exact mechanism is not clear cell damage and affects either directly or indirectly virus immune mediated process.
Brain infection is often a primary infection because of direct transmission of virus through neuronal path from the peripheral to the brain via nerve trigeminus or olfactorius. Factors that accelerate the HSE is not known. Although HSE is often found in patients with decreased immune system, most people have never experienced immune system suppression.

Genital Herpes Sign and Phase

The incubation period ranges from about 3-7 days. Based on whether someone had contacts with Herpes Simplex Virus (HSV-2), genital herpes infections have 2 phases, namely:
Phase of infection (lesions) Primary, characterized by:

• Can occur without symptoms (asymptomatic)
• Beginning with a burning sensation, burning and itching on the affected area.
• Then the resulting vesicles (spots) clusters, easily broken, giving rise to injury (similar ulceration) on the surface of skin redness (erythema), and pain.
• Furthermore, to be followed by fever, malaise whole body (malaise) and muscle pain.
• Happened enlarged lymph nodes around the infected area genital herpes.