Up to 20 percent of the population at any given time is shedding herpes simplex virus, according to the "5-Minute Clinical Consult" textbook. Risk factors for contracting the virus include sexual intercourse with an infected person, occupational exposure--such as in a hospital or dental office--newborns exposed to an actively infected mother and those with immune compromise, such as AIDS or diabetes. The effects of herpes virus can be difficult to manage.
Genital Herpes
Each year, there are 300,000 to 500,000 new cases of genital herpes, according to the "5-Minute Clinical Consult" textbook. Risk factors include lower socioeconomic status, increasing age, African-American race and number of lifetime partners. Genital herpes infection has an incubation period of one to 45 days. According to the Merck Manual, genital herpes is the most common ulcerated sexually transmitted disease in developed countries. Seventy percent of cases are contracted during asymptomatic or clinically unrecognized shedding of the virus. Condom use during sexual activity is only 60 percent effective. Patients with genital herpes present with lesions that affect the labia of the vagina or the penile glans, shaft or urethra. These lesions are usually painful and cause a flu-like syndrome during the first outbreak. Symptoms such as fever, headache, malaise, painful urination and painful sexual intercourse can be caused by genital herpes.
Herpes in Pregnancy
A first herpes infection can cause a spontaneous abortion in 45 percent of pregnancies and preterm labor in another 35 percent, according to the "5-Minute Clinical Consult" textbook. The greatest risk of transmission to the newborn is from a mother with her first infection. The rate is as high as 50 percent. Caesarean section is indicated in mothers with active genital lesions at the time of labor. Neonates that become infected have a survival rate of 95 percent if the infection stays localized to one area, 85 percent survival if the virus infects the central nervous system and 30 percent survival if the infection becomes systemic, according to the "5-Minute Clinical Consult" textbook
Ocular Herpes
Ocular herpes occurs when herpes virus infects the eyes. Patients with ocular herpes may have symptoms that decrease their visual acuity or lesions that affect the cornea and or eyelids. Corneal infection causes pain, tearing, light sensitivity and ulcers. Infection may cause permanent visual loss, according to the "5-Minute Clinical Consult" textbook.
References
- "5 Minute Clinical Consult 2010"; Frank J. Domino, MD, Editor; 2009
- Merck Manual Online Medical Library: Herpes Simplex Virus Infections
