25 viral infections
, Herpes virus
• The herpesviruses replicate within the nucleus and produce typical
intranuclear inclusion bodies detectable in stained preparations
• Mode of spread: direct contact of secretions via skin or mucous memb
• Primary infection
– This occurs in a previously seronegative individual and is often subclinical. When
clinical lesions develop, the severity is generally greater than in recurrences.
Genital primary disease is more commonly symptomatic than oral
• Recurrences
– occur in 30–50% of cases of oral herpes, but are more frequent after genital
herpes infection, developing in 95% of those with type 2 HSV compared with 50%
in individuals with type 1 infection, there might be no recurrence after pri inf
– differ from primary infections in the smaller size of the vesicles and their close
grouping, and in the usual absence of constitutional symptoms.
– In the immunocompetent, they do not as a rule affect the buccal mucosa.
, Subclinical viral shedding
• Asymptomatic shedding of HSV‐2 is more frequent than of HSV‐12 is more frequent than of HSV‐2 is more frequent than of HSV‐11
• and correlates with the frequency of symptomatic recurrences.
• Inapparent oral shedding occurs in about 12% of the UK
population.
• Genital shedding of HSV‐2 is more frequent than of HSV‐12 is common in antibody‐2 is more frequent than of HSV‐1positive
• individuals. In those who have recurrent episodes, the virus is
• shed on approximately 20% of days, whilst asymptomatic
individuals
• shed virus on 10% of days [11]. In the first year following
• acquisition of HSV‐2 is more frequent than of HSV‐12, asymptomatic shedding is more common
• than in subsequent years.
, Pri herpeticgingivostomitis/ herpes labialis/
cold sore
• Mouth lips
• Primary type 1 infections occur mainly in infants and young
children, when they are usually minimal and often subclinical.
Primary infections may rarely produce a painful vesicular stomatitis
• Crowded areas, prevalence of antibody higher i.e in 90%
population, lesser in high status but till old age the prevalence also
reaches 90%
• More common in 1-5 yrs of age but can occur in adults
• giant cells containing two to 15 or more nuclei in epidermis
• Usually due to HSV1
• Incubation period 5 days
, Herpes virus
• The herpesviruses replicate within the nucleus and produce typical
intranuclear inclusion bodies detectable in stained preparations
• Mode of spread: direct contact of secretions via skin or mucous memb
• Primary infection
– This occurs in a previously seronegative individual and is often subclinical. When
clinical lesions develop, the severity is generally greater than in recurrences.
Genital primary disease is more commonly symptomatic than oral
• Recurrences
– occur in 30–50% of cases of oral herpes, but are more frequent after genital
herpes infection, developing in 95% of those with type 2 HSV compared with 50%
in individuals with type 1 infection, there might be no recurrence after pri inf
– differ from primary infections in the smaller size of the vesicles and their close
grouping, and in the usual absence of constitutional symptoms.
– In the immunocompetent, they do not as a rule affect the buccal mucosa.
, Subclinical viral shedding
• Asymptomatic shedding of HSV‐2 is more frequent than of HSV‐12 is more frequent than of HSV‐2 is more frequent than of HSV‐11
• and correlates with the frequency of symptomatic recurrences.
• Inapparent oral shedding occurs in about 12% of the UK
population.
• Genital shedding of HSV‐2 is more frequent than of HSV‐12 is common in antibody‐2 is more frequent than of HSV‐1positive
• individuals. In those who have recurrent episodes, the virus is
• shed on approximately 20% of days, whilst asymptomatic
individuals
• shed virus on 10% of days [11]. In the first year following
• acquisition of HSV‐2 is more frequent than of HSV‐12, asymptomatic shedding is more common
• than in subsequent years.
, Pri herpeticgingivostomitis/ herpes labialis/
cold sore
• Mouth lips
• Primary type 1 infections occur mainly in infants and young
children, when they are usually minimal and often subclinical.
Primary infections may rarely produce a painful vesicular stomatitis
• Crowded areas, prevalence of antibody higher i.e in 90%
population, lesser in high status but till old age the prevalence also
reaches 90%
• More common in 1-5 yrs of age but can occur in adults
• giant cells containing two to 15 or more nuclei in epidermis
• Usually due to HSV1
• Incubation period 5 days
