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A recurrent viral infection, herpes simplex is subclinical in about 85% of cases. The others produce localized lesions and systemic reactions. After the first infection, a patient is a carrier susceptible to recurrent infections, which may be provoked by fever, menses, stress, heat, and cold. In recurrent infections, the patient usually has no constitutional signs and symptoms.
Herpes simplex is caused by Herpes-virus hominis (HVH), a widespread infectious agent. Type 1 herpes, which is transmitted by oral and respiratory secretions, affects the skin and mucous membranes and commonly produces cold sores and fever blisters.
Type 2 herpes primarily affects the genital area and is transmitted by sexual contact. Cross-infection may result from orogenital sex.
Primary HVH is the leading cause of gingivostomatitis in children ages 1 to 3. It causes the most common nonepidemic encephalitis and is the second most common viral infection in pregnant women. It can pass to the fetus transplacentally and, in early pregnancy, may cause spontaneous abortion or premature birth.
Teaching Checklist: Treating and preventing herpes simplex
Teach the patient with genital herpes to use warm compresses or take sitz baths several times per day. Tell him to use a drying agent, such as povidone-iodine solution, to increase his fluid intake, and to avoid all sexual contact during the active stage.
Recommend that pregnant women with Herpesvirus hominis infection have weekly viral cultures of the cervix and external genitalia starting at 32 weeks’ gestation.
Instruct patients with herpetic whitlow not to share towels or utensils with uninfected people. Educate staff members and other susceptible people about the risk of contracting the disease.
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