HERPES VIRUS

Herpes simplex virus (HSV) infection

Herpes Labialis (cold sores) - localised collection of blisters with a red base, usually on or around the lips, that develop into crusts and disappear without scarring. Manifestation of a recurring infection with the herpes simplex virus (HSV), usually but not exclusively HSV-1. Lesions are contagious until dried out.

Genital herpes is almost exclusively a sexually transmitted infection, generally caused by HSV-2, although the prevalence of genital HSV-1 is increasing. Most transmission occurs via sexual contact with an individual who may be asymptomatic but is still shedding the virus. There is some evidence that genital HSV increases the risk of acquiring (and transmitting) HIV infection.

Genital herpes in pregnancy – in early pregnancy is associated with an increased risk of spontaneous abortion, fetal growth restriction, preterm labour and congenital herpes. In later pregnancy, genital herpes caries an increased risk of neonatal infection.

Herpes zoster virus infection

Chickenpox Highly contagious infection with the varicella-zoster herpesvirus, usually affecting children. An attack gives lifelong immunity, but the virus remains dormant in nerves and in later life may cause shingles (see below) Causes crops of itchy vesicles, typically starting on the back. Spread by direct contact or the respiratory route, via droplets. Seek advice if chickenpox exposure or infection occurs during pregnancy or if neonatal infection.

Shingles Rash caused by reactivation of the dormant chickenpox (varicella zoster) virus, often many years after original infection. The condition can be painful, and last a long time, and in some patients post-herpetic neuralgia can develop or persist more than 90 days after the onset of the rash. Shingles is not infectious, but a person who has never had chickenpox may become infected with chickenpox from a person with shingles. A national vaccination programme was launched in September 2013 for patients aged 70 – 80. Uptake of the vaccination is highest among patients aged 76 (76.7%) with cumulative coverage lowest in those aged 71(47.5%) Less than half of those who became eligible for vaccination under the catch-up scheme in 2019-2020 took up the invitation. Uptake is more likely if shingles vaccination is proactively offered in primary care.