Talk:Herpes simplex virus

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Contents 1 Non-human viruses 2 Testing 3 nicknames 4 pics 5 Referencing 6 Seroprevalence? 7 Fact Checking 8 Why does Cold Sore Redirect to Herpes? 9 Content in wrong location 9.1 Text removed 10 Community links 11 Eye 12 Unproven cures? 13 transmission 14 abstinence prevention 15 Spammy Links 15.1 How useful are these? 16 Alzheimer's, APP and the path of the virus away from the ganglion 17 "Limitation" to HSV I and II 18 1 or 2 19 Eye herpes 20 Prevelance 21 Headline text 22 re: eye herpes 23 Transmission 24 Something not made clear 25 added section on ocular herpes 26 Disclosure to new partners 27 Herpes simplex and canker sores 28 Simplex explanation 29 Treatment

[edit] Non-human viruses

Could someone please post an article about EHV, Equine Herpes Virus, and perhaps mention it in the "other viruses" section? There is a German article at http://de.wikipedia.org/wiki/Herpes_(Pferd) that could serve if someone that actually knows German would translate it. I was trying to find more information about EHV-1 due to the outbreak earlier this year at Pimlico. psu256 19:57:59, 12 April 2006 (UTC)

[edit] Testing

I find that there is a lot of mis-information and ignorance about herpes testing--even among doctors! (one told me that there was no such thing as a type-specific blood test)--but the page doesn't include any information on that. I'd like to see at least general information about type-specific vs. non-type-specific tests, but even better would be information about e.g. cultures vs. DNA tests, etc... People who are getting tested for herpes need more than just "positive" or "negative".

I know... this is Wikipedia, so write it myself... maybe someday I will, but if somebody else wants to go first, please do.

Loraan 19:23, 31 January 2006 (UTC)

[edit] nicknames

while i did see that some nicknames were removed (justifiably afaik), i did add "the gift the keeps on giving" as it is in common usage in north america, and i added citation to a credible site to back it up. Slamorte 18:18, 28 December 2005 (UTC)

[edit] pics

are there not any available pics of genital herpes? i have a feeling a lot of folks will be turning to this page for an initial and basic self-diagnosis, and a pic of one outbreak on a labia minor and/or one outbreak on a penile shaft would probably be worth the proverbial 1000 words.

and is the major facial outbreak pic really needed? it has shock value, sure, but it is a very rare form of outbreak, and really creepy. Slamorte 18:18, 28 December 2005 (UTC)

I just started a major edit of this page and put the new handy "inuse" message up. Thalia/Karen 03:19, Dec 21, 2003 (UTC)

I first contracted HSV-1 about 25 years ago. The only effective treatment I've ever found is the amino acid supplement L-Lysine: in large enough doses, it will actually halt an outbreak. In my case, this amounts to 1-2 grams an hour (e.g., 2-500mg pills every half hour), taken as soon as blisters start forming and continuing until the tingling/itching stops (usually 8-12hrs).

I used to take a daily "maintenance" dose of 500mg a day; however, I found this didn't always prevent outbreaks, and when I stopped taking it daily, outbreaks didn't seem to occur any more frequently. Theresa D.

[edit] Referencing

Please reference things properly. It is not sufficient to simply cite (Author, Year) in the text - a proper bibliographical reference is necessary or you may as well not reference at all. A lot of the recent material recently added to this page cannot be verified due to poor referencing. Techelf 03:45, 9 Mar 2005 (UTC)

[edit] Seroprevalence?

Perhaps the article can explain what this is, since there is no article that is devoted to it. When I hear that 21.6 percent of the US population is seroprevalent to Herpes, it makes me wonder.Cornince 02:33, 25 July 2005 (UTC)

Seroprevalence is the number of poeple in a population who have antibodies (in this case, against HSV) in their blood serum. If you take 1000 Americans, and draw their blood, and measure the presence of antibodies to HSV, 216 will have them, and 784 won't. - Nunh-huh 02:37, 25 July 2005 (UTC)

This statement is not backed up: Also, since 60-90% of the population is seropositive for HSV-1

If the NIH and references linked-to by it are acceptable sources these may at least back up 50-80% --69.183.34.24 07:18, 14 June 2006 (UTC)

• MedlinePlus Medical Encyclopedia - Herpes labialis
• American Social Health Association - Herpes Resource Center

[edit] Fact Checking

Eggs are not known for either high arginine or poor lysine/arginine ratio. In fact, eggs are considered moderately protective against outbreaks. I removed egg whites from the "triggers" section and replaced it with something a lot more antagonistic to lysine...walnuts. Egg White 33 206 195 1.056 Walnuts 100 466 2520 0.185 http://www.herpes.com/Nutrition.shtml

[edit] Why does Cold Sore Redirect to Herpes?

because cold sores are caused by the Herpes Simplex HSV-1 virus. Quazywabbit 09:15, 24 November 2005 (UTC)

I thought it could be HSV-2 and other viruses also. --Gbleem 07:23, 24 December 2005 (UTC)

Many people (myself included, until recently, um, disambiguated...) believe that Canker Sores are cold sores. Canker sores are usually inside the mouth, while cold sores are outside. Perhaps some mention of this confusion could be made, with a pointer to Mouth Ulcer or Canker_sore. User:Zirconscot 12 January 2006

A lot of people use the term Canker to refer to any kind of mouth sore. Common terms just aren't as specific as medical ones. --Gbleem 22:50, 30 April 2006 (UTC)

While it may be the case that cold sores are caused by HSV-1, many readers of wikipedia, such as myself, aren't as much interested in the medical perspective of the larger general class of HSV. I had a few questions that I wanted answered about cold sores that this page doesn't address: Do the active ingredients in products such as Carmex actually help or hinder healing of cold sores? Is this treatment inconclusive? What's the process by which these active ingredients work to help reduce or prevent cold sores? These questions aren't answered on the current page... it would be nice to have a section on Cold Sores or to not redirect the page from Cold Sore and instead link from that page to this page for the more general discussion of HSV. This is what seems to be done with the page on Mouth Ulcer. Joseph Lorenzo Hall 04:52, 24 December 2005 (UTC)

well, i think it would be pretty redundant to have a wikipage on cold sore, and another on HSV-1, when in fact they are the same thing. so what i nack the suggest for creating a section in HSV for "cold sores and cold sore treatment." Slamorte 18:18, 28 December 2005 (UTC)

[edit] Content in wrong location

Someone pasted the following text into the section "Neonatal herpes simplex". This information doesn't belong in that section; rather it is an overview of the whole condition. The information seems reasonably valid, but it is largely redundant to content already in the article. So, I am removing it from the main page and moving it here. But if people want to go through it and see if there is useful information to splice back into the main article, I wouldn't object to that. --Arcadian 02:04, 23 November 2005 (UTC)

[edit] Text removed

The following are correct statements about herpes simplex virus type 2 (HSV-2) and are known in the general medical and scientific community:

a) Between 7% and 33% of the adult population has HSV-2;

b) HSV-2 has a characteristic ability to establish latency;

c) Symptomatic recurrences have been associated with

• Physical stress;
• Emotional Stress;
• Exposure to ultra-violet light;
• Tissue damage;
• Suppression of immune system;

d) Incidence at delivery is reported from 0.01% to 0.39% for all women,regardless of past history of genital herpes.

e) Risk factors include:

• Maternal true primary infection at delivery creates highest risk of infection to infant;
• Rupture of amniotic membranes longer than 6 hours before delivery with active infection in mother, is associated with increased risk of infection in infant;
• Fetal scalp monitor can be site of viral entry into the child;

f) Incidence of intrapartum infection is estimated at 85% to 90% of all neonatal cases;

g) The main risk of HSV-2 transmission to the neonate is at term during vaginal delivery; perinatal infection accounts for approximately 85% of all cases of neonatal herpes. The most common source of HSV in perinatal infection is the birth canal. As the neonate passes through the birth canal, it comes into contact with infected secretions; the site of entry for the virus is usually the eye, nasopharynx or an abrasion secondary to scalp electrodes or forceps. There are various sites of HSV shedding in the birth canal, and it is likely that cervicovaginal shedding poses a greater risk than that from the vulva because the neonate is in close contact with the vaginal mucosa for several hours, but is only in light and transient contact with the vulva during delivery. Any break in the in the infant’s skin may increase the risk of neonatal HSV infection.

h) The rate of asymptomatic shedding at labour measured by HSV culture varies from 0.35% to 1.4% and is no higher than at other times in the pregnancy.

i) HSV-2 infection in infected mothers is most often localized to the genitals

j) CNS infection (encephalitis): Approximately one-third of all infants with neonatal herpes have CNS infection only. It is thought that this represents axonal transmission of virus to the CNS. In contrast, in infants with disseminated infection, the brain is probably seeded by a blood-borne route which results in multiple areas of necrosis. In infants with CNS infection who are not treated, the mortality rate is 50%. The long term prognosis is poor with most survivors suffering from neurological impairment.

k) Treatment:

• Perinatally acquired HSV-2 is amenable to treatment by antiviral agents.
• Acyclovir is the anti-viral agent of choice.
• Without treatment with anti-viral agents, 70% of infants presenting with HSV-2 localized to the skin, eye and/or mouth will develop involvement of the central nervous system or disseminated infection.
• The possibility (without proof by viral isolation) of HSV-2 infection to a neonate requires aggressive, immediate treatment with intravenous acyclovir.
• Acyclovir is safe to use during pregnancy.
• Acyclovir is safe for use in newborns.

[edit] Community links

I'd like to add links to online communities for HSV-1 and HSV-2 where people can get moral support as well as information, but the added links have been removed. How come?

If you've got a website you'd like to add, feel free to propose it here. On the highly trafficked medical pages, we get a lot of unscrupulous marketers trying to put in links promoting their products, so that's why we now have the warning at the top of the external links section, asking people to bring external links to the talk page before adding it. If nobody here objects after a week, then go ahead and add it. --Arcadian 22:00, 9 December 2005 (UTC)

I've taken a closer look at the links you tried to add, and I might have been too hasty. I looked at the first one, and saw it was created only a month ago and didn't have many entries on it. However, the second one, though it's only a few months older, does have a significant number of posts. In any case, while I'd object to the first link going in, I'll abstain on the issue of the second link. --Arcadian 22:08, 9 December 2005 (UTC)

I removed a duplicate in the links section, and added a couple of herpes dating sites. I'd like to add a couple more "community" links, unless anyone objects:

• Sex and Dating With Herpes in London
• Thoughts and Meditations on Holistic Treatment for Herpes
• Herpes Doctor Public Forums

[edit] Eye

Boy, I feel sorry for the person with the eye infection! How's he going to be able to close his eye now? 4.159.113.21 01:36, 18 December 2005 (UTC)

[edit] Unproven cures?

Well, the person who wrote this article sure enough didnt do any research into the effectiveness of DMSO. There's been plently of articles and research done indicating DMSO can enter a cell and inhibit the herpes virus. For instance, the website: http://freedomantiviral.addr.com/dmso.htm , shows such evidence. Just do an internet search. Then, if the author did any research at all, they would have also discovered that thousands of people worldwide (not in the USA) use DMSO for other treatments, without any side effects and prescibed by doctors! For all we know the author is in with the medical establishment and pharmacutical companies spreading dis-information to the public. Regardless of what's said, DMSO is effective and has been proven to inhibit the herpes virus in clinical medical studies.

I object to this article's neutrality, that all of the treatments listed require prescription medications. Tea tree oil, from the Body Shop is very effective in treating both herpes of the lips and genital herpes. Gilliamjf 05:34, 11 March 2006 (UTC)

[edit] transmission

Hello From Experience!!!! I had a cold sore when I was younger on my lip. I believe HSV1.. later in life HSV2 contracted through sex. intercourse. Immediately apparent in two spots, reverted to just the one main place.. later by accident, I transferred it to my nose, now it has appeared in several different places inside and outside nostrils and once further toward my lip. It's VERY important to me that I am fastidiously careful not to let it near my eye. I believe that either of the forms can cause blindness if the virus reaches the cornea. If an eye infection does occur one must be fastidious in keeping it calm. use an ongoing low dose repressant to avoid outbreaks. Fingers can spread the virus during sex just as much as any other contact so it s disconcerting that EVERYONE is so hung up on what touches what. When I have an outbreak I only touch the sores with something else and I use anti-bacterial soap a lot. People are not always responsible for how they touch themselves when they're asleep either, especcially when something is itchy, so please take this information and share it. :)

It's not really clear in the article. Can Herpes be transmitted from the mouth to the genitals? (during oral sex)

Yes it can. It's rare for HSV1 oral to be transmitted to the genitals but it can happen, especially if the "giver" has a cold-sore at the time. HSV2 oral is rare, but I would assume it could be more easily transmitted to the genital area, since HSV2 "prefers" the genital area. By the same token, I would assume a genital HSV1 infection could be spread to the oral area relatively easily, but HSV2 genital would not be so easily spread to the oral area. I'm basing these assumptions on educated guess-work rather than hard evidence. If anyone has any evidence it would be good to get it onto this page.

I read somewhere on line that infection with one type of the virus in one location affords some immunity to infection from the other type of the virus AT THAT LOCATION. Since most people by adulthood have acquired HSV-1 at the mouth (even if they don't know it), the thinking is that that makes it more difficult to acquire an HSV-2 infection AT THE MOUTH. On the other hand, with the rise of the practice of oral sex, HSV-1 infection at the genitals is supposed to be increasing. Does anybody know if this is correct? [Stephen Kosciesza]140.147.160.78 17:06, 20 June 2006 (UTC)

Although well intended, these sentences were annoying to me; "Women are more susceptible to acquiring genital HSV-2 than men. On an annual basis, without the use of antivirals or condoms, the transmission risk from infected male to female is approximately 8-10%. This is believed to be due to the increased exposure of mucosal tissue to potential infection sites. Transmission risk from infected female to male is approximately 4-5% annually." This is not helpful unless you know the frequency of contact during the year of this study. Could the risk of infection be clarified?"

Can anyone commment on the concept of autoinnoculation? Also, I have heard conflicting reports from MD's regarding how many times you can be infected. One stated that you can only get HSV1 and HSV2 one time each, meaning you would be immune to exposures from others once infected with both type I and II, yet another stated that you could be infected as many times as you were exposed to either. If the latter is correct, during a break out of one type, is it expected that it would occur at all sites of infection of that type, or just be isolated to the one area?

[edit] abstinence prevention

I have an issue with this sentence in the article: "Abstinence, including from kissing/oral sex, is another way to prevent contracting or spreading this disease." this isn't really a method of prevention. certainly if you're abstinent you won't get herpes but this is like saying, the way to avoid a car crash is to not drive, it's not useful information.Vicarious 22:59, 7 February 2006 (UTC)

I completely agree. This isn't helpful information at all, it's bordering on the stigmatic. "Abstinence from kissing"? Seriously? That means that I can't let my grandmother kiss me, right? Can I kiss my kids? What about if I haven't been diagnosed and don't have symptoms, should I not kiss anyone, just in case? Ditto for sex. It's daft.

[edit] Spammy Links

I'd like to suggest removing these 3 links. They're spammy, and dont provide any good quality information.

• Herpes Treatments
• Herpes Information Site
• Herpes Coldsores Treatment

Any objections?

[edit] How useful are these?

And I would like to add the links to the http: // icd9.chrisendres.com/ website are not very useful at all, because they just come up with a restatement of the same. Is there a BETTER medical dictionary or website than this one? Surely!

[edit] Alzheimer's, APP and the path of the virus away from the ganglion

"Hypothetically, by interfering with the HDAC enzymes' effectiveness, it may be possible to block the virus's ability to hide" was pure gold, because it's carefully written but seems to be the only thing I could find anyway about full cures. It is also useful for similar virii that hide in the ganglion.

In addition to this I have found this information, but I am not knowledgeable enough to add the information to the article in a coherent and careful manner.

It is from http://www.sciencedaily.com/releases/2003/11/031107055048.htm

The article relates a low link to Alzheimer's. In this study the action of the virus is described as moving AWAY from the ganglion by `APP`. This could be useful information for someone. Jago25 98 18:13, 19 April 2006 (UTC)jago25_98 at hotmail

[edit] "Limitation" to HSV I and II

HSV I and II are the only forms of Herpes Simplex Virus that are in both colloquial and specialist nomenclature referred to as Herpes Simplex Virus. I understand the idea behind wanting to list all the other forms of Herpes Simplex Virus but the truth is you would end up listing the majority of the Herpesviridae phylogeny going far beyond eight. If you feel that a form of HSV needs attention or there is already a sub heading within HSV for further explanation. From Steadmen's to A.D.A.M. I cannot find expansive notation for anything outside of HSV I and II under any HSV heading and I can hardly see making the current redirect for something as simple as “Herpes” into anything that would surpass them.

Acstbandit 14:49, 24 April 2006 (UTC)

[edit] 1 or 2

"HSV asymptomatic shedding is believed to occur on 2.9% of days while on antiviral therapy, versus 10.8% of days without. Shedding is known to be more frequent within the first 12 months of acquiring HSV-2." Is this HSV 1 or HSV 2? --Gbleem 22:51, 30 April 2006 (UTC)

[edit] Eye herpes

Either forms of the herpes can affect the eye, (as well as other soft tissues that we know about, the labia of the vagina, the penis (right down to and including the scrotum hairy or not), the anus, the mouth and lips, the skin around the mouth the nose inside and out. I've never seen a list officially myself but I have had HSV2 for 5 years, I observed it on the person who had it before me I've researched and I know this to be true).

I've seen it appear in a lower eyelid and it looks like a stye, or a boil in the eyelid. Its painful in such a sensitive area and difficult to treat. CARE must be taken to repress the virus to avoidid it travelling into the eye and affecting the cornea, which could potentially cause permanent damage.

Anyone know anything about eye herpes?

What would you like to know?PedEye1 16:20, 19 November 2006 (UTC)

[edit] Prevelance

There should really be references made to the prevelance of the virus.

[edit] Headline text

[edit] re: eye herpes

see above

i don't know how to add stuff to wiki properly so i'm just putting it here cos its more of a comment cos i don't know how if its 100% accurate

herpes cna occur in the eye i believe its called (or causes?) dendritic ulcers. it can cause pain in the eye or distorted vision, it is treatable and can be reaccuring, much like cold sores i guess untreated it can cause permanent scarring,

i am not sur eif it would be classified under hsv1 or 2 or somethign completly difffernt

[edit] Transmission

is it possible to get herpes from drinking out of the same bottle of coke?

YES Very likey if you've got a sore at the time. Unlikely but still a tiny tiny bit possible if you haven't

Please see above in transmissions.

[edit] Something not made clear

The article says that the disease is currently not curable. It also states that a cold-sore on the lip is caused by the same virus as genital herpes.

It is not made clear if the virus is, therefore, with a person for life after they contract it - and therefore if, anyone who has ever had a cold sore on their lip, is technically a life-long herpes sufferer who is also prone to bouts of genital outbreak!

This seems to be what the article implies, but.. I am left thinking "surely not!". Can someone please clarify this, first here and then in the article? EuroSong ^talk 12:03, 26 July 2006 (UTC)

No, you would not have genital outbreaks, because cold sores are Oral Herpes, not genital herpes.Apofisu 19:04, 31 July 2006 (UTC)

Thanks. This should be clarified in the article. EuroSong ^talk 21:25, 31 July 2006 (UTC)

Actually its not that simple.. both can potentially be spread. And both you have for life. But sometimes they fade away and remain dormant forever. When you get older it's less likely that you'll get either.

As far as I know HSV1 goes away sooner and is less aggressive/???

[edit] added section on ocular herpes

I'm not a doctor nor a medical researcher, but I am a long-time sufferer of ocular herpes, so I wrote this section from what my doctor told me and the research I did when I was diagnosed. However, I don't have any up-to-date references. Can someone help out? Rimi 11:09, 13 August 2006 (UTC)

[edit] Disclosure to new partners

I have a big issue with the following section, but I didn't want to edit it myself (being a complete newbie to Wikipedia.)

Doctors at some hospitals and health clinics actually advise men not to tell their partners[citation needed] unless the woman is pregnant, reasoning that the psychological effects of herpes far outweigh the physical effects in adults. This advice is still controversial, especially as genital herpes affects women significantly worse than it does men.

"still controversial" (as opposed to not controversial later on...?) A doctor advising a patient not to tell their partner they might be giving them a virus is not controversial, it's unethical. (I don't know anything about the legal issues but my personal opinnion would be that any doctor giving this kind of advice should have their medical license revoked.) And there isn't even a source sited for this. Could somebody please remove this bit?

SarahAM 21:55, 15 August 2006 (UTC)

I don't believe that this can be happening!. It is most certainly a disgrace to the medical world of that company, and in my opinion it should be reported to an authority or a news broadcaster. It's not a logical reasoning at all, its a gender divide, making a sexist assumption on behalf of women. In this day it's outrageous behaviour.

It is absolutely unethical for a physician to tell someone not to disclose their sexually transmitted infection (STI) status. A subtler point is that persons are infectious at times, even if they have no symptoms or signs of recurrence. Also, many persons with HSV-2 have no idea they have the infection. Testing and education in addition to ethical behaviour are vital to reducing transmission. Daily antiviral therapy use by the potentially transmitting partner can also reduce transmission within couples (New England Journal of Medicine 2004 vol 350 pages 11-20).

[edit] Herpes simplex and canker sores

I am a bit confused by what this page says about the relationship between HSV and canker sores (aphtous ulcers). It dismisses any link whatsover. The herpes diagnosis service which can be accessed through a link at the bottom of the article (http://www.herpesdiagnosis.com/pregnancy.html) says that first episode of HSV involves: "fever, malaise, myalgias, inability to eat, irritability, and cervical adenopathy, may last from 3 to 14 days. Fever lasting from 2 to 7 days and swollen lymph nodes in the neck are common. Lesions may involve the hard and soft palate, gingival, tongue, lip, and facial area. HSV-1 infection of the pharynx usually results in fluid filled or ulcerative lesions of the lower pharynx and/or tonsils. Lesions on the tongue, inside the cheek, or gums may occur later in the course in one-third of cases. The lesions rapidly rupture, become ulcerative, and last approximately 12 days with the number of vesicles peaking at about 6 days and gradually diminishing. The lesions can be very painful and make swallowing uncomfortable, leading to other clinical symptoms of drooling or difficulties in drinking and eating. Dehydration secondary to poor fluid intake leads to hospitalization in a small percentage of affected children."

I am not a specialist but to me lesions of soft palate, gingival, tongue are just other words to describe canker sores.

Canker sores are generally idiopathic (no-one knows what causes them). In contrast, cold sores are caused by the herpes virus. Lesion just means that there's a hole or opening in the tissues. With canker sores, no-one knows what causes them. With HSV, the HSV causes them. Same symptoms (a lesion in the skin), different causes. WLU 19:25, 17 October 2006 (UTC)

[edit] Simplex explanation

What exactly is a simplex virus? Is it called that because of its geometry or for another reason? It might be helpful to explain this or link to an explanation within this article. --GentlemanGhost 17:27, 29 October 2006 (UTC)

[edit] Treatment

Who wrote the treatment topic because it needs to be fixed and is very simple and not written well. needs to show medical options not just some supernova treatment....

—The preceding unsigned comment was added by Paulm27 (talk • contribs). 03:53, 12 December 2006

Please elaborate on what is wrong and what needs to be done to fix it :-) David Ruben ^Talk 03:17, 12 December 2006 (UTC)

The edit you are talking about was vandalism and has since been reverted. WLU 12:12, 12 December 2006 (UTC)