Herpes is an infectious disease caused by a herpes simplex virus (Mosby, 2009). The very inflammation of herpes is called herpes recurrence (Mosby, 2009). Nowadays, the most common types of the disease are the herpes simplex virus I and herpes simplex virus II that can cause characteristic features of the disease on lips, eyelids, palate, nose, genitals and other body parts (Spencer, 2005). The type of the diseases does not depend on the type of virus, which lives in human body, but it rather depends on the place where it appears (Spencer, 2005). The paper deals with the disease’s analysis, taking into account advice on disease prevention, its prevalence in the Unites States and foreign countries, and disease management. Herpes virus appears to be an inflectional disease that lives in the human’s body for the whole life, periodically revealing due to a number of reasons.
Herpes simplex is the collective name for infections caused by herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2) (Cozic, 2011). The development of herpetic disease in humans is always associated with the presence of fairly coarse immunodeficiency state and the stronger the immune disorders are, the greater the severity of the disease is (Cozic, 2011). The term “herpes” (from Greek “creeping”) was used by Herodotus in 100 B.C. to describe blisters, accompanied by fever (Spencer, 2005). Viruses, belonging to the herpes virus family, are widely distributed in nature. They may be present without the symptoms and cause disease in various species of wild and domestic animals (cats, dogs, horses, cows, chickens, fish, etc.) and humans.
The virus is transmitted, primarily, the following ways: direct contact (including sexual transmission), airborne droplets, through household and hygiene items (shared towels, handkerchiefs, etc.), or vertical paths (from mother to child) (Cozic, 2011). Such contamination can occur in the process of birth (contact with mother’s birth canals), transplacentally or due to the virus penetration into the uterine cavity through cervical canal of the cervix (the upward path) (Cozic, 2011).
All viruses are polytrophic (omnivorous) and can infect any part of the human’s body or organs, depending on the immune disorders one has (Spencer, 2005). According to epidemiologists, women all around the world underestimate the danger of herpetic infections, whereas complications of herpes in women are more common than in men (DMOZ – Health: Conditions and Diseases: Infectious Diseases: Viral: Herpes, 2015). The herpes virus enters the nervous system through nerve endings (Spencer, 2005). After getting to the nervous system, it multiplies in nerve cells and becomes asymptomatic – latent (Spencer, 2005). In the last phase, the virus manifests itself through its replication and migration through nerve cells to the site of rash (Spencer, 2005).
Nowadays, there are known and discovered over 100 types of herpes viruses (Cozic, 2011).
Herpes is a very common disease in the modern world. According to scientific data, about 90% of the world’s population is infected with the herpes virus (Cozic, 2011). Moreover, a person can be infected simultaneously by several strains of the virus. The incidence of genital herpes is most common among women aged 20-35 years (Genital Herpes – CDC Fact Sheet, 2015). In Europe, herpes is on the second place after trichomoniasis among sexually transmitted infections (Cozic, 2011). According to the latest data researched by Japanese in the era of sexual revolution, when virtually every family, a married couple used oral sex, urogenital contacts, up to 47% of cases (out of 50) of genital herpes were caused as a result of oral sex by the first type herpes virus (Genital Herpes – CDC Fact Sheet, 2015).
The intensity of virus distribution, including genital herpes, increases significantly over time. In 1980, approximately 16% of the US population had genital herpes, while in 2002 the percentage increased up to 24% (about 60 million people) (Genital Herpes – CDC Fact Sheet, 2015). Clinical manifestations of genital herpes are very active, which causes great suspicion among the infected, and among health workers who are not sufficiently armed with the means to combat this widespread and, in general, extremely difficult disease (Cozic, 2011).
The fourth type of herpes virus (Epstein-Barr virus) proceeds in the following way in Russians, Americans and Europeans: basic, principal characteristics – the temperature to 39-40 degrees, which lasts for several weeks, severe sore throat and lymphadenopathy (swollen lymph glands) (Cozic, 2011).
However, when it reaches Chinese, especially those who live in the southern regions of China, the same virus causes nasopharyngeal cancer (nasopharyngeal carcinoma) (Cozic, 2011). All in all, the virus acts as the endemic. When the virus infects youth and young adults (the so-called young adults – 20-25 years) in Africa, the same virus of infectious mononucleosis can cause Burkitt lymphoma – a malignant tumor of the upper jaw (Cozic, 2011).
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The disease diagnostics are based on a set of anamnestic, clinical (characterized by painful vesicular rash, intoxication syndrome with hyperthermia of varying severity degrees, damage of internal organs) laboratory data (Wagoner & Hook, 2012). During the clinical activity process, the general analysis of blood sometimes detects negligible radiation with lymphomonocytosis (Wagoner & Hook, 2012). During herpetic urethritis, microhematuria and leukocyturia can be detected (Wagoner & Hook, 2012). In case of the meningeal syndrome, the CSF pressure increases, and the moderate lymphocytic cytosis is determined (Wagoner, Hook, 2012). When there is any damage to the liver, the aminotransferase activity and the level of bilirubin can significantly increase (Wagoner & Hook, 2012). According to the localization of affection, such diagnostics as ophthalmologic, laryngological, uroscopic, and vaginal are performed (Wagoner & Hook, 2012).
The methods of specific diagnostics can be divided into two groups: direct and indirect (Wagoner & Hook, 2012). Direct methods reveal the viruses in biological fluids and tissues, while indirect ones allow one to register a specific immune response to infection (Wagoner & Hook, 2012).
Direct methods of diagnosis include microscopy, polymerase chain reaction, and the cultural method (Wagoner & Hook, 2012). These methods are highly specific, reliable, but also extremely expensive. Indirect methods include complement fixation, immune-enzyme analysis of IgM- and identification of specific IgG-antibody, the reaction of immunofluorescence, latex agglutination reaction, and detection of antibodies to specific antigens (Wagoner & Hook, 2012). The methods of this group are less specific and credible but relatively cheap and can be used as screening tests. It should be remembered that any laboratory tests should necessarily be measured only with regard to clinical and anamnestic data.
During the disease’s outbreak, a dermatologist can analyze herpes virus by taking a look at the injured part of the body (in case the virus is external and no organ is affected) (Spencer, 2005). To affirm that a patient has herpes simplex, a dermatologist may take a swab from a sore and send it to a research center. In case, there are no visible indications of the virus, the respective person conducts wound restorative tests or diagnostics (e.g. blood tests can detect the herpes simplex infection). Moreover, the nursing role is of particular importance when any complications that require immediate intervention of the qualified personnel occur. Accordingly, the management tactics may vary, depending on the severity, type, location, and consequences of the virus (e.g. if a patient’s condition is hard, he/she may spend some time at the hospital under the supervision of responsible people). If the situation is not complicated, the main nursing role will be to examine a patient and assign the requisite treatment.
Patients with a mildly complicated disease course are treated at home. Only patients experiencing severe herpes infections are subjected to hospitalization. The management strategy is divided into the treatment of clinical manifestations (i.e. either primary or clinical manifestation of relapse) and anti recurrent treatment (Cozic, 2011). The therapy of clinical manifestations means topical or systemic prescription of chemotherapy antiherpetic: 0.2 g acyclovir 5 times a day for 10-14 days, valacyclovir 0,5-1 g 2 times a day for 10-14 days (Cozic, 2011). At the same time, a doctor prescribes acyclovir or pencyclovir ointment for topical use (Cozic, 2011). Famciclovir is prescribed to use 0.25 g 3 times a day for 10-14 days (Cozic, 2011). The aim of the treatment of primary or clinical recurrent manifestations is the reduction of the period of objective and subjective symptoms (Cozic, 2011).
Pathogenic therapy is determined by the presence, nature and severity of violations on the background of pathological process (Cozic, 2011).
The provocation of herpes virus recurrence can be caused by hypothermia, fatigue, and emotional stress (Spencer, 2005). When it comes to the herpes virus, a significant role is played by the human nervous system. The more stable the immune system is – the more secure is its control over the virus. Herpetic infection contributes to a significant decrease in immunity, making the body accessible to the disease (Spencer, 2005). Insufficient attention to one’s health is a vivid answer to the dilemma: “How to get ill with herpes?” A healthy lifestyle is one of the prerequisites for preventing herpes or disease recurrence. It is necessary to eliminate anything that lowers the immunity: avoid stress, do not drink alcohol and smoke tobacco, abandon strict diets (Cozic, 2011). It is advisable to participate in physical exercise, take vitamins and adaptogens, create conditions for full relaxation, and refrain from contact with sick individuals (Cozic, 2011).
A particular attention should be paid to the prevention of herpes relapse, if one plans on having a baby. Herpes during pregnancy should result in an appeal to the district midwife, who will provide appropriate monitoring of a future mother. The danger is that the virus can cause acute, including genital herpes, which already carries a potential risk to a baby’s development (Cozic, 2011).
Currently, there are no treatments or vaccines to prevent infection completely. At the same time, there are drugs that limit the reproduction, and transmission of virus through the skin, and soften the itching during the periods of symptomatic disease (Cozic, 2011). With localized forms of herpes that occur easily and with a few relapses – once in every 6 months or less, the treatment can be limited to the usage of symptomatic drugs that have a disinfecting effect (Cozic, 2011). If the disease recurs frequently, like once in every 3 months or more often, the treatment requires a special approach to therapy (Cozic, 2011). Acyclovir (tablets, injections or ointments) is an excellent pharmacological drug that helps to eliminate herpes of the first and second types, but will not kill the virus entirely (Cozic, 2011). The treatment of genital herpes is also effectively performed with the help of acyclovir (Genital Herpes – CDC Fact Sheet, 2015). The treatment of herpes in patients with severe acute or recurrent forms is performed in two stages (Spencer, 2005). During the first stage, in the acute period of the disease, a patient utilizes antiviral drugs, often both topically and orally or parenterally (Spencer, 2005). In the same period, it is appropriate to apply gamma immunoglobulins, interferons, and their inducers (Spencer, 2005).
One of the most common human viral infections is herpes simplex, which is a serious medical and social problem. Nowadays, there are eight types of herpes virus that affect human’s health. At least 90% of people in the world are infected with HSV, but only 20% have any clinical signs of infection. The doctors of many specialties in their practice have faced this disease.
A more thorough sample studies give the reasons to believe that almost all the inhabitants of planet Earth are the carriers of the absolute majority of herpes viruses. Unfortunately, there is no unique medication that can stop the dissemination and prevalence of the virus. Nevertheless, modern medicine offers a great variety of pharmacological products that help to loosen or pause the negative consequences of the disease. All in all, herpes viruses are widespread, and if the body gives grounds for their operation, the disease cannot be avoided, unless a person lives in an airtight sterile box.
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