Herpes Disease

1.Definition

Genital herpes is genital infection with typical symptoms of clustered vesicles with a recurrent basis is eritem. Genital herpes occur in the genitals and surrounding areas (buttocks, anal area and thighs).
There are two types of HSV: HSV-1 and HSV-2 and both can cause genital herpes. HSV-2 infection is often transmitted through sexual contact and can lead to recurrence and a painful genital ulceration. Type 1 is usually on the mouth and type 2 of the genital area. HSV can cause a series of illnesses, ranging from ginggivostomatitis to keratokonjungtivitis, encephalitis, venereal disease and infection in neonates. Complications are the subject of thought and attention of several experts,
Herpes simplex-oral facial usually heal themselves. But in patients with low immunity, can be found in lesions of severe and extensive ulcer pain in the mouth and esophagus.

2. Etiology

Genital herpes caused by HSV or herpes virus hominis (HVH), which is a member of the family Herpesviridae. As for the types of HSV:
Herpes simplex virus type I:
In general, causing lesions or sores around the face, lips, mouth mucosa, and neck.
Herpes simplex virus type II:
Generally causes genital lesions and surrounding areas (buttocks, anal area and thighs).
Herpes simplex virus belonging to the herpes family of viruses, in addition to HSV which is also included in this group are Epstein Barr (mono) and varicella-zoster virus that causes herpes zoster and varicella. Most cases of genital herpes caused by HSV-2, but did not rule out HSV-1 causes the same abnormalities.
Generally caused by HSV-2 is primarily transmitted through vaginal or anal sex. Some of this year, HSV-1 has been more often also causes genital herpes. Genital HSV-1 spread through oral sex with a cold sore in the mouth or lips, but
Trigger these include trauma or coitus, fever, physical or emotional stress, UV light, indigestion, food allergies and medications, and some cases no clear cause. Transmission is almost always through good relations seksul genital genito, ano genital genital or oro.
By HSV infection may be latent without clinical symptoms and the group responsible for the spread of disease. Infection with HSV virus starting from contact with the mucosa (orofaring, cervix, conjunctiva) or skin abrasion. Viral replication in epidermal cells cause destruction of the dermis daan cellular and keradangan.



3. Symptoms
Initial infection of 63% HSV-2 and 37% HSV-1 is asymptomatic. Symptoms of early infection (during the initial episode took place at the time of initial infection) symptoms typically appear between 3 to 9 days after infection, although asymptomatic infection is slowly in the first year after diagnosis will be undertaken in approximately 15% of cases of HSV-2. Initials episode which is also a primary infection can progress to more severe. HSV-1 and HSV-2 rather difficult to distinguish.
The main signs of genital herpes is wound around the vagina, penis, or in the anal region. Sometimes the wounds of genital herpes appear on the scrotum, buttocks or thighs. The wound may appear around 4-7 days after infection.
Symptoms of Herpes Outbreaks also called, appeared in two weeks after an infected person and can only take place for several weeks. The symptoms are as follows:
Pain and dysuria
Urethral and vaginal discharge
Systemic symptoms (malaise, fever, myalgias, headache)
Painful lymphadenopathy in the inguinal area
Pain in the rectum, tenesmus
Sign :
Eritem, vesicles, pustul, multiple ulceration, erosion, lesions with krusta depending on the level of infection.
Inguinal lymphadenopathy
Pharyngitis
Cervisitis

a. Primary genital herpes
Primary infection usually occurs a week after sexual intercourse (including oral or anal contact). But it is more common after a long interval, and usually half of the cases showed no symptoms. Eruption may be preceded by prodormal symptoms, which led to wrong diagnosis of influenza. Papul a small lesion on the basis eritem and develop into vesicles and quickly form a superficial erosion or ulceration that is not pain, more often on the glans penis, preputium, and the frenulum, penile corpus is more rarely seen.

b. Recurrent genital herpes
After primary infection clinical or subclinical, at a time when there are trigger factors, the virus will undergo reactivation and multiplication of return so that there was more recurrences, at that time in the host's specific antibody, so there is disorder and symptoms arise not as heavy as the primary infection.
Trigger factors include: trauma, excessive coitus, fever, indigestion, fatigue, stimulating food, alcohol, and some cases difficult to know the cause. In most people, the virus can become active and cause Outbreaks several times a year. HSV abode in nerve cells in our body, when the virus is triggered to be active, it will move from the nerves to the skin. Then multiply and injuries can occur at the scene of the Outbreaks.
Regarding the clinical picture of herpes progenitalis: gejaia clinical progenital herpes can be mild to severe depending on the stage of disease and immunity of the host. Disease stage include:
Primary infection - latent stage - virus replication - Recurrent stage
Clinical manifestations of HSV infection depends on the place, and host immune status. Primary infection with HSV develop in people who have not had previous immunity against HSV-1 or HSV -2, which usually becomes more severe, with symptoms and signs of systemic and often causes complications.
Various clinical manifestations:
1) oro-facial infection
2) genital infections
3) other skin infections
4) ocular infection
5) disorders neurologist
6) decreased immunity
7) Neonatal herpes

4. Treatment

There is no cure that can eradicate herpes virus from the body, but antiviral medications can reduce the frequency, duration, and severity of Outbreaks. Antiviral drugs also reduce asymptomatic shedding; it is believed asymptomatic genital HSV-2 viral shedding occurs on 20% of days per year in patients not Undergoing antiviral treatment, versus 10% of days while on antiviral therapy. Non-prescription analgesics can reduce pain and fever during initial Outbreaks. Topical anesthetic treatments such as prilocaine, lidocaine or tetracaine can also relieve itching and pain.


Management of genital HERPES
Until now there has been no satisfactory drug therapy for genital herpes, but treatment generally need to be considered, such as:
local hygiene
avoiding trauma or trigger
The use of idoxuridine treatment of herpes simplex lesions locally for 5% to 40% in dimethyl sulphoxide is very useful. However, this treatment has some side effects, including the patient will experience great pain, skin maceration can also genital HERPES PREVENTION
Until now there is no effective material to prevent HSV. Condoms can reduce the transmission of the disease, but transmission can still occur in areas not covered by a condom during the excretion of the virus. Spermatisida surfactant containing nonoxynol-9 caused by HSV becomes inactive invitro. In addition, the best, do not perform oral genital contact in the situation where there are symptoms or oral herpes is found.
In summary there are 5 major steps for the prevention of genital herpes are:
Educating high-risk person to get genital herpes and other STDs to reduce the transmission of infection.
Detect untreated cases, either symptomatic or asymptomatic.
Diagnose, counsel and treat infected individuals and follow up appropriately.
Evaluation, counsel and treat sexual partners of infected individuals.
Screening with early diagnosis, counseling and treatment important role in prevention.

Provention of Herpes:
•Avaoid freesex
•Faithful to one partner
•Personal hygiene