Herpes simplex virus

This article is about the virus. For information about the disease, see Herpes simplex. For information on the United States Navy Ship, see HSV-2 Swift.

The herpes simplex virus (HSV) is a virus that manifests itself in two common viral infections, each marked by painful, watery blisters in the skin or mucous membranes (such as the mouth or lips) or on the genitals. The disease is contagious, particularly during an outbreak, and is incurable with present technology. An infection on the lips is commonly known as a "cold sore" or "fever blister". These are sometimes confused with canker sores or aphthous ulcers, which have a similar appearance; these appear inside the mouth and are not caused by the herpes simplex virus. When asymptomatic, HSV lies dormant in the bodies of the nerve cells, replicating within the axons towards the skin during an outbreak. When the outbreak has passed, the virus 'dies back' along the nerve until it is only present in the nerve body. The dormancy of the virus within the nerve bodies contributes to the difficulty of treatment.

Transmission

HSV is generally transmitted by direct contact of lips and/or genitals when the sores are present, or just before they appear (known as shedding). In addition, herpes may be transmitted during childbirth, which can be fatal to the infant. The immature immune system of the child is unable to defend against the virus and even if treated, infection can result in brain damage. Transmission occurs while passing through the birth canal and the risk of infection is minimal if there are no symptoms or exposed blisters during delivery. The first outbreak after exposure to HSV is commonly more severe than future outbreaks, as the body has not had a chance to produce antibodies; this first outbreak also carries the risk of developing meningitis.

Outbreaks are generally preceded by sensations of burning, itching or tingling before visible blistering occurs. Subclinical shedding can also occur at any time, resulting in transmission without symptoms.

Treatment

There is currently no cure or vaccine for HSV. Treatment is restricted to Aciclovir (trade name Zovirax), which reduces the duration of symptoms and accelerates healing. Treatment should begin at the first symptoms of an outbreak for best results as far as duration and healing; should treatment begin before the lesions appear, it is possible that the outbreak can be averted.

Another option is the use of daily suppressive therapy, in which antivirals are taken every day over the course of years. Suppressive therapy reduces frequency of symptoms and recurrence of outbreaks. In addition, suppressive therapy reduces subclinical shedding, lowering the risk of transmission through sexual contact or kissing.

The amino acid lysine has demonstrated the ability to reduce the duration of infection through inhibiting the replication of the HSV. When foods high in lysine are consumed in preference to foods high in arginine, HSV replication may be inhibited; conversely, consuming foods high in arginine may interfere with the therapeutic use of lysine.

==Legal redress== link title Whether the law can help a person who catches HSV depends on the “jurisdiction” where he or she contracted it. A “jurisdiction” is a geographical area, and the world is divided into several hundred jurisdictions. Often, these correspond to whole countries: for example, Canada is a jurisdiction, and New Zealand is a jurisdiction. In other cases though (often in countries whose regions have a history of independence), jurisdictions correspond to smaller areas such as States or principalities: for example, California, Texas, New York… and all of the fifty States are each distinct jurisdictions, even though they form part of a single country (the USA). Each jurisdiction defines its own rules regarding the transmission of STIs such as HSV.

Criminal prosecutions

An example of a criminal prosecution for transmitting herpes is from the jurisdiction of "England and Wales".

The English case was called R v Sullivan. In late 1998, Dr Sullivan, in his early 30s, began dating the complainant, a lawyer, also in her early 30s. The two had unprotected intercourse over the course of seven months and, at that point, the woman claimed she experienced a primary outbreak of genital herpes. The public prosecutor brought a criminal prosecution against the doctor for sexual assault, on the basis that the woman’s consent to intercourse had been rendered void by the doctor’s failure to reveal an “important fact” – the fact that he had herpes. In the end, the judge found the doctor not guilty, because the public prosecutor didn’t manage to prove that doctor knew he had herpes, nor that – if he did – it was him who had given it to the complainant.

Civil claims for damages

Many civil claims for the transmission of herpes are heard in the 50 jurisdictions of the United States, usually based on "negligence" (if the transmission occurred accidentally) and sometimes "battery" (if the transmission was deliberate).

The first case that allowed such a claim to succeed was the 1984 case of Kathleen K v Robert B, decided by the California Court of Appeals. Other similar decisions followed including Long v Adams in 1985 (Georgia) and Berner v Caldwell in 1989 (Alabama). Since this time, such public figures as Robin Williams, Stevie Wonder, Michael Vick and others, haved been sued for monetary damages for transmitting HSV, not always successfully.

Other herpes viruses

There are eight members of the herpes virus family that are known to cause human disease, including not only the herpes simplex viruses (HSV-1 and HSV-2), but also the following:

• varicella-zoster virus (VZV, or HHV-3) which causes shingles, chickenpox, and Ramsay Hunt syndrome type 1
• Epstein-Barr virus (EBV, or HHV-4)
• cytomegalovirus (CMV, or HHV-5)
• human B cell lymphatic virus (HHV-6)
• roseola poorly characterised virus (HHV-7)
• Kaposi's sarcoma-associated herpesvirus (KSHV, or HHV-8)

References

• Herpes during pregnancy "What About Herpes and Pregnancy?". HerpesDiagnosis.com. Retrieved 2006-10-15. {{cite web}}: Check |url= value (help)
• "Herpes Symptoms". The Complete Herpes Information Center. Global Herbal Supplies. Retrieved 2006-10-15.
• Genital Herpes Reference Guide for HSV-2
• Mouth Ulcers, Cold Sores,etc