HERPES SYNDROME : TREATMENT AND PREVENTIVE MEASURES

HERPES SIMPLEX

DEFINITION

Herpes simplex is a viral disease which affects the human body and is categorized based on the location of the infection. Oral herpes involves the face and mouth. It may result in blisters in groups often called cold sores or fever blisters or may cause a sore throat.

AETIOLOGY

It’s caused by Herpes simplex virus

There are two types of this virus- type 1 (HSV-1) and type 2 (HSV-2)

HSV-1 more commonly causes oral infections whiles HSV-2 causes’ genital infection

INCIDENCE

This is one of the most common STI’s worldwide. There has been a 17% increase in diagnosis of genital herpes. The peak incidence is in 16 to 24 years old of both sexes.

MODE OF TRANSMISSION

Transmission occurs by direct contact with body fluids or lesions of an infected individual. It may still occur while symptoms are not present. Susceptible mucous membranes include the genital tract, rectum, mouth, and oropharynx.

PATHOGENESIS

The herpes simplex virus passes through body fluids (saliva, semen or fluid in the female genital tract) or in a fluid from a herpes sore. The virus also has access to an uninfected person through the skin and mucous membranes (mouth or genital areas). It then enters the vulnerable cells and tries to reproduce in the cell nuclei destroying the host cells. Fluid-filled blisters appear which later develops into ulcers.

CLINICAL PRESENTATION

• Fever  
• Blister formation
• Myalgia
• Headache
• Tender inguinal lymphadenopathy
• Multiple painful shallow ulcers
• Vulval lesions
• Herpetic whitlow
• Herpes keratitis
• Vaginal and urethral discharge
• Sore throat
• Pharyngotonsillitis

 DIAGNOSTIC INVESTIGATIONS

• Physical examination
• History of Herpes virus infection
• Culture of virus from lesions
• Direct fluorescent antibody
• Skin biopsy
• Polymerase chain reaction 

MANAGEMENT (MEDICAL)

No method eradicates herpes virus from the body, but antiviral medications can reduce the frequency, duration, and severity of Outbreaks

Analgesics such as ibuprofen and paracetamol can reduce pain and fever

Topical anesthetic treatments, such as procaine, lidocaine, benzocaine or tetraCain can also relieve itching and pain

Anti-viral drugs such as Acyclovir, Famciclovir and valaciclovir

NURSING INTERVENTION

• Increase comfort by:
• Encourage bed rest if the disease is severe.
• Administer pain medication such as analgesics.
• Encourage patient to void in a warm sits bath if painful or retention occurs.
• Encourage fluid intake.
• Encourage patient to wear loose cotton undergarments and loose clothing.
• Instruct patient to keep the area clean and dry.
• Warm saline gargle should be given

NURSING INTERVENTION

• Restore skin integrity by
• Keeping lesions clean and dry
• Teaching patient not to rub or scratch lesion
• Teaching patient appropriate application of acyclovir cream Improve self-esteem by,
• Exploring with patient her feelings about being “herpetic”
• Encourage patient to discuss her feelings with family and significant others

PATIENT EDUCATION

• Discuss signs and symptoms with patient and means to alleviate them
• Emphasize the importance of Pap smear to detect cervical transformation
• Remind patient of the effect on a neonate and the importance of notifying her health care provider if she became pregnant.
• Review various treatments with the patient, especially acyclovir route and administration.
• Assist the patient to recognize precipitating factors such as heat, stress and fever. 

PREVENTION

Avoid oral contacts with others and sharing objects that have contact with saliva.

Abstain from oral sex

Individuals with symptoms of herpes should abstain from sexual activity whiles experiencing any of the symptoms.

Early detection and treatment

COMPLICATION

• Herpes simplex encephalopathy
• Meningitis
• Newborn infection
• Rectal inflammation (proctitis)
• Pneumonia
• Skin infections 

REFERENCE

Medicine and Medical Nursing (Revised Edition) by R. Boakye-Yiadom

Nurses’ Dictionary (25th Edition) Edited by Barbara F. Weller

Www.nhs.uk/Condition/genital-herpes  www.Medscape.com