Herpes Simplex I & II
Herpes simplex I is almost inevitable (70-95%
seropositive reported world wide). Spread by casual contact
can be prevented by avoiding skin contact with active lesions.
Herpes simplex II can be prevented by the use of
condoms whether lesions are present or not. Health care
professionals should practice universal safety guidelines by
using gloves. Individuals with active infection should be
isolated away from immunocompromised individuals.
Pregnant women pose an interesting dilema; whether to
have natural birth or cesarean section to prevent neonatal
herpes via vertical transmission. A cesarean
section would prevent transmission but the procedure is
very risky for the mother and child. Several countries
advocated for examination of mothers the final 4-6 weeks of
gestation but this procedure was a poor indicator of actual
transmission. The current procedure involves examining the
cervix and vulva for genital lesions and specimens tested for
HSV. If lesions and/or HSV specimens are positive, a cesarean
section is performed.
Varicella Zoster Virus
Since infection provides lifelong immunity, no preventive measures
are recommended for Varicella infection in children. In neonates,
the immuno compromised and adults (nonimmune pregnant women), infection
could potentially be fatal. Consequently, Varicella-Zoster immune
globulin (ZIG) should be administered three days post infection.
Donors and recepients of blood or organ transplants should be
tested for the presence of antibodies. Antibodies found in recepients
indicate previous infection whereas antibodies in donors indicate
potential CMV infection. Blood should be tested when transfusing to
premature infants, pregnant women and immunocompromised individuals.
Treatment of severe CMV infection should be with ganciclovir.
This medication can also be used as a prophylactic but may have toxic
effects if used for more than three months. Forscarnet may be used as a
second-line drug once the body has build resistance to ganciclovir.
Chemotherapy has been proven ineffective in control. Please see
Human Herpes Virus 6
By the age of 2 or 3 all children have become infected.
Consequently, similar to CMV, ganciclovir or forscarnet may be used for
Human Herpes Virus 7
Human Herpes Virus 8