Herpes simiae (B virus)
Overview
A type of herpesvirus which occurs in monkeys but can be transmitted to humans through bites or through contact with infected monkey tissue as in a laboratory situation. The virus infects the brain (encephalitis) and the surrounding membrane (meningitis).
Symptoms
* Brain infection * Infection of membrane around brain * Fever * Headache * Malaise * Vomiting * Neuromuscular dysfunction * Visual disturbances * Cranial nerve dysfunction * Psychiatric symptoms * Seizures * Paralysis * Respiratory symptoms * Spinal cord infection * Meningitis * Stiff neck * Nausea
Causes
Genital herpes is usually caused by infection with herpes simplex virus Type 2, but some studies report increasing incidence of infection with herpes simplex virus Type 1. This disease is typically transmitted through sexual intercourse, orogenital sexual activity, kissing, and hand-to-body contact. Pregnant women may transmit the infection to neonates during vaginal delivery if an active infection is present. Such transmitted infection may be localized (for instance, in the eyes) or disseminated and may be associated with central nervous system involvement. An estimated 86 million people worldwide are thought to have genital herpes.
Diagnosis
Accurate assessment helps identify infectious diseases and prevents avoidable complications. Complete assessment consists of patient history, physical examination, and laboratory data. The history should include the patient's sex, age, address, occupation, and place of work; known exposure to illness and recent medications, including antibiotics; and date of disease onset. Signs and symptoms, including their duration and whether they occurred suddenly or gradually, should be included in the history as well as precipitating factors, relief measures, and weight loss or gain. Detail information about recent hospitalization; blood transfusions; blood donation denial by the Red Cross or other agencies; recent travel or camping trips; exposure to animals; and vaccinations. (See Immunization schedule.) If applicable, ask about possible exposure to sexually transmitted diseases or about drug abuse. Also, try to determine the patient's resistance to infectious disease. Ask about usual dietary patterns, unusual fatigue, and any conditions, such as neoplastic disease or alcoholism, that may predispose him to infection. Notice if the patient is listless or uneasy, lacks concentration, or has any obvious abnormality of mood or affect.
Treatment
Acyclovir has proved to be an effective treatment for genital herpes. I.V. administration may be required for patients who are hospitalized with severe genital herpes or for those who are immunocompromised and have a potentially life-threatening herpes infection. Oral acyclovir may be prescribed for the patient with a first-time infection or recurrent outbreak. Other agents include famciclovir, valacyclovir, and penciclovir; these drugs suppress symptoms but don’t cure the infection. Daily prophylaxis with acyclovir reduces the frequency of recurrences by at least 50%, but this is only appropriate for a patient with frequent outbreaks and may not decrease transmission rate of the disease. Foscavir, a powerful antiviral agent, is the treatment of choice for herpes strains that are severe in nature or have become resistant to acyclovir and similar drugs. Administered I.V., foscavir can have several toxic effects, such as reversible impairment of kidney function or induction of sei-zures. As with other antiviral drugs, this drug doesn’t cure herpes.
Resources
Herpes simiae (B virus): Another name for Simian B virus infection