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Appendix I
PROSPECTS FOR IMMUNIZING AGAINST HERPES SIMPLEX VIRUSES 1 AND 2

Disease Description

Illness caused by herpes simplex viruses 1 and 2 generally is characterized by cutaneous and mucosal lesions; however, initial infections in some individuals are asymptomatic, while others experience severe systemic disease. Infection is complicated by lifelong retention of virus or viral genetic material in the ganglia. The latent virus may cause recurrences of the disease when activated by factors such as sunlight, fever, menstruation, stress, or drugs. The virus also may be shed asymptomatically. The disease may be severe and generalized when it occurs in immunocompromised persons, neonates, or those with atopic dermatitis. Infections of the eye may lead to blindness, and herpesvirus encephalitis can be fatal. Herpes simplex, especially type 2, has been linked epidemiologically with cervical cancer in women (Nahmias et al., 1982).

The two serotypes of HSV differ in their most frequent sites of infection and their prevalence at different ages. HSV-2 traditionally has been regarded as a virus transmitted primarily by venereal contact or by maternal genital infection to a newborn; these infections occur most often during adolescence or early adulthood. HSV-1 is found at body sites above the waist, usually the mouth, and is most common in childhood, it is usually transmitted by non-venereal contact, but can be transmitted venereally. The initial illness usually is more severe than recurrences, although, as noted above, first infections can be subclinical.

Pathogen Description

HSV-1 and HSV-2 belong to a family of DNA viruses that has over 60 members affecting a wide range of hosts. Herpes viruses in humans

The advice and assistance of Y.Bryson, W.Cates, L.Corey, M.Guinan, R.E.Johnson, A.J.Nahmias, and R.Whitley in the preparation of this appendix are gratefully acknowledged. The committee assumes full responsibility for any judgments or assumptions.



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