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neous necrosis, viremia with dissemination to various organs causing meningoencephalitis, pneumonitis, hepatitis, and coagulopathy.

DISEASE BURDEN

Epidemiology

For the purposes of the calculations in this report, the committee estimated that there are 500,000 new oral infections with HSV each year in the United States. These infections occur in people between 1 and 44 years of age. There are approximately 20,000 new ocular infections with HSV each year. These occur in people between 1 and 84 years of age. There are approximately 1,500 cases of central nervous system infection with HSV each year. The incidence was assumed to be highest in children between 5 and 14 years of age. It was also assumed that there are 300,000 new cases of genital HSV infections occurring primarily in people between 15 and 34 years of age. There are also 1,500 new cases of neonatal HSV infections each year. See Table A9–1.

Disease Scenarios

Oral Infections

For the purposes of the calculation in this report, the committee assumed that the vast majority of symptomatic primary oral infections with HSV last 1 week and are associated with an HUI of .9. 2% of the infections are associated with an HUI of .62. It is assumed that 30% of infections are associated with 10 years of minor recurrences (HUI of .9) lasting 1 week and 5% of infections are associated with 5 years of similar recurrences of a longer period per year.

Ocular Infections

For the purposes of the calculations in this report, it was assumed that all ocular infections are associated with 2 weeks of an acute conjunctivitis, keratitis, or blepharitis (HUI of .9). It is assumed that 30% of infections become chronic and result in an HUI of .9 for two weeks per year for 10 years.

Central Nervous System Infections

For the purposes of the calculations in this report, it was assumed that all CNS HSV infections are associated with a flu-like illness, and that chronic neurologic sequelae of HSV infection occurs in 20% of teenagers and 15% of



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