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1. HERPES VIRIDAE Prevalent as early as ancient Greek times. Hippocrates described the cutaneous spreading of lesions. Shakespeare is thought to have been familiar with these lesions and their transmission and mentioned in his Romeo and Juliet . In 1893 Vidal recognized the human transmission of HSV infection from one individual to another. In 1919, Lowenstein confirmed experimentally the infectious nature of HSV. In 1920's and 1930's, the natural history and range of infections of HSV were studied. By the 1940's and 1950's, research established on diseases caused by HSV .

2. The members of this family are also known as herpesviruses . Name is derived from the Greek word herpein ("to creep or crawl"). Latent, reactivation , recurring and lytic infections are typical of this group of viruses. Herpesviridae , a large family of DNA viruses that cause diseases in animals and humans.

8. 2 .Growth on Chick embryo CAM Shiny, non necrotic pocks.

9. Pathogenesis Enters ‘thru’ defects in skin &mucus membranes. Local multiplication Local LN involvement. Retrograde axonal flow from sensory nerves …. Reaches Ganglia. Maintains latency Viral replication in the nerves. Decreased CMI. Centrifugal migration to skin & mucus membranes. Recurrence of the disease. Physical, Emotional stress. Trauma, Fever. Sun light. Trigeminal, Sacral

13. . Herpetic lesions in oral cavity Dental anomalies followed by Herpes viral infections.

15. Eczema herpeticum Severe form of Atopic eczema (Kaposi's varicelliform eruption.) Extensive ulceration. Eye infections: Branching/dendritic corneal ulcer.

17. -Symptomatic infections with sores, fever and lymphadenopathy of genital tract , heal within 2-4 weeks. -Patients may suffer with 4-5 outbreaks (recurrent) within a year. -Causes psychological distress. -Infection during late pregnancy poses a greater risk of transmission to the baby. - Sacral radiculopathy common with urinary retention. HSV- 2 transmitted by auto infection, sexual /orogenital contact. Most infections are asymptomatic.

18. Genital herpes Shaft of the Penis Labial herpes Perianal herpes

19. 2.Neonatal herpes Localized to Skin , eyes, mouth. Disseminated infection leads to Multi organ involvement (Liver, Adrenals, Brain) Complication: Neurological impairment. 3.Aseptic meningitis:

21. 3.Antigen detection : Fluorescent antibody , ELISA 4.Viral isolation: Cell line culture – growth within 1 -3 days. 5.Molecular techniques: PCR and DNA probes. Treatment : No cure. Acyclovir : Primary infection (< 72 hrs). Reduce the recurrences. Famciclovir: For resistant cases.

24. Lab. Diagnosis : Same as HSV. Specimens : Buccal / Cutaneous lesions Prophylaxis : V – Z immunoglobulins. Live attenuated varicella vaccine.

30. IMN like disease: Young adults. Hepatitis, fever, atypical lymphocytosis. (No pharyngitis, no lymphadenopathy, Negative for heterophile antibody) Respiratory tract infections: Pneumonitis in infants. Immunocompromised individuals: Pneumonia Fatal encephalitis Chorioretinitis

31. Lab. Diagnosis: Adults: Urine, Saliva, BAL, Semen & Cervical secretions. Neonate: Urine 1. Microscopy: Centrifuged deposits of secretions. Giemsa stain: Cytomegalic cells

32. 2.Isolation: “ Human diploid fibroblast cell” culture. Large retractile cells with cytoplasmic granules. 3.Serology: Anti CMV IgM Ab estimation by ELISA. Treatment: Ganciclovir & Foscarnet. Prophylaxis: Acyclovir.

34. Pathogenesis Infected saliva. Pharyngeal epithelial cells (Multiplies locally). Persistence Shed in saliva Invades blood stream Infects B. lymphocytes . Liver Spleen Polyclonal activation cell death . Unchecked replication results in Lymphomas Neoantigen formation Atypical lymphocytosis .

36. 2.Chronic fatigue syndrome. 3.Malignancies associated with EB. Burkitt’s lymphoma (Malignant B cell lymphoma of jaw) Nasopharyngeal carcinoma Lymphomas in HIV infected persons.

37. Lab diagnosis 1.Blood smear examination : Atypical Lymphocytosis. 2.Paul - Bunnel test: Heterophile antibody detection test. Inactivated serum + 1% sheep RBC suspension  37 0 C  4 hrs  Agglutination (>100) 3. EBV Specific antibodies: EBNA Ab EBNA Ig M VCA, Ig G VCA 4. PCR: More sensitive.

40. Alzheimer's disease atherosclerosis cholangiocarcinoma Crohn's disease chronic fatigue syndrome fibromyalgia Irritable bowel syndrome multiple sclerosis pancreatic cancer pityriasis rosea Type II Diabetes Research is currently ongoing into a variety of side-effect or co-conditions related to the herpesviruses.

41. Prepared for e -learning by Dr .P.SRINIVASULU REDDY , M D., Professor, Department of Microbiology Narayana Medical College NELLORE