herpes labialis

Hi,

i would like to know is it common that normal population has herpes simplex virus type 1?

Yes, you are right. Herpes simplex labialis is the most common presentation of HSV-1 (herpes simplex virus type 1 strain).

if a patient develops herpes labialis and recovers from it and the virus lies dormant in nerve cells, do he/she still infectious?

Once there is an infection, generally herpes viruses are known to remain in the body indefinitely, with viruses lying dormant in the sensory nerve ganglia (the same also happens with VZV - varicella zoster virus that causes chickenpox and herpes zoster).

When are these people infective to others?

1. When they are symptomatic
2. More than 1-2 weeks before AND after a symptomatic infection
3. During periods of asymptomatic shedding
   • Most often during the first 12 months of infection
   • But some persons may be infective for an even longer time

why certain people are just carriers and others develop the cold sores?

This is difficult to explain. As mentioned above, the natural history of HSV is that it remains in the body after an infection and most are carriers. Potential triggers for recurrence are exposure to sun, fever due to any cause, excessive stress, menstrual periods etc. Some individuals may get recurrence with no obvious triggers.

Originally Posted by kw lee

Is there any long-term complication associated with HSV type 1 in adult patient

The commonest long term complication is recurrent flare-ups. Some patients may develop herpes simplex virus encephalitis and keratitis.

Originally Posted by kw lee

What advice should medical doctor give to symptomatic patient regarding:

• hygiene practice: can they share cup/ plate/ kitchen utensil with others
• breast feeding
• with their spouse during intimate contact: are they at increased risk for HSV type 2...
• taking care of their children : avoid kissing child

HSV is contagious during active infection and all the above should be avoided. In addition, it is better to avoid sharing personal items such as razors, towels and lipstick when the lesions are active. After touching the sores, hands must be washed with hot water before any other contact.

Since HSV-1 is very common (up to 90%) in general population, it is not practical to avoid contact when the lesions are not active.