• Class I
• Enveloped icosahedral
• large
• infects host for life
• goes latent in neurons
• exists as episome in nucleus

• caused by stress, aging (immunosenescence), surgery or other medical interventions, cancer
• specific viruses inhabit specific neurons

HSV 1 and 2

Cold Sores and Genital Warts

Varicella-zoster virus (Herpes zoster virus)

chicken pox & shingles

Epstein-Barr virus

Mono and Burkitt lymphoma

Cytomegalovirus

mononucleosis

Environmentally fragile (outside of human host they dont survive well because theyre not hardy)

• direct contact
• HSV 1: face (kissing)
• HSV 2: sex
• greater when virus is active vs latent
• autoinnoculation (you spread it on yourself) is possible

• Virus travels up nerve to dermis (mucus membrane)
• Virus replicates in epithelial cells
• causes an immune response (inflammation, vesicle formation)
• virus can use vesicles to get to next host

• cold sores, fever blisters, h. labialis
• 5-7 days
• itching
• pain first half of occurence
• tenderness possible
• vesicle formation and weeping is common

• Genital warts, h. genitalis
• 5-14+ days
• Itching
• Pain throughout
• tenderness common
• very sensitive vesicle formation and weeping common

• neonatal herpes (from passage through birth canal)
• Herpetic whitlows (from broken skin)
• Ocular herpes (virus takes different nerve branch to eye instead of lips) 

• medications treat symptoms only be inhibiting viral replication
• Acyclovir
• Valacyclovir
• Trifluridine
• OTC pallative agents

• avoid physical contact
• condoms (HSV2)
• Gloves (herpetic whitlows)
• Vaccine: Herpevac for Women- glycoprotein subunit vaccine

HHV 3

• From respiratory droplets, lesion fluids
• contact may be direct or fomites
• humans are only host
• enter through respiratory tract or eyes

• Incubation: 10-20 days
• Pruritic (itchy) rash on TRUNK, face and forehead, sometimes extremities (centripetal distribution)
• fever, malaise (debilitating fatigue), anorexia (avoidance of food)
• symtpoms 2-3 weeks

• Macule
• Papule
• Vesicle
• Weeping from vesicle
• Scab

• Self-resolving
• Antipuritics
• calamine or caladryl
• antihistamine lotions
• baths with soda bicarbonate
• Acyclovir for extreme cases

• Fever and Malaise
• Painful and pruitic rash (may leave permanent scars)
• Nerve disorders ( paresthesia (numbness) hyperesthesia (oversensitivity))
• Treatment same as chickenpox

• Both are live attenuated, single dose
• Varivax (chickenpox)
• Zostavax (shingles) 

• Mostly viral, some bacteria
• EBV (HHV-4) causes most, then CMV(HHV-5)
• "Kissing disease" or glandular fever

• HHV4 
• 70% Americans harbor this virus
• Latency in B cells not neurons
• Integrates its DNA into the B cell host genome as a provirus 
• Doesnt exist as an episome
• can disrupt a gene necessary for cell division thus causing the cell to become cancerous 

• Saliva through kissing, sharing utensils, cups

1. HHV 4 infects B cells
2. HHV 4 goes latent, prevents B-cell apoptosis
3. T-Cells recognize infected B cells
4. Civil war between B-cells and T-cells causes symptoms. 

• Fever
• Headache
• Sore throat
• Splenomegaly, hepatomegaly (enlargerd liver)
• Malaise
• May cause tumors (Burkitt's lymphoma) 

• most cases: palliative (treat the symptoms)
• severe cases
• acyclovir
• passive Ig 
• Interferon
• no vaccine, no control measures