Cold Sores

     

Introduction

Non-genital Herpes Simplex Virus type 1 (HSV-1) is a common infection that most often involves the oral Mucosa or lips (Herpes Labialis). The primary oral infection may range from a symptomatic to a very painful sore, leading to poor oral intake thus dehydration. 

These recurrent infections cause cold sores that can affect appearances and qualities of life. Although HSV-2 also can affect the oral Mucosa, this is much less common and does not tend to become recurrent.

Labia meaning lip, but Labia of the genital are sexually transmitted but both Lip and Genital Labia; the lip and mouth Labiais called Orofacial Herpes while the mouth is Herpetic Stomatitis. (Stoma is a Greek word meaning mouth)

Non genital herpes simplex virus (HSV-1) is a common type of cold sore which is nonsexual transmitted in children and revolves around the oral Mucosa and lips (Herpes Labialis) most identified by Lesions 

Non genital HSV types of contaminations include Aphthous Ulcers, acute Paronychia, Varicellazoster virus infection, Herpangina, Herpes Gestationis (Pemphigoid Gestationis), pemphigus vulgaris, and Behçet syndrome. Other nonoral Herpes Simplex Virus type 1 infections include Herpetic Keratitis, Herpetic Whitlow, Herpes Gladiatorum, and Herpetic Sycosis of the beard area.

Epidemiology 

Herpes Labialis is common throughout the world. A large survey of young adults on six continents reported that 33% of males and 28% of females had herpes Labialis on two or more occasions during the year before the study. The lifetime prevalence in the United States of America is estimated at 25–50% of the adult population. Lifetime prevalence in France was reported by one study as 32% in Males and 42% in Females. In Germany, the prevalence was reported at 32% in people aged between 35 and 44 years, and 20% in those aged 65–74. In Jordan, another study reported a lifetime prevalence of 26%

Causes

·         HSV-1, comes in contact with oral Mucosal tissue

·         Reactivations of Virus in the body since it remain latent after treatment

·         Stress, weather, fever, dehydration, menstruation or local skin trauma

·      
            Surgical procedures like lip tattooing, Dermabrasion, neural surgery or dental

·         Infected family or hospital members affect a Child which can upgrade into the dangerous (Neonatal Herpes Simplex-NHS).

·        
          Body transfer infections after touching a Lesion (Autoinculation) usually conjunctivitis or keratitis

·         Herpetic Whitlow by sucking infected fingers

·         Herpes in the mouth is more likely to be caused by HRV-1 or HSV-2

·         The virus (HSV) duplicatively attacks inside the Neurons, Epidermal and Dermal cells.

·         It moves from the skin’s developing sensory dorsal root Ganglion when a child comes in contact with an infected person, that means Oral HSV-1 infections restarts in once affected children right from the Trigeminal Sensory Ganglia, affecting the facial, oral, Labial, Oropharyngeal, and Ocular Mucosa.

·         It is also transmitted through Kissing, sharing utensils, and towels, remember transmission occurs quickest on skin in children because it is made up of the mucous membranes.

·         Attacks can be triggered by sunlight, fever, psychological stress, or a menstrual period

Symptoms                                                                                                                                    The signs and symptoms of primary HSV or HSV -1 include sore throat, fever, painful ulcers, dizziness, nausea, headaches, but the most fastest is the acute herpetic Gingivostomatitis ( inflammation of the gums and cheek mucosa) mostly n children while for teenagers, critical Lesioned Pharyngitis occurs on the cheeks and gums.                                    The earliest infestation signs will appear in 2 to 20 days depending on the immunity of a person.

·         The reactions of a patient may show between the effected time periods of 48 to 60 hours but the signs may not be seen even after 96 hours.

·         Regular or repeated infections can be caused by extreme temperatures like sun exposure, fever, stimuli, trauma, ultraviolet radiations and immunosuppression

·         This virus is often dormant for a period of time, its flexible, meaning it will always come back especially 1 to 7 times in 5 years but of which period the symptoms are simpler and little

·         Adults get Pharyngitis like the infectious mononucleosis (Glandular fever)

·         Most people develop Dysphagia (pain swallowing) and Lymphadenopathy (inflamed lymph node) in other words, oral infection are in HSV-1 compared to HSV-2 

 

The Evolution of HRV-1

•        The Latent (virus storage area), Prodromal (tingling itchy and reddening skin on infected area)
•         Inflammation ( production and attacks on the body cells at end of nerves)
•         Pre-Sores (visible itchy, painful blisters on the lip tissue between the lip and skin Alson known as the Vermilion border but a times chin, cheeks or nose )
•         Open Lesion ( painful infectious blister burst to merge and swollen lymph gland under the jaw with fevers)
•          Crust or scab (a blood serum of Immunoglobulin proteins is formed at the healing process but more painful due to the cracks of the casts which release infectious fluids)
•          Healing (Meier complex develops underneath the scab with irritations, itchiness and some pain)
•         Post-scab (the reddish scar at the infected area showing cell renewal as scabs break off or peel off)
•          Herpes simplex Labialis (reinfection inside the intraoral HSV stomatitis also known as the mouth, contaminates the gums, back of the tongue usually with herpes Labialis, alveolar ridge and the hard palates)

Treatment

According to Australian researcher, the HSV future treatment maybe Africa’s Shea tree, butter and nuts, which Shea butter is made from?        

The Shea or Shi tree formerly known as Butyrospermum Parkii now scientifically called Vitellaria Paradoxa is indigenous to Africa as food and medication mostly in the Tribal people of Bambara, Gonja, Acholi, Kusal, Yoruba, Igbo, among others.

·         Medically, the Shea tree, nuts and butter are used to treat, colds, wounds, joint pains among others in the major 19 West and Central African Countries namely; Benin, Burkina Faso, Cameroon, Central Africa Republic, Chad, Democratic Republic of Congo, Ethiopia, Ghana, Guinea, Guinea Bissau, Ivory Coast, Mali, Niger, Nigeria, Senegal, Sierra Leone, South Sudan, North Sudan, Togo, and Uganda.

·         Oral Acyclovir suspension is an effective treatment for children with primary Herpetic Gingivostomatitis. Oral Acyclovir, Valacyclovir, and Famciclovir are effective in treating acute recurrence of herpes Labialis (cold sores). 

·         Recurrences of Herpes Labialis may be diminished with daily oral Acyclovir or Valacyclovir. Topical Acyclovir, Penciclovir, and Docosanol are optional treatments for recurrent Herpes Labialis, but they are less effective than oral treatment. 

·         Docosanol, a saturated fatty alcohol, is a safe and effective topical application that has been approved by the United States Food and Drug Administration for Herpes Labialis in adults with properly functioning immune systems. 

·         An antiviral, Anesthetic, Zinc Oxide or Zinc Sulfate cream is applied soon after it starts. Antiviral medication like Acyclovir and Penciclovir, increase the healing speed by almost 10% accuracy.  Famciclovir or Valacyclovir, is effective in a single dose, exactly a week

Transmission

HSV-1 is rare in children and often transmitted through the skin, whereas in in youth, it mostly transmitted through sexual contacts, a US college research stated that the highest population was greatest in women whose partners had records of oral sores and a non-HSV sexually transmitted disease like Herpes making the HSV-1 upgrading into Orofacial Lesions (Herpes Labialis3); 50 to 90% of adults get attacks of HSV

The virus is transmitted by direct contact with infected secretions like saliva and can remain dormant in the system until it's triggered by things like a cold, emotional stress, illness, trauma and exposure to sunlight

Prevention

The best prevention, is avoiding sharing smooches and coffee cups. Or anything with saliva contacts; do not kiss infected people, do not share towels, 

The likelihood of the infection being spread can be reduced through behaviors such as avoiding touching an active outbreak site, washing hands frequently while the outbreak is occurring, not sharing items that come in contact with the mouth, and not coming into close contact with others (by avoiding kissing, oral sex, or contact sports).

Because the onset of an infection is difficult to predict, lasts a short period of time and heals rapidly, it is difficult to conduct research on cold sores. Though Famciclovir improves lesion healing time, it is not effective in preventing lesions; Valaciclovir and a mixture of acyclovir and hydrocortisone are similarly useful in treating outbreaks but may also help prevent them.

Acyclovir and valacyclovir by mouth are effective in preventing recurrent herpes Labialis if taken prior to the onset of any symptoms or exposure to any triggers. Evidence does not support L-lysine.

Antiviral medications usual reduce the re-attacks of HSV

NOTE: People with HSV during winter or the wet seasons tend to get attack.

References 

"Cold Sores / Herpes". www.bccdc.ca. Archived from the original on 6 June 2017. Retrieved 29 May 2017.

Xu F, Sternberg MR, Kottiri BJ, et al. Trends in herpes simplex virus type 1 and type 2 seroprevalence in the United States. JAMA. 2006;296(8):964–973.

Opstelten W, Neven AK, Eekhof J (December 2008). "Treatment and prevention of herpes labialis". Can Fam Physician. 54 (12): 1683–1687. PMC 2602638 Freely accessible. PMID 19074705. Archived from the original on 2010-10-28.

Opstelten W, Neven AK, Eekhof J (December 2008). "Treatment and prevention of herpes labialis". Canadian Family Physician. 54 (12): 1683–7. PMC 2602638 Freely accessible. PMID 19074705.

Chi, CC; Wang, SH; Delamere, FM; Wojnarowska, F; Peters, MC; Kanjirath, PP (7 August 2015). "Interventions for prevention of herpes simplex labialis (cold sores on the lips)". The Cochrane Database of Systematic Reviews. 8: CD010095. doi:10.1002/14651858.CD010095.pub2. PMID 26252373.

"Oral Herpes - National Library of Medicine". PubMed Health. Archived from the original on 10 September 2017. Retrieved 29 May 2017.

Rahimi H, Mara T, Costella J, Speechley M, Bohay R (May 2012). "Effectiveness of antiviral agents for the prevention of recurrent herpes labialis: a systematic review and meta-analysis". Oral surgery, oral medicine, oral pathology and oral radiology. 113 (5): 618–27. doi:10.1016/j.oooo.2011.10.010. PMID 22668620.