GENITAL HERPES

(Herpes Simplex Virus II)

Presented by:

Callora, Goergette Ann Mambulao, Gliza Jane

Diaz, Angelica Tado, Sahara Mae
 Genital herpes
• is a recurrence, life-long viral infection that
causes hepatic lesions (blisters) on the cervix,
vagina, and external genitalia

•The name herpes comes from the Latin

herpes which, in turn, comes from the Greek
word herpein which means to creep.

• It is one of the most common and incurable

sexually transmitted disease that is spread by
sexual activity including oral sex
TWO TYPES OF HERPES VIRUS

1.) Herpes Simplex Virus type 1 (HSV 1) - HSV type

1 infection is mainly nongenital, occurring above the
waist (often on the lips or nose

2.) Herpes Simplex Virus type 2 (HSV 2).). HSV

type 2 infection occurs primarily below the waist as
a sexually transmitted genital infection.

NOTE: It is possible for HSV type 1 to cause genital

infection and for HSV type 2 to cause oral lesions
MODE OF TRANSMISSION

• Sexually transmitted or
It can be transmitted asexually
• from wet surface
• by self transmission
• touching a cold sore
• touching the genital area
 There is no cure for herpes.
Once infected, the virus remains
in the body for life. However,
after several years, some people
will become perpetually
asymptomatic and will no longer
experience outbreaks, though
they may still be contagious to
others.
 GLOBALLY:
HSV-2 infection has never been
systematically estimated. As of
October 1, 2008 more than half a
billion people are infected with the
herpes simplex virus type 2, the virus
that causes most cases of
genital herpes, and nearly 24 million
new cases happen per ye 536 million
people aged 15-49 are infected with
herpes simplex type 2 virus.
 NATIONALLY
Philippines had approximately 21 Million
cases of genital herpes as of year 2008
according to National Foundation for
Infectious Diseases.
LOCALLY
From the Sentinel STI Etiologic Surveillance
System (SSESS) their studies showed that
the prevalence of syphilis, genital warts and
genital herpes were still not that high in the
country and particularly there is 0.03% of
genital herpes cases in Davao City.
ETIOLOGY
PRECIPITATING FACTORS:
• Herpes Simplex Virus type 2

• Multiple Sex Partners

• Unsafe sex

• Immunocompromised
 PREDISPOSING FACTORS

•Poor Hygiene
•Starting Sexual activity before 18
•Gender: Women
 SYMPTOMS:
Dysuria Anorexi
a
Halitosi
Fever
s
Dyspareunia Oral cold sores
Pain, burning and Lymphadenopat
tingling sensation hy
in the affected
area
PATHOPHYSIOLOGY
Predisposing Factors Precipitating Factors
Poor hygiene  Herpes Simplex Virus II
Starting sexual activity Before 18  Having multiple sex partners
 Unsafe sex
Gender: women  Immunocompromised

Enters mucosal surface

Initiate replication in cells of the epidermis and dermis

Viral envelope glycoprotein C (gC) binds to a cell particle

Heparin sulphate binds to variety of protein ligament (gD), (gH), (gL), (gB)

Formed a complex and creates a hemifusion state then creates an entry pore

Virus fuses directly with the plasma membrane and release

protein in the cytoplasm which includes some toxin.

FEVER Replication continues and provides entry to the cutaneous neurons Lymphadenopath
y
 Virus ascends through a peripheral nerve to the sacral dorsal ganglia

Continuous to permit infection of the sensory

or autonomic nerve endings ORAL COLD
Ulcerated Blisters at
skin the genital SORES
area Virus transport intra-
axonaly and enter the halitosis Severe
dysuria dyspareunia mouth pain
neuronal cell and
migrates in the axon
Burning and
tingling sensation
Virus takes-up anorexia
permanent residence in
the nerve cell
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 LATENCY ESTABLISH
Exposure to
FEVE strong
R sunlight
Breakage of latency causes
virus to travel back down to the
STRES nerve axon
S Irritation of
the genital
Immune area
suppression
Leads to renewal of virus
proliferation in the nerve
cell

REOCCURENCE OF INFECTION

GENITAL HERPES
 If treated If not treated:
•Medications •Complications
Acyclovir (Zovirax)
-Multiple Sclerosis
Famiclovir
Analgesics -Alzheimer’s disease
•Tests
Viral culture -Cervical Cancer
Tzanck test -Perianal ulcer

Continuous exposure to
Prevent reoccurence of outbreak infection

Overwhelming infection

Medical Sepsis
V. MANAGEMENT

• There is no cure for HVS-2 infection, but

treatment is aimed at relieving the
symptoms. The goals are to prevent the
spread of infection, to make the patient
comfortable, to decrease potential health
risks, and to be supportive and initiate a
counselling and education program.
 DIAGNOSTIC TESTS

Sensitivity
Refers to the likelihood of the test correctly
diagnosing herpes.

Specificity
The probability of a test correctly determining that
a patient does not have herpes.
A. Viral culture

• This is where the virus is grown in

material known as a culture medium. A
viral culture looks for the presence of
the virus in the lesion.
• Provides a way to tell whether the
infection is caused by HSV-1 or HSV-2
B. Tzanck Test (Herpes skin test;
Chicken pox skin test)
• The Tzanck test is a method of testing for the
herpes simplex virus (which causes
cold sores, fever blister, or genital sores), or
varicella-zoster virus (which causes
chickenpox and "shingles").

C. Blood Tests (serologic tests)

NURSING
MANAGEMENT
• Assessment
• Goals
• Nursing intervention
 Relief of Pain

 Control of Infection
 Patient Education
 Patient Education and Self-Care
for Genital Herpes
PHARMACOLOGICAL
MANAGEMENT
• ACYCLOVIR (Zovirax )

Classification: ANTIVIRALS

Indication:
• Recurrent genital herpes infections.
• Treatment of limited non-life threatening herpes simplex
infections in immunocompromised patients
ACTION:
• Interferes with viral DNA synthesis .It inhibits
the viral replication,decreases viral shedding
and reduced time for healing lesions.
ADVERSE REACTION/SIDE EFFECTS
seizure, dizziness, headache
diarrhea, nausea, vomiting
pain, phlebitis and local irritation
 IBUPROFEN (Advil )
Classification: antipyretics ,antirheumatics,
nonopioid analgesic, nonsteroidal
anti-inflammatory agent

Indication:
•Mild to moderate pain od dysmenorrheal
•Slows progression of lung disease
Action:
Inhibits prostaglandin synthesis.
Decreased pain and inflammation.
Reduction of fever.
ADVERSE REACTION/SIDE EFFECTS:

• headache, dizziness, drowsiness

• blurred vision and tinnitus

•GI bleeding, constipation, vomiting and
abdominal discomfort and nausea,
• skin rashes
 ACETAMINOPHEN (Acephen)
Classification: para-aminophenol derivative,nonopioid
analgesic, antipyretic

Indication:
Mild pain or fever

Action:
May produce analgesic effect by blocking pain
impulses, by inhibiting prostaglandin or pain receptor
sensitizers. May relieve fever by acting I hypothalamic heat-
regulating center. Relieves pain and reduces fever.
SURGICAL MANAGEMENT

There is no need for surgical treatment for

genital herpes. But if you are pregnant and genital
herpes is diagnosed or suspected at the time of
labor and delivery, a cesarean section (surgical)
delivery may be recommended to protect the baby
from getting a herpes simplex infection, which can
cause serious health problems. A mother can pass
the herpes simplex virus (HSV) to her baby if she
has a sore or blister present during a vaginal
delivery.
Thank You…