User:JMOclaman/sandbox

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Primary Infection
The likelihood of infection can be reduced through avoidance of touching an area with active infection and contact sports and frequent hand washing and use of mouth rinsing (anti-viral, anti-bacterial) products. [x] [MOU1] During active infection (outbreaks with oral lesions) avoid oral-to-oral kissing and oral-genital sex without protection. [x] [MOU2] [MOU3] HSV1 can be transmitted to uninfected partners through oral sex, resulting in genital lesions. [x][MOU4]  Healthcare workers working with patients who have active lesions are advised to use gloves, eye protection, and mouth protection during physical, mucosal, and bronchoscopic procedures and examinations. [x][MOU5]

Recurrent Infection
In some cases, sun exposure can lead to HSV-1 reactivation, therefore use of zinc-based sunscreen or topical and oral therapeutics such as acyclovir and valaclycovir may prove helpful. [x] [MOU6] [MOU7] [MOU8] Other triggers for recurrent herpetic infection includes fever, common cold, fatigue, emotional stress, trauma, sideropenia[MOU9], oral cancer therapy, immunosuppression, chemotherapy, oral and facial surgery, menstruation, and epidural morphine, and upset GI. [x][MOU10]  Surgical procedures like nerve root decompression, facial dermabrasion, and ablative laser resurfacing can increase risks of reactivation by 50-70%. [X][MOU11]

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Treatment
Despite no cure or vaccine for the virus, a human body's immune system and specific antibodies typically fight the virus. Treatment options include no treatment, topical creams (indifferent, antiviral, and anaesthetic), and oral antiviral medications. Indifferent topical creams include zinc oxide and glycerin cream, which can have itching and burning sensation as side effects and docosanol. [x]  [MOU12] Docosanol is a saturated fatty alcohol with comparable efficacy to topical antiviral agents. Due to its mechanism of action, there is little risk of HSV drug resistance.[MOU13]   Antivirals cream include acyclovir and panacyclovir [x] [MOU14] Oral antivirals include acyclovir, valacyclovir, and famacyclovir, which can have nausea and headache as side effects. [x] [MOU15] Anaesthetic creams include lidocaine and prilocaine which has shown reduction in duration of subjective symptoms and eruptions. [x][MOU16]

Treatment recommendations vary on the severity of the symptoms and chronicity of the infection. [x] [MOU17] Treatment with oral antivirals such as acyclovir in children within 72 hours of illness onset has shown to shorten duration of fever, odynophagia, and lesions, and to reduce viral shedding. [x] For patient with mild to moderate symptoms, local anaesthetic such as lidocaine for pain without antiviral may be sufficient. However, those with occasional severe recurrences of lesions may use oral antivirals. Patients with severe cases such as those with frequent recurrences of lesions, presence of disfiguring lesions, and serious systematic complications may need chronic suppressive therapy on top of the antiviral therapies.

Mouth-rinse with combinations of ethanol and essential oils against herpes as therapeutic method is recommended by the German Society of Hospital Hygiene. References