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VIROLOGY PRESENTS

HERPES SIMPLEX VIRUS 1 & 2

HERPES SIMPLEX VIRUS 1 & 2

Pathophysiology

Diagnosis

Structure

Epidemiology

Infections

Taxonomy

Levels

Pathophysiology

Diagnosis

Structure

Epidemiology

Infections

Taxonomy

Levels

Pathophysiology

Diagnosis

Structure

Epidemiology

Infections

Taxonomy

Levels

Pathophysiology

Diagnosis

Structure

Epidemiology

Infections

Taxonomy

Levels

Pathophysiology

Diagnosis

Structure

Epidemiology

Infections

Taxonomy

Levels

Pathophysiology

Diagnosis

Structure

Epidemiology

Infections

Taxonomy

Levels

The Epidemiology

who - what - where - how

13%

HSV-2 has a lower prevalence But is still common.Its main site of infection is the genital mucosa

HSV-1 has a higher prevalence worldwide.Its main site of infection is the oral mucosa

67%

Herpes simplex viruses 1&2

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Route of Transmission

mother to baby during birth

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Through direct physical contact

Once it hits the neuron, it will make its way to the dorsal root ganglion where it will then establish latency for future reinfection

It will invade deeper until it reaches a peripheral nervous system neuron; infecting epithelial cells on its way

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The Invasion:

After transmission, The virus enters through weak and compromised points in the epithelial mucosa

LEVEL 1/4

Which of the following statements is true

HSv-1 targets oral mucosa and hsv-2 targets genital mucosa

HSv-1 targets genital mucosa and hsv-2 targets oral mucosa

hsv-1 and -2 both target gential and oral mucosa equally

LEVEL 2/4

All of the following are possible routes of transmission EXCEPT:

Through various forms of sexual contact

From mom to baby through the placenta

From fomites and bodily fluids

LEVEL 3/4

What is the location of latency for HSV?

Dorsal root ganglion

Ventral root ganglion

Epithelial cell nucelei

Why is HSV transmitted only through direct contact?

LEVEL 4/4

HSV cannot survive on its own, it must have a host or it can't infect

Its not, it can be transmitted via fecal-oral route too

It has an envelope that needs to be detected before infecting

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CONGRATULATIONS!

You know what HSV is!

GAME OVER

CONTINUE?

yes

NO

The pathophysiology

Breaking boundaries

How HSV infects host cells

as HSv fuses into the cell, the envelope is broken down and its contents are dispersed within. of most interest, the nucleocapsid

HSv glycoproteins are detected by receptors on the host cell's surface membrane. This initiates the fusion of virus and host cell

After replication,the new HSV will re-envelope and exit the nucleus

the viral DNA undergoes multiple cycles of transcription and translation to replicate the genome

within the nucleus, the capsid is taken apart to expose the viral DNA inside

the nucleocapsid makes its way to the nucelus

How HSV infects host cells

Now there is a new HSV ready to infect other cells !

The nucleocapsid emerges from the host cell, enveloping itself with part of the host membrane

How HSV infects host cells

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LEVEL 1/3

Where is the site of the viral DNA replication?

On the host surface membrane

Inside its own nucleocapsid

Within the nucleus of the host cell

LEVEL 2/3

How is fusion of HSV into the host membrane initiated?

It forces itself into the membrane

via Detection of viral surface glycoproteins by host receptors

HSV has adhesins on its surface that initiate the fusion process

LEVEL 3/3

What part of the virion enters the nucleus for DNA replication?

the Envelope

ONly the DNA itself

the nucleoCapsid

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CONGRATULATIONS!

You know how it breaks in!

GAME OVER

CONTINUE?

yes

NO

Family - subfamily - genus - species

Hsv-1&2taxonomy

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Human herpes virus 1/2

Simplexvirus

alpha herpesvirinae

Herpesviridae

Species

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Genus

Sub family

Family

Taxonomy

LEVEL 1/5

Which suffix is used in the naming of a virus family?

-viridae

-virinae

-virus

LEVEL 2/5

What is the family for Human simplex virus?

Simplexviridae

Herpesviridae

alpha herpesviridae

What is the subfamily for Human simplex virus?

LEVEL 3/5

Betaherpesvirinae

Alphaherpesvirinae

Gammaherpesvirinae

LEVEL 4/5

What are the subfamilies divided based on?

Their hemolysis pattern

Their host range

Their dominance levels

What genus of herpesviridae do HSV 1 & 2 belong to?

LEVEL 5/5

Simplexvirus

Varicellovirus

Herpesvirus

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CONGRATULATIONS!

YOU KNOW ITS LEGAL NAME!

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CONTINUE?

yes

NO

The Four layers

Virion Structure

Lipid envelope

Glycoproteins

The outermost layer of the virusComposed of the lipid bilayer of the host membrane after budding glycoprotein spikes initiate infection by attaching to host cell receptors

Envelope

Lipid envelope

Tegument

Glycoproteins

an Amorphous layer between the capsid and envelope filled with various proteins for virion reproduction, infection, etc. unique to herpesviridae

Tegument

Lipid envelope

Nucleocapsid

Tegument

Glycoproteins

icosahedral capsid composed of 162 capsomers its purpose is to protect the core viral genome(hence "nucleo" capsid)

Capsid

Lipid envelope

dsDNA genome

Nucleocapsid

Tegument

Glycoproteins

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Contains the entire viral genome herpesviridae all have linear, double stranded DNA

Core

LEVEL 1/5

What type of DNA is within the core of the virus?

NEXT

Circular single stranded

Linear double stranded

linear single stranded

LEVEL 2/5

What layer of herpes simplex virus is the arrow pointing to?

NEXT

The tegument

The nucleocapsid

The Lipid envelope

LEVEL 3/5

What part of the envelope initiates infection of a host cell?

NEXT

The glycoprotein spikes

The envelope itself

The proteins within the tegument

LEVEL 4/5

Which structure is unique to species within family Herpesviridae?

NEXT

The linear dNA in the core of the virus

The spiked envelope membrane

The viral protein filled tegument

LEVEL 5/5

What is the geometric shape of the HSV nucleocapsid?

Amorphous

NEXT

Helical

Icosahedral

Next Level

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CONGRATULATIONS!

You know what it looks like!

GAME OVER

CONTINUE?

yes

NO

HSV-1&2 Infections

What do they do?

Categorized based on predominant infective species. Causative agents may overlap in these manifestations

neonatal herpes

Hsv-2

Genital herpes

Herpes simplex encephalitis

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Herpetic keratitis

Hsv-1

Infections

gingivostomatitis

LEVEL 1/4

What is a notable difference between primary and recurrent infection regarding the way they present?

Primary infects first and recurring infects after that

Primary infections present with more severity than recurring

Primary infections only occur due to HSV-1 and Recurring due to HSV-2

LEVEL 2/4

Which infection uses a fluorescent stain to visualize the ulcers?

Herpetic Keratitis

Genital herpes

Gingivostomatitis

LEVEL 3/4

What is a way for a mother to avoid giving her baby human simplex virus during the birthing process?

Give her a virus neutralizing injection for the birth

bathe the baby immediately after to remove the maternal secretions

perform a c-section to minimize the newborns possibility of exposure to moms HSV

LEVEL 4/4

Which of these infection is predominately caused by an HSV-2 infection?

Herpes simplex encephalitis

Neonatal herpes

Gingivostomatitis

Next Level

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CONGRATULATIONS!

YOU KNOW WHAT IT DOES TO YOU!

GAME OVER

CONTINUE?

yes

NO

Lets diagnose

How to catch them!

Exam

Samples

seeing sores or symptoms of the before mentioned infections aid in diagnosis. however, absence of symptoms doesnt rule out HSV

proper samples to collect are Swabs from sores, saliva, Ceribrospinal fluid,bodily secretions, and blood

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Naat testing,like PCR, is the most accurate diagnostic method. Cultures and antibody detection can also be done, but PCR is the go-to.

diagnosis

Test

LEVEL 1/3

What is the most preferred testing method for diagnosing HSV?

Culture of collected sample

Antibody detection

Nucleic acid amplification testing

LEVEL 2/3

All of theses are possible samples EXCEPT:

BOdily secretions

Feces

cerebospinal fluid

LEVEL 3/3

Why do you think lack of signs and symptoms does not rule out an HSV infection?

Not everyone present with symptoms; they can be asymptomatic

It doesnt, you must have symptoms to diagnose a pt with HSV

pt might be in between recurring infections and is not currently presenting symptoms

Credits

Level Select

CONGRATULATIONS!

YOU KNOW HOW TO FIND IT!

GAME OVER

CONTINUE?

yes

NO

"7.8/10 too much virus"

- Jaye Traub

Real reviews

"Even though it was a free game...i still need compensation for my suffering"

- Kayla Kruk

"Umm? played the game and now i have HSV? WTH?"

- Michael Fullerton

"Could be better. it was not SIMPLEX enough ;D"

- Madyson Lamb

not actually true :)

"Reminds me of the only gift my ex-husband gave me"

- Abby mercer

"Came here because i heard there were peas. TURNS OUT IT WAS HERPES"

- Aisha zanib

(References)

Honorable mentions

Atlas Entry—Herpes simplex virus (Hsv) geographic epithelial keratitis. (n.d.). Retrieved March 13, 2024, from https://webeye.ophth.uiowa.edu/eyeforum/atlas/pages/HSV-keratitis/index.htm Chodosh, J., & Ung, L. (2020). Adoption of innovation in herpes simplex virus keratitis. Cornea, 39, S7. https://doi.org/10.1097/ICO.0000000000002425 Wald, A., & Corey, L. (2007). Persistence in the population: Epidemiology, transmission. In A. Arvin, G. Campadelli-Fiume, E. Mocarski, P. S. Moore, B. Roizman, R. Whitley, & K. Yamanishi (Eds.), Human Herpesviruses: Biology, Therapy, and Immunoprophylaxis. Cambridge University Press. http://www.ncbi.nlm.nih.gov/books/NBK47447/ Whitley, R. J. (1996). Herpesviruses. In S. Baron (Ed.), Medical Microbiology (4th ed.). University of Texas Medical Branch at Galveston. http://www.ncbi.nlm.nih.gov/books/NBK8157/ Zhu, S., & Viejo-Borbolla, A. (n.d.). Pathogenesis and virulence of herpes simplex virus. Virulence, 12(1), 2670–2702. https://doi.org/10.1080/21505594.2021.1982373

Stay viral :P

THANKS!

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HSV Family

Any species of human herpes viruses are a part of the family Herpesviridae. The suffix -viridae is consistent for the familial names of viruses.

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HSV Species

The species human herpes viruses 1 and 2 fall within genus Simplexvirus HSV-1 affects the oral mucosa HSV-2 affects the genital mucosa

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HSV Subfamily

Herpesviridae is divided into three subfamilies. HSV is within alphaherpesvirinae.The suffix -virinae is consistent for the subfamilial names of viruses. The subfamilies are divided based on their host range: Alpha - broad range (neurotropic) Beta - restricted range (lymphotropic) Gamma - very restricted range (lymphotropic but only T and B cells)

HSV Genus

Alphaherpesvirinae divides into Simplexvirus and Varicellovirus. Simplexvirus causes herpesVaricellovirus causes shingles. The suffix -virus is consistent for the genus names of viruses.

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We know that HSV-2 tends to target genital mucosa instead of oral mucosa like HSV-1. This puts newborns at a high risk of attracting the virus if the mother were to have HSV-2. The baby would be exposed to the virus immediately upon passing through the birth canal Important to note that the virus itself does not cross the placenta! The direct contact with the mothers secretions is what infects the baby!

From mom to baby!

• Sexual
• Oral-genital
• Kissing (especially adults to babies)
• Contact with bodily fluids
• Fomites

The only way of transmitting HSV is through direct contact. This is due in part to the virion being enveloped in the lipid bilayer. Forms of common transmission routes are:

Don't touch me !

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Reinfection of this HSV-1 manifestation is less drastic, leaving a person with only an oral lesion (called cold sores) whenever their immunity is low.

• Fever
• Sore throat
• Erythema of the throat/mouth
• Lesions (vesicular or ulcerative)

This HSV infection is a result of the host's first ever interaction with the virus. The first infection is the most severe with its symptoms of :

The Start of Cold Sores

We expect to see:

HSV keratitis is self-limiting like all other types of HSV infections. However, reinfection can lead to serious outcomes like vision impairment or even blindness

Herpatic keratitis happens when there is direct contact of HSV with the eye, or reinfection of the virus that has migrated from its initial site to the eye.

Infection of the Eye

• Conjunctivitis
• Blephiritis
• Dentritic ulcers (seen under fluorescent staining →)

Reaching the point of encephalitis can happen either at primary infection (typically in young adults since the first infection has the harsher symptoms) or during reinfection (typically in elderly since their immunity decreases over time)

HSV encephalitis usually presents with a fever, headaches, and seizures. The onset of the primary infection is insidious. Symptoms outside of encephalitis will start as minor and then evolve from there; becoming more severe with each reinfection

Big Brain

Like with all other HSV infections, the primary infection is the most severe. The severity of reinfection depends on host immunity

• Fever
• Itching
• Myalgia

A person with genital herpes can present with:

Predominantly caused by HSV-2 (although cases caused by HSV-1 have been on the rise)

Herpes Down Under

• Papules
• Blisters
• Ulcers

Rarely are there cases where baby contracts the virus before birth. Newborns affected in these cases are usually born prematurely and have a poorer prognosis

Majority of cases, the mother had passed the virus from intrapartum exposure. Those newborns exhibit fever, sepsis, or seizures.

It was noted that those who deliver via C-section are less likely to pass on the virus to their newborn.

We are aware that HSV can be transmitted from mother to baby during the birthing process if she is infected.

Why Mother

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