Herpes B Treatment & Management
- Author: Sowmya Nanjappa, MD; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD more...
The guidelines for medical treatment of individuals exposed to herpes B virus are complex. Refer to the most recently published guidelines for a detailed discussion. The substance of these guidelines is delineated below. Prompt attention to a potential exposure is vital to minimize the risk of this disease, which carries high morbidity and mortality rates.
Cleansing of the exposed area within minutes of the episode is the only means of preventing a contaminated wound from progressing to actual infection. The herpes B virus is likely to enter host cells within 5 minutes.
At least 15 minutes of scrubbing and/or irrigating the exposed area is recommended. Sterile saline or rapidly flowing water is used for the eye, and decontaminants (eg, soap solution, povidone-iodine, chlorhexidine) can be used at other sites.
Dakin solution (0.25% hypochlorite) has been suggested for high-risk deep lacerations or needle sticks. The solution must be fresh, and standard decontaminants should be used after a 5-minute treatment. Dakin solution should never be used to wash the eyes or mucous membranes.
Antiviral therapy is clearly indicated for suspected clinical cases of human herpes B virus infection; use of prophylactic antiviral therapy is problematic.
The decision regarding postexposure prophylaxis should be individualized and made by a health care provider experienced with the evaluation, treatment, and prevention of herpes B virus infection. Early prophylaxis may prevent either overall or symptomatic infection; on the other hand, infection is quite rare compared with the number of exposures.
The ability of therapy to prevent herpes B virus infection is not documented, and therapy can suppress shedding and seroconversion, further complicating diagnosis. In addition, the length of therapy is undefined.
Incision of wounds directed at diagnosis or treatment is usually of little benefit and can increase the risk of secondary bacterial infection. Therefore, it is not generally recommended.
For prevention protocol and specimen testing, obtain appropriate consultation from occupational health personnel of primate centers. In addition, the National Institute of Health’s National Center for Research Resources funds the National B Virus Resource Center, which is an excellent resource for numerous topics related to herpes B virus, including both diagnostic testing and education. Other resources include the Centers for Disease Control and Prevention and the National Institute for Occupational Safety and Health.
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