Talk:Herpes simplex

Herpes and Alzheimer's

• Hi There. I found some very interesting information about a possible link scientists have found between Herpes Simplex Type I and Alzheimer's disease. As the article states: "a physical connection between the herpes simplex virus and amyloid precursor protein [has been found], a protein that breaks down to form a major component of the amyloid plaques that are consistently present in the brains of persons with Alzheimer's disease." Here is the link: http://www.sciencedaily.com/releases/2003/11/031107055048.htm I'll try to write something about it if the main editors of the page think its appropriate. What do you think? Saritamackita (talk) 01:12, 15 March 2008 (UTC)

Hi Saritamackita, IMO I think, since a section on Bell's palsy made it into the article with its limited and disputed data, it would only be fair to do the same for the Alzheimer's connection (the general public may be curious about this) - only it would be better if scientific journal articles rather than popular press were used as sources and that a balanced argument is presented (i.e. although the science daily article reports a potential relationship of herpes viruses with Alzheimer's it also states that too many conclusions regarding this relationship should not be made). ~ Ciar ~ _{(Talk to me!)} 01:23, 15 March 2008 (UTC)

thanks for the feedback. I'll keep all that in mind. My only question, though, is how do I get access to these scientific journal articles without having to pay for them? Saritamackita (talk) 01:40, 15 March 2008 (UTC)

You could try going through pubmed - some articles listed there are free, so if you are lucky, you may find a relevant free article there. ~ Ciar ~ _{(Talk to me!)} 04:08, 15 March 2008 (UTC)

Hi guys, I've added an entry to the Alzheimer's section based on the publication on which the Scientific American articles is based. See recent edits from "Celian". —Preceding unsigned comment added by 192.38.44.250 (talk) 19:55, 8 December 2008 (UTC)

If Herpes simplex is linked to Alzheimer's, I wonder if Herpes Zoster (the chickenpox/shingles virus) might not be similarly linked. My dad had shingles because of chickenpox, and he eventually died of multiple system atrophy. There has been speculation that at least some of the Parkinson plus syndromes may actually be variants of Alzheimer's--Robert Treat (talk) 05:53, 25 August 2009 (UTC).

Drink plenty of water and you'll live in peace==Herpes Herbal Treatment==

• Here is another popular science article about Prunella vulgaris [also known as self-heal], an herbal herpes treatment that I found interesting. http://www.sciencedaily.com/releases/2003/05/030520083354.htm. I suppose I have the same issue writing about this as I have about writing about the Alzheimer's-Herpes link though (little to no access to scientific journal articles). I'm starting to miss college right now. Those were the days of absolute access to information.

--Saritamackita (talk) 01:39, 15 March 2008 (UTC)

I just got through writing a little thing about this along with the foot note, but the foot note didn't really work out. If someone could help me with this, that would be great. --Saritamackita (talk) 02:45, 15 March 2008 (UTC)

Cha de Bugre. Let it be known!

Antiviral activity of an extract of Cordia salicifolia on herpes simplex virus type 1. Hayashi K, Hayashi T, Morita N, Niwayama S. Planta Med. 1990 Oct;56(5):439-43. —Preceding unsigned comment added by 78.148.115.127 (talk) 16:40, 2 July 2008 (UTC)

Peer review

We got some great comments during herpes simplex peer review. I copied them to the "To Do" list for ease. If any editors want to help plough through these and improve herpes simplex for WP:FAR, please go ahead! ~ Ciar ~ _{(Talk to me!)} 02:34, 25 March 2008 (UTC)

New Link

I found a virology article that I found very interesting about Herpes. I think it would be good as an extra information source on Herpes. Let me know what you think. http://www.futuremedicine.com/doi/full/10.2217/17460794.2.1.1?cookieSet=1 Saritamackita (talk) 05:07, 25 March 2008 (UTC)

There is a database of Herpes simplex host/viral interactions at http://www.polygenicpathways.co.uk/herpeshost.html with videos relevant to each stage of the life cycle, which may be of interest. —Preceding unsigned comment added by 86.25.250.244 (talk) 02:08, 18 October 2010 (UTC)

Oral/Genital infection rates

The statistics only show HSV-1 and HSV-2 infection rates, not the location as to what's infected. Klosterdev (talk) 03:06, 2 April 2008 (UTC)

Non-drug heat treatment mentioned

There are some products (such as Hotkiss and Therapik) that use battery-powered heat and can reduce the severity of an episode. Failing to find any scholarly articles, I have added a mention of this under treatment and an on-line media link from New Zealand.SuW (talk) 21:16, 5 April 2008 (UTC)

Hi there, I reverted that addition because the link was to a press release from one of the companies themselves, and I couldn't find secondary sources. I think some sort of secondary source would be required before adding it to the article (otherwise there would be far too many links to products that claim to have some benefit). AndrewGNF (talk) 21:23, 5 April 2008 (UTC)

The pictures are...

GROSS! Why do we need to get so graphic. I'm against pictures on this article, because is can scare your every day Joe, who doesn't have a strong stomach. Herpes is bad. Nobody needs to see it. —Preceding unsigned comment added by NatWill2 (talk • contribs) 02:09, 11 April 2008 (UTC)

Nobody needs to read it. If you don't like it, don't read it. Nbauman (talk) 23:35, 7 May 2008 (UTC)

I agree - they gave me a fright when I was just looking about information about my coldsore. I don't need to see a pic of a manked up lady mank please.

Thanks. —Preceding unsigned comment added by 203.41.8.65 (talk) 00:18, 11 August 2010 (UTC)

To the person two posts above who wrote about the pics - if you have a coldsore, that coldsore could also passed along to your 'lady mank.' The pictures are educational. I wish there could be another pictures of less severe genital in addition to the current picture shown. Typically only initial outbreaks look like the pictures found in the article; subsequent outbreaks can look more like a razor bump/pimple.Anamiatan (talk) 09:50, 31 March 2011 (UTC)

Absolutely correct, the pictures are educational and should be on the site. http://www.information-on-herpes.com/herpes-pictures has some pictures and one of them shows a subsequent outbreak looking like a pimple...called crust. I had added a link to the images, but a moderator thought that they were not needed...go figure. Davidandkimbenton (talk) 16:43, 7 May 2011 (UTC)

The picture of herpetic gingivostomatitis is actually a picture of apthous ulcers, which are not caused by herpes, nor contagious.

I agree that pictures need to be graphic, but one of the primary reasons more than 90% of people infected claim they are not infected is because MOST people do not have such extreme outbreaks. It would be helpful to show pictures of more typical symptoms, and not what it looks like when you get a severe primary outbreak. 69.91.168.229 (talk) 18:56, 6 June 2011 (UTC)

'Stress' is not a proven trigger of outbreaks

I read the supposed reference link #45. In no way did it prove that stress caused a herpes outbreaks. Pure theory and nothing more as far as I can see. And note the name of the journal: "Hypotheses". —Preceding unsigned comment added by 63.193.144.79 (talk) 09:49, 15 April 2008 (UTC)

Many papers have cited stress as a trigger. The listed paper was perhaps not convincing. The only supposed trigger that has not been PROVEN to my knowledge is menstual cycle. I will try to post more refs in the near future. pikipiki (talk) 05:35, 8 May 2008 (UTC)

I disagree, from personal experience, stress can lead to outbreaks.Edmund Schluessel (talk) 02:30, 26 August 2009 (UTC)

Stress is without a doubt a trigger of outbreaks. If you need proof, read anything about the links between stress and immunology. This is common knowledge. Placebo also works extremely well to reduce the incidence of outbreaks -- this is more evidence that peace of mind/stress correlated to how well your body does at keeping the virus suppressed.

69.91.168.229 (talk) 18:58, 6 June 2011 (UTC)

In my experience, stress can indeed trigger outbreaks, but in order to include this information in Wikipedia we need reliable references. A quick search yielded this [1]. Perhaps others can find better references?--Gautier lebon (talk) 07:16, 7 June 2011 (UTC)

What?

"Risk Factors for acquiring HSV-2 include: ... black race;" Wait, what? First, there is a general consensus that there are no races. And how could a race have a color? It's like asking what color "red" has. This line should be rewritten, so it's not racist-POV. Also, there should be a source that says that certain ethnicities are more likely to be infected. Thanks, and don't turn this into a silly race conversation that has nothing to do with this POV. That could be held in some other article, such as race. —Preceding unsigned comment added by Ran4 (talk • contribs) 18:40, 29 April 2008 (UTC)

I believe that was one of my additions, and it is based on the STD surveys conducted since the early 60's and the information derived from them, as well as several retrospective seroprevalance studies done on sera collected during the NHANES studies. The information is available on the CDC.GOV website and any issues that you have with the way they title their surveys and the facts that are derived from them should be taken up with the Center for Disease Control, the US government, those researchers that have used the NHANES material in their research, or JAMA, NEJM, JID, STD, and other journals that have published these findings. If you would like more information try PUBMED.GOV and search "NHANES herpes seroprevalence". If you would really like to blow a gut, search "herpes seroprevalence survey". The paper at the top of the list, about HSV-2 in NYC, from STD April 2008, contains the phrase "Black women had the highest seroprevalence (59.7%) of any sex or race/ethnicity group." I again apologize for confusing you with facts. pikipiki (talk) 06:06, 8 May 2008 (UTC)

I also reverted your deletion. I read medical textbooks and journals all the time, and they regularly refer to "black race" or "African-American." They usually specify "self-identified." So that's what "black race" means. They also regularly refer to "Ashkinazi Jews" or "people of Celtic origin" for other diseases. Some diseases are more frequent in some populations, and "black race" is a good marker for those populations.

People with "black race," or whatever you prefer to call it, are more likely to have sickle cell anemia, and aggressive breast and prostate cancer, and diabetes, and less likely to have osteoporosis. Feel free to separate the genetic and environmental components.

The bottom line is that when a doctor has a patient in the hospital who is steadily declining while they try to figure out how to save the patient's life, they can save the patient's life more often if they use race as a clue in coming up with a diagnosis.

Would you prefer that they try to diagnose that patient without taking race into consideration? Nbauman (talk) 15:28, 8 May 2008 (UTC)

The following text is copied from a discussion on Nbauman's (talk page regarding the same subject, in an attempt to make the discussion available to all interested parties. Please help us sort out the issue in question. Thanks, ~ Ciar ~ _{(Talk to me!)} 13:54, 9 May 2008 (UTC)

Hi Nbauman, I couldn't hep but notice the small conflict beginning on the herpes simplex page over race/gender issues in the lead paragraph, so I wrote directly on the concerned user's talkpage to invite them to comment on the article's talkpage - they may be a new user that is not completely familiar with WP procedures so may not realize there was a discussion occurring there! I agree the sentence is question is a little clunky and might benefit from rewording - maybe some compromise can be worked out! Best wishes, ~ Ciar ~ _{(Talk to me!)} 17:51, 8 May 2008 (UTC)

Thanks. I'm trying to use it as a teachable moment. This issue comes up regularly. I didn't think of using the talk page of an anonymous user. Nbauman (talk) 17:55, 8 May 2008 (UTC)

I am a new user. My issue with the sentence is that you are taking seroprevalence data, and making a statement about risk factors based upon that data. Seroprevalence data of virus infections is not the same as risk factors. I have no problem with mentioning what percentage of the populuation of women, urban, racial, etc. have the HSV virus. But to say that simply having sex with a female, black person, poor person, or a city dweller puts you at risk of HSV2 is applying personal bias to the data. The risk factor of HSV2 is unprotected sexual contact. If you just limit your statement to the data without trying to apply an interptation (sp) to the data i will be content. Until then I will deleting that biased sentenced. (I did notice that you were previously lectured on Wiki's bias rules). —Preceding unsigned comment added by 70.165.104.101 (talk) 20:05, 8 May 2008 (UTC)

So sorry to butt in here - the risk data doesn't actually mean you are at higher risk of acquiring HSV infection if you have sex with the listed groups of individuals, it means the listed individuals show a higher risk of acquiring the virus themselves, from whatever source. Maybe we could move the discussion to Talk:herpes simplex? ~ Ciar ~ _{(Talk to me!)} 20:28, 8 May 2008 (UTC)

Yes, let's take the discussion to Talk:herpes simplex, which is where it belongs. I'll be glad to continue it there. Nbauman (talk) 21:05, 8 May 2008 (UTC)

From my scan of the article in question, it seems to me that the indicated populations have higher seroprevalence, but not that these groups are more likely to be infected given exposure. As it's worded now, I think it's ambiguous and would agree with a change that was more specific in simply saying that these groups have higher seroprevalence. AndrewGNF (talk) 19:44, 9 May 2008 (UTC)

Risk factor is part and parcel of the epidemiology of a disease. It does not mean they are more likely to catch the disease if exposed. It is part of diagnosing the disease. To ignore risk factors is to endanger your patient. Imagine leaving a child to die because you don't want to offend them and ask if they're Jewish and might have tay-sachs. If it will make 70.165.104.101 feel better, I'm willing to post HSV-1 neonatal risk factors which are: White race, young age, first pregnacy, HSV seronegative, and receptive oral sex in the third trimester, along with the appropriate references.pikipiki (talk) 09:43, 13 May 2008 (UTC)

Nahmias AJ. Neonatal HSV infection Part I: continuing challenges. Herpes. 2004 Aug;11(2):33-7. PMID: 15955265. Reference for my comment above on NHSV-1.pikipiki (talk) 09:58, 13 May 2008 (UTC)

As part of the copyedit process I have taken that sentence out. Not due to bias or POV, but because it just doesn't belong there. My role as a copy editor is not to evaluate the factual basis of any statement, but just to make the text read well. When I get to the epidemiology section the satement, or at least the intent of the statement will go in there. You all can argue about it then. :) Livitup (talk) 20:43, 23 May 2008 (UTC)

Copyedit Progress

Greetings from this humble representative of the League of Copy Editors... :)

Normally when copyediting an article I just attack with my red pen, and upload the changes all at once or in big chunks. But since this article is long, complex, and has subject matter experts actively editing the article I'm going to take a different approach. Since you all are far more familiar with the subject than I am, I'm going to propose major changes here for your comment, before I make them. This will draw out the copyedit process, but I think the reward will be a much better article and no angry editors. :)

To start with the lead:

• Overall comment, the lead is really long. There's a lot of detailed information that I think should be moved to individual sections of the article. I'll make those changes, but make that the last edit, so you can revert it if you think I cut too deep.

Agree, the unfortunate problem with having a long article is the intro tends to grow - I've tried to cut down some of it, but it needs someone with better grammar to form more efficient sentences. Chop away - there should not be any info in the lead that isn't covered in more detail in the main article. There is one sentence in particular (see the discussions above on this talk page) that is causing concern that may need some subtle tweaking so it doesn't get misinterpreted too - any suggestions?~ Ciar ~ _{(Talk to me!)} 17:11, 23 May 2008 (UTC)

You wanted the red pen, you got the red pen. :) Oh, and I took care of that troubling sentence in particular. :) I think that's something you can cover in more detail in the appropriate subsection, which will probably result in people reading it better and not getting worked up about it. :) Livitup (talk) 20:32, 23 May 2008 (UTC)

• I agree with your peer reviewer that references don't belong in the head. Hopefully my reworking the head will take care of a lot of that, but you can help me by moving the references to the first place that those facts are stated in the article.

I did this, and I think I preserved all your references too! Not bad for someone who hates research. :) Livitup (talk) 20:32, 23 May 2008 (UTC)

• From the first paragraph: "Oral herpes, colloquially called cold sores…" I think should read "Oral herpes, the visible symptoms of which are colloquially called cold sores…" Would that be more factually correct, as the sores themselves are not herpes per se, but symptoms of the viral infection?

I do not have any problem with your alternative so would support that change.~ Ciar ~ _{(Talk to me!)} 17:11, 23 May 2008 (UTC)

Done. Livitup (talk) 20:32, 23 May 2008 (UTC)

• End of the first paragraph: "Occasionally, these viruses reactivate and return to the area…" Occasionally is vague, can you quantify it at all?

This is a difficult thing to do - reactivation differs from individual to individual - some people have reactivations many times in a year, others never (noticeably) reactivate.~ Ciar ~ _{(Talk to me!)} 17:11, 23 May 2008 (UTC)

Meh, I just cut the sentence. I cover the posibility in another statement, and you can delve more deeply into this in the relevant section. Livitup (talk) 20:32, 23 May 2008 (UTC)

• Third paragraph: "developing countries, such as those in Sub-Saharan Africa…" and "industrialized countries like the United States and countries in Northern Europe…" I think calling out individual regions or countries isn't necessary and is probably even pejorative. Can we let the terms "developing countries" and "industrialized countries" stand on their own?

Yes, the regions are described in more detail further down the manuscript in the epidemiology section - perhaps this actual sentence (in a more elgeant form ;)) can be moved to the introductory statement for that section?~ Ciar ~ _{(Talk to me!)} 17:11, 23 May 2008 (UTC)

Cut it for now, but I'll remember to make sure the intent is conveyed in the proper section. Livitup (talk) 20:32, 23 May 2008 (UTC)

• Also in the third paragraph: "The risk of infection for HSV-1 is associated with lower standard of hygiene and a more crowded living environment." Lower than what? More crowded than what? Again, I fear POV influence with these statements.

Ahhh, this is getting into the risk assessment statements - they need work! So, I think this part is supposed to highlight that higher seroprevalence of HSV-1 is reported in groups that live in more crowded environments - the hygiene thing I'm not sure about. With the additional sentence closing out that paragraph, I think this sentence is actually redundant and may be removed - maybe another editor should comment.~ Ciar ~ _{(Talk to me!)} 17:11, 23 May 2008 (UTC)

I agree, and I removed it. This goes along with the general theme of not cluttering the head with details, it's just a summary. You can cover that later in the epidemiology. Livitup (talk) 20:32, 23 May 2008 (UTC)

I will go ahead and make some minor edits to the prose, punctuation, and grammar, but will wait for your comments for the bigger edits. Livitup (talk) 16:18, 23 May 2008 (UTC)

Yay! Welcome Livitup!! I am glad you have arrived - the article is in dire need of copyediting! I've responded to some of your comments above - hopefully in a helpful way. There are some other editors that regularly come through here too, so maybe they'll add some comments too. Please, work your magic and if anything looks out of place, I'm sure we can communicate that with you here. Thanks. ~ Ciar ~ _{(Talk to me!)} 17:11, 23 May 2008 (UTC)

*shy bow* Let me know what you think of what I did to the head and we'll progress from there. Livitup (talk) 20:32, 23 May 2008 (UTC)

Wow....how do you guys do that!!??! The intro is much improved and reads very smoothly - thanks! Looking forward to the rest :o) ~ Ciar ~ _{(Talk to me!)} 21:20, 23 May 2008 (UTC)

• Hi again. The section lead for disorders and orofacial herpes are done. I cut out a number of lines that dealt with seroprevalence in underdeveloped vs. industrialized nations. I think that discussion belongs soley in epidemiology. I'm saving everything I cut in a Word document, so I'll make sure all the things I cut end up back in the article at some point. I also trimmed a chunk out about how the virus goes latent in the nerves. Since this seems to be the case for all the disorders, I'll go back to the section head and add this information back in there, and clarify things for a particular disorder when needed. Let me know what you think! I'll try to get a handful more disorders done tomorrow. Livitup (talk) 20:08, 29 May 2008 (UTC)
• Up to (but not including) Ocular herpes is done. Please give feedback. :) Livitup (talk) 20:20, 30 May 2008 (UTC)
  • Sorry my responses are taking so long. I'm a little swamped right now!! I rearranged one sentence a tiny bit, but everything else looks grand! I'm happy about you moving chunks of seroprevalence data into epidemiology - it would be much better placed in that section. I can see the same thing is needed for the neonatal section, which is getting a little long. Looking good so far Livitup. Thanks, I greatly appreciate the help!! ~ Ciar ~ _{(Talk to me!)} 20:25, 2 June 2008 (UTC)
    • Es no problemo. I've actually been absent for several days myself... on a much needed "unplugged" vacation. Just wanted to update you that I haven't abandoned you and I'll be back with more sections shortly. Livitup (talk) 16:21, 11 June 2008 (UTC)

• I've written articles about HIV for doctors, and I've written medical articles on other subjects for non-doctors.

My impression of the lead is that the vocabulary is too difficult for the ordinary reader. Believe it or not, there are intelligent, well-educated people who couldn't define "immunocompetent."

I even think the language is too complicated for doctors. The general medical journals would simplify that language, at least in some sections of the journal. (Why say "colloquially" instead of "commonly"?)

When I finish writing something, I go through it word by word, and ask myself, "Is there a more common word that would say the same thing?" Then I go through it sentence by sentence, and ask myself, "Can I rewrite this in a simpler sentence (or two simpler sentences) that would say the same thing?"

BTW, that last edit is incorrect -- about 1/5 of the population is infected with HIV, according to blood tests, although they don't always show symptoms (I guess the article didn't make clear the meaning of "seropositive.") Nbauman (talk) 15:28, 8 June 2008 (UTC)

Hi Nbauman, The article is still a bit substandard when you consider something for FA or real publication quality (and I can say that since I have done a lot of the poor hashing of it recently!) but Livitup is doing a great job whittling the excessive and redundant text down to something comprehensive. I think once that painful job is done, we can start looking at the "complete article" and assess its shortfalls as far as content and readability to a wide audience go. I think it would be great to have your expertise for this process if you are interested in helping out. As for the words you point out, yes, I agree "immunocompetent" is not a word in common use but we should probably introduce it somewhere in the article so readers begin to understand the terminology since it is used a lot around these disease articles on wikipedia. It is, at least, linked in the lead for the time being. Colloquially, however, I do not have a problem with, and have been using this word myself since I was a young teen - and believe me, I'm no English major :o). I think, since "commonly" is used in the following sentence, the word "colloquially" allows a little variation and makes the article read a little more interestingly, don't you think? The last comment you made, I'm uncertain how to answer - are you referring to the anonymous addition (and deletion) of "HSV" infection that occurred here?. Yeah, I can understand how the seroprevalence of HSV infection is confusing. I did begin to introduce that into the epidemiology section - but again, it is not great and needs some other eyes. The HSV seroprevalence/blood test data, I think gets confused by people working in non-herpes viruses - folks I know working in the field actually base the number of people infected with HSV as the same as people with antibodies against the viruses because HSV is not typically cleared from the body (it just hides) - so the difference we need to define and make clear is HSV antibodies may be the same as infection but is not an indicator of "active" disease. Of course, the 1 in 5 HSV positive people only reflects values in the United States - we need to keep this clear too and not give the article too much North American bias. If you have any suggestions on how to define this clearly, please, please, please add it - your contributions would be most welcome and I need all the help I can get!! Thanks, ~ Ciar ~ _{(Talk to me!)} 18:46, 8 June 2008 (UTC)

Just to take one point -- I know that many people believe that variation makes writing more interesting to read, but I object to it in medical writing, where the most important goal is to be clear to the reader (who may be reading it alone at 2am in confusion and panic). In medicine, the terms are precise, and there's a big difference between "incidence" and "prevalence," for example. I try to be safe and use the same word that my source used, unless I'm very familiar with the subject. I once worked in a law firm, where the clear, precise meaning of the language was also very important (when somebody reads a will 20 years later, for example), and they always repeated the same word for the same concept.

Then there are foreign speakers. A recent article in the New Scientist pointed out that most people who use English are not native speakers. I know lots of native speakers of French and Norweigian who speak excellent English, but there are others who are still learning it or struggle with it. Sure, they know what "colloquially" means, or they can look it up, but the more syllables you have, and the less-common words you have, the more difficult it is to read. This is especially true when the reader has the burden of trying to understand technical information. When you add the burden of a less common vocabulary to that, it becomes much more difficult to understand. There actually is published research on this, but I think it makes intuitive sense too.

The best example of medical writing for the layman that I know of is the Merck Manual Home Edition. If you want to write clearly for the layman, read that and do what they do. That's what I do.

But even medical journals, like BMJ, edit their magazine to use simpler vocabulary. Even if you're a doctor and you know all this jargon, it's just easier to read simpler language. Nbauman (talk) 20:43, 8 June 2008 (UTC)

I have no dog in this fight; as a copyeditor my role is to make the article conform to the manual of style and rules of English. As such I try very hard not to change the tone or meaning of text I edit. I take this rule particularly to heart when dealing with technical articles where the inferred meaning of a word may change the way a reader interprets a researcher’s work.

What I have been doing is adding wikilinks to words that I think are medically specific or not commonly known by the medical layman–a category I fall into myself. My personal opinion is that linking medical terms is probably an acceptable middle ground for an article where technical terms are required.Livitup (talk) 16:21, 11 June 2008 (UTC)

People often say, "If readers find a word they can't understand, they can just click on the Wikilink." I strongly disagree. The link is usually as difficult to understand as the original article. I always use a specific example, which usually convinces people.

For example, suppose someone wanted to understand what Immunocompetence meant in this article. And they have a good reason for a precise understanding -- you're telling them, "Don't worry, it's not fatal if you're immunocompetent." People can get very worried when they read medical information in Wikipedia. (One woman wrote in one of the Talk pages that when she read the article on -- I think -- multiple sclerosis, she cried.)

Click on Immunocompetence and see what you get:

Immunocompetence is the ability of the body to produce a normal immune response (i.e., antibody production and/or cell-mediated immunity) following exposure to an antigen....

If you parse that sentence, it's ultimately saying, "Immunocompetence is a normal immune response," and if you parse it further, you get "Immunocompetence is immunocompetence." That's not much help.

In order to understand that definition, you have to understand the words:

"immune response"

"antibody"

"cell-mediated immunity"

"antigen"

I've talked to cancer patients, social workers, and other non-specialists who are likely to read my medical articles, and I was surprised to find that even intelligent, well-educated people don't know a lot of words that you or I would take for granted. After those conversations, I would never use phrases like that in an article without defining them, because I know they won't understand them.

If you have no special medicine or biology training, I'll put it to you: Define each of those words without looking them up. Can you tell me off the top of your head exactly what "cell-mediated immunity" is?

Wikilinking is no excuse for not writing an article in easy layman's language in the first place. (I do think that we should follow the everyday terms with technical terms in parenthesis, as the Merck Manual does, so people can learn the technical terms.) Nbauman (talk) 18:55, 11 June 2008 (UTC)

Several issues have been confused during the copyedit process. Certain areas of HSV-1 and HSV-2 have been mixed and some of the references are no longer in the right places. I would suggest that the intro is general info on HSV, and later in the body of the article the details HSV-1 and 2 would be provided. I'll try to put in time next week. I also added somewhat to the immunocompetent page. Let me know if it's clearer.pikipiki (talk) 14:57, 13 June 2008 (UTC)

Please don't take offense, but no, I don't think it's clearer.

Let's start again. What's the most important thing people should know about herpes simplex? How would you say it in the simplest possible sentence? (I think that sentence should have the word "blister" in it.) Nbauman (talk) 18:01, 13 June 2008 (UTC)

I was keenly aware of the risk of mucking the article up during the copyedit process. I have no medical training, and I'm afraid that is showing here. The most I knew about herpes before this is that I don't want to get it. :)

So.... If I'm breaking things, from a factual standpoint, please let me know. What I was trying to do was focus on one particular topic at a time and limit the discussion of a particular topic to the section that addresses that topic. I fear that's where I may have introduced inaccuracies in the text. The article jumped around quite a bit before I started mucking with it, especially in the Disorders section; there was discussion of treatment and epidemiology of each disorder within the section for the disorder itself. But when I get to the epidemiology section I don't know what I am going to do, because a lot of that discusses the rates of infections for specific disorders. ARGH!

Another current problem is that we use "HSV-1" and "HSV-2" for the first time in Disorders, but they are never defined before that; there is no section that talks about the virus itself. I think I'll add a sentence or two with a link back to Herpes Simplex to do the heavy lifting for the virus.

This is harder work thank I expected. :) Oh, and if you want to start swapping out medical terminology for language a layman would understand, I won't object. Part of me says that, as an encyclopedia, we can write to a more technical level than we would a newspaper article, but I also see your points, Nbauman. Livitup (talk) 19:04, 16 June 2008 (UTC)

I was always taught that a medical writer or editor had to thorougly understand every word of the copy that he was editing. If you don't understand it you have to find out, by starting with the Merck Manual, if necessary, and reading the original papers until you understand it. We used medical dictionaries very heavily.

Some publishers do use editors who may not know the technical material, but can read it with a non-specialist's eye and tell us whether it's easy for a non-specialist to understand. Those editors make a lot of queries, and by the time they get through with the article, they should understand it as thoroughly as everyone else.

But you can't edit something you don't understand. I can't imagine how you could do it. Nbauman (talk) 22:08, 16 June 2008 (UTC)

Grammar and style are the same whether you are writing about apples or oranges. I'm not saying I don't understand, but I'm not in the medical community, so my level of knowlege is probably just a bit north of the lay-person. That said, I was able to figure out what immunocompenent meant. :) I research where I need to, I ask questions of the authors when needed, and if I doubt myself, I don't make the change. Sure, medical publishers can employ copy editors with medical backgrounds, but for the rest of the non-specialist world, non-experts will have to do. I did OK when I was a features copyeditor, without being a specialist in the civil war, local politics, ballet, opera, or any of the other hundreds of topics that crossed my desk. 194.78.35.170 (talk) 16:16, 17 June 2008 (UTC)

Sorry, I forgot to log in before posting that. :) Livitup (talk) 16:18, 17 June 2008 (UTC)

There's one big difference between medical editing and everything else -- medical editing can be much more important to the reader's life. Someone wrote in Talk that, when she read the article for (I think) multiple sclerosis, she cried, because the life expectancy was so short. Medical writing has to be much more accurate. The stakes are higher. If I get my facts wrong, I can really hurt somebody. Nbauman (talk) 17:50, 17 June 2008 (UTC)

Virus active in saliva?

I didn't see any info on this in the article, but is the HSV-1 active in your saliva at the time of an outbreak or any other time? Most cold sores occur on or around the lips which would be close enough to your mouth to assume your saliva is infected, but if you have a cold sore under or in your nose, or on your cheek, would the virus be present in your saliva as well? Related, during asymptomatic shedding, would it also be present and active in your saliva? If it was in your saliva, then technically you would be able to spread it by coughing or sneezing on someone close enough to inhale the small particles. Is there any research on this anywhere? —Preceding unsigned comment added by 209.66.100.204 (talk) 16:45, 2 June 2008 (UTC)

Yes, HSV-1 is typically spread in childhood and adolescence in undeveloped countries and lower SE circles through non sexual transmission, whereas HSV-2 is almost always associated with sexual transmission. You can search pubmed.gov using the search terms "HSV" or "herpes," "shedding," and "saliva,". One does not need lesions to shed and because 60%-98% of infection is asymptomatic, virus is often shed from the oral cavity (but not from the parotid gland) without any detectable signs and it is subject to certain triggers such as sunlight, stress, and trauma.pikipiki (talk) 14:45, 13 June 2008 (UTC)

Edit of 19 June 2008

"Lexicon" -- do you mean "vocabulary"? Yes, your vocabulary is too technical.

Why say "lesion" instead of "sore"? Why say "alleviate" symptoms instead of "reduce" symptoms? Why say "symptomatic episodes" instead of "symptoms"?

Before you do any more, stop and read the Elements of Style.

A later edition of The Elements of Style had a nice section that told you to use simple, familiar words instead of latinate words, but that edition is still under copyright and not free on the Internet. It's good advice anyway.

Section 9, "Make the paragraph the unit of composition: one paragraph to each topic," would be particularly helpful. Nbauman (talk) 15:32, 19 June 2008 (UTC)

Gosh, I have to agree with Nbauman, the lead was much better before. I'm sorry to say that Pikipiki - I know you meant well. The whole point of having the article copyedited was to reduce the unnecessary detail and jargon, especially from the lead section, which was way too long before the copyedit began, and I think Livitup had done a pretty good job. Other than the inclusion of the two different HSV viruses, do we really need to put all that extra information back into the lead? Detail is supposed to go into the main body of the article, no? ~ Ciar ~ _{(Talk to me!)} 16:04, 19 June 2008 (UTC)

I wasn't going to say it myself, but I agree for the most part.

Otherwise, my status update for today is:

• Disorders—All done, except Neonatal. There were some major changes to that section reciently, and I want to see if you decide to keep them before I edit that section. I had an off-line edit of that section done, using the old version, which I can use to edit it again. Let me know when consensus is reached on that, or if I should just tackle what's there now.
• Recurrences and triggers—Done
• Transmission and prevention—I've done an initial copy edit of this. As part of it, I merged the Asymptomatic Shedding section into this section. I need to go through it again on paper and do a second pass. I think some things don't align perfectly in this section yet.
• I have copyedits done on paper for Diagnosis, Treatment, and Psychological and social effects. I'll upload those Monday.
• I haven't touched Epidemiology yet. :)

A comment on the comments of Nbauman: I tend to agree with you that the entire article could be made to read more simply. I'm reluctant to do that all by myself, as I'm afraid I could change the meaning of something by substituting a "common" word for a technical/medical word. Is a sore the exact same thing as a lesion? I propose to continue on my current path, finish this current copy edit, and then revisit the issue as a whole when the prose is otherwise stable.

Feedback is always welcome. Livitup (talk) 21:05, 20 June 2008 (UTC)

Now you're getting it. Is a "sore" the same thing as a "lesion"? That's exactly the kind of question that continually comes up when anyone tries to edit medical text, and that's why medical editing is so difficult.

The meaning of "lesion" actually depends on the context. I just did a quick text search through the NEJM, and "lesion" is used to refer to lung cancers, multiple sclerosis spots, skin ulcers, areas of abnormal bone thickness, areas of abnormal bone thinness, areas of damage to a chromosome, things that appear on an x-ray that they can't identify, and almost any injury or damage to a specific area.

It's a lot easier to edit these things if you can query the doctor who wrote it, or if you have a doctor or editor nearby that you can ask.

Otherwise, you have to understand the material very well. The best way I've found to understand it is to start with the Merck Manual (which is free online), and read a few review articles, preferably in the New England Journal of Medicine (which is not free). With PubMed, you can find review articles that are free online, although some are easier to understand than others. Some of the easy journals to understand are American Family Physician and the Canadian Medical Association Journal. Articles in JAMA are free after 1 year. Medscape is free and sometimes has good review articles but it's not always that easy for laymen to get through. Same for eMedicine.

Actually, there really is a need on Wikipedia for people who don't understand medicine that well to read medical entries and tell us which articles are too difficult for a layman to understand. That's a big problem. We need people to mediate disputes between editors who want to simplify it and editors who want to make it more technical (or as they would say, "precise"). Nbauman (talk) 06:31, 21 June 2008 (UTC)

June 24...

In the diagnosis section there is the sentence:

"Primary orofacial herpes is readily identified by clinical examination in persons without a previous history of lesions, and with reported contact with an individual with known HSV-1 infection."

Question for the medical team: does the person need to fit both of these conditions (no previous history and reported contact) or either of these conditions (no previous history or reported contact)?

Thanks! Livitup (talk) 18:30, 24 June 2008 (UTC)

It means both in this context. GrahamColm^Talk 18:40, 24 June 2008 (UTC)

OK thanks! Livitup (talk) 18:44, 24 June 2008 (UTC)

• (re)Edited the lead.
• Can someone take a look at this sentence:

"A Tzanck test (smear) can also be performed, although this cannot differentiate between herpes simplex and varicella (chicken pox) (the primary infection of varicella zoster virus (VZV or shingles)."

For one thing you're missing a closing bracket. For a second thing, the latter part of that sentence is awash with brackets anyway. How much of that can be cut out if a Wikilink is added? This is an article about Herpes, not varicella/chicken pox/varicella zoster virus/VZV/shingles. Livitup (talk) 18:44, 24 June 2008 (UTC)

I recommend deleting the whole sentence, (and any reference), this test is not widely used and it does not confirm HSV infection. GrahamColm^Talk 19:38, 24 June 2008 (UTC)

• Treatment contains the following senetnce about Abreva:

"It was the subject of a US nationwide class-action suit in March, 2007 due to the misleading claim that it cut recovery times in half."

I don't know about this—I work in the UK. GrahamColm^Talk 19:38, 24 June 2008 (UTC)

Was the drug's manufacturer (Avanir Pharmaceuticals) the defendant? I can look that up myself if nobody else responds before the next time I look at the article. I would like to reword that sentence, but I'm missing something. Otherwise Diagnosis and Treatment are both done. Livitup (talk) 19:25, 24 June 2008 (UTC)

As of June 30...

I have done what I consider my final pass through this article. I have uploaded all my work up to Transmission and prevention. I have on-paper edits for the rest of the article, which I will try to upload tomorrow. Livitup (talk) 19:05, 30 June 2008 (UTC)

Copyedit Complete

Well, it took more than "tomorrow", but I finally uploaded all my changes to the article, and I consider it about as completely copyedited as I can make it.

My parting suggestion would be to strip some sections of the article out into thier own articles. I'm thinking mainly of the Epidemiology sections—they could become one article Epidemiology of Herpes Simplex. If you want any help writing a summary to include in the main artilce, I'd be happy to work on it; just ping me on my talk page.

It's been fun and educational. Sorry it took so long in the end, and I hope you're happy with my contributions. Best of luck and happy editing. (Oh, and please let me know if the article makes it to FA.) Livitup (talk) 19:45, 8 July 2008 (UTC)

Thank you so much!! It is definitely an improvement - now we can see the stuff that needs to be fixed and referenced. I agree that sub-articles are needed. The neonatal section is getting huge and can probably stand alone. Maybe if I ever get any free time I might tackle it :) Good luck with the your next copy-editing job....I'm sure it will be a breeze compared to this one huh!!!! ~ Ciar ~ _{(Talk to me!)} 17:15, 9 July 2008 (UTC)

Epidemiology: North America: United States

The first two paragraphs of this section are very confusing with the use of the term "seronegative." For example, the sentence "Women that are seropositive for only one type of HSV are only half as likely to transmit HSV as the seronegative mother" seems nonsensical unless it is clarified that this seronegative person is indeed infected with the virus. Perhaps "infected, but still seronegative" or "infected, but not yet seroconverted" or something along that line would clarify. As it is, it appears to say that a seronegative mother (implying uninfected, without clarification) is more likely to transmit a virus that she does not have than someone who has the virus.

Dr.Luke.sc (talk) 16:03, 12 August 2008 (UTC)

Hi Dr.Luke.sc, Thanks for pointing out the issues that need fixing - this article is not quite done and still needs improvement, so your comments are much appreciated. I have reworded the paragraph a little to (hopefully) make more sense out of it. Feel free to reword if your language skills are better than mine :)

Best wishes, ~ Ciar ~ _{(Talk to me!)} 17:11, 12 August 2008 (UTC)

Hello ~ Ciar ~ Thanks. It is much better now. Yesterday, I made a minor change in the next paragraph and combined the two, as the latter appeared to be a concluding disclosure of the former. Another thought: does that much discussion of immunological mechanics actually belong there, or should

A seronegative mother that contracts HSV at this time has up to a 57% chance of conveying the infection to her baby during childbirth, since insufficient time will have occurred for the generation of protective antibodies before the birth of the child, whereas a woman seropositive for both HSV-1 and HSV-2 has around a 1-3% chance of transmitting infection to her infant.[70] Women that are seropositive for only one type of HSV are only half as likely to transmit HSV as infected seronegative mothers.

be a part of Transmission and prevention? Please have a look at what I just changed and see what you think.

Best regards, Dr.Luke.sc (talk) 15:19, 13 August 2008 (UTC)

Is this wrong?

From the section on neonatal herpes: "The resulting increase in the number of young women becoming sexually active while HSV-1 seronegative has contributed to increased HSV-1 genital herpes rates..." ...I was under the impression that they were getting the virus from someone and they're not all lesbians. Shouldn't it be young people/adolescents? I'm completely ignorant about biostatistics, it just struck me as possibly unintentionally POV. 70.181.43.249 (talk) 15:55, 3 October 2008 (UTC)

Yes and no. I believe this statement was originally part of the neonatal herpes section explaining the mechanism by which the mother and then the baby contract herpes. That said, anyone (male or female) who is seronegative and engages in oral sex with a seropositive partner runs the risk of infection. However woman are more susceptible and always have a higher seroprevalance then their male counterparts in every segment of society. pikipiki (talk) 05:56, 25 August 2009 (UTC)

This Article Contradicts Itself

In section "Mechanism"

"Antibodies that develop following an initial infection with a type of HSV prevents reinfection with the same virus type—a person with a history of orofacial infection caused by HSV-1 cannot contract herpes whitlow or a genital infection caused by HSV-1. "

In section "The risk of spreading the disease"

"The virus requires physical contact to spread, and accordingly it is possible for the virus to spread to other points on the infected individual's body. This can occur after the virus presents itself on the hands or fingers ("herpes whitlow") - which can occur via masturbation or simply prodding an infected site."

There is no contradiction. Prior to seroconversion a person can reinfect other areas of their body, this is called auto-inoculation. The classic case would be a toddler with a primary oral infection who sucks his thumb and gives himself a herpetic whitlow on his thumb. After seroconversion, an immuno-competent person cannot re-infect another area of his body. Antibodies prevent this from occurring.pikipiki (talk) 05:56, 25 August 2009 (UTC)

Saliva's effect on cold sores

Petroleum jelly is cited as being effective against cold sores because it keeps water and saliva from coming in contact with the cold sore. Why is contact with water or saliva a bad thing? I think this needs more explanation as to why saliva or water reduce the healing time for cold sores. 199.46.200.232 (talk) 20:16, 3 February 2009 (UTC) Jagguar

Check pubmed for papers on "lactoferin".pikipiki (talk) 05:57, 25 August 2009 (UTC)

Coldsore V cold sore

Why does "Cold sore" redirect to canker sore but "Coldsore" (one word) redirects to Herpes

It was a mistake that appears to be fixed now. Jason Quinn (talk) 15:04, 31 December 2008 (UTC)

thanksEdmund Schluessel (talk) 02:28, 26 August 2009 (UTC)

Separate page for "cold sore"?

I'd personally support a separate page for "cold sore". Its purpose should just be to show a few pictures, mention the cause, and mention current treatment (or lack thereof). If the reader wants to pursue the issue further, then they could read the "Herpes simplex" article. That article is much more comprehensive than I think most people searching for "cold sore" desire and its length, in essence, provides a barrier to the information for which people care about. Jason Quinn (talk) 15:12, 31 December 2008 (UTC)

I agree with this - I know I personally came here searching for a fairly straightforward overview of causes, symptoms and treatments, and got a lot of fairly complicated info - well done on getting it together, but more than I was bargaining for! 121.220.192.112 (talk) 02:39, 27 January 2009 (UTC)

That's a failing of the article. According to Wikipedia style manuals like WP:MEDMOS and MTAA, the article should be written for the non-specialist reader, and the introduction especially should be easy for the non-specialist reader to understand. We should also introduce every section with an easy-to-understand summary. We can do that without eliminating any of the more technical information below.

Some of us have been trying to figure out how to make medical articles easier to understand. You're actually better able to answer that question than we are. What exactly is it about the article that makes it difficult to understand? The language? Does it cover more esoteric varieties of HSV than you want to know about? Would you like to have the same information written more clearly? The theory is that we put the easy stuff at the beginning, and the more difficult stuff below, so you can read as much as you can understand, or want to read, and if you get to a point where you can't follow it any more, that won't do any harm. Would that be a problem for you?

Until then, if you want a good, simple explanation of HSV, the best medical writing for laymen that I know of is the Merck Manual Home Edition. The editors here should compare our writing with the Merck's writing. Nbauman (talk) 04:49, 27 January 2009 (UTC)

I support the proposal. The best way to make the content more comprehensible is to split out the individual conditions. Are there any objections to me doing this? --Arcadian (talk) 18:12, 28 February 2009 (UTC)

I'd say go for it Arcadian! Some pages already exist for some of the lesser known herpes-associated conditions, but not so much for the more common ones, and I've thought the neonatal stuff was really starting to overwhelm the article! Thanks for volunteering, ~ Ciar ~ _{(Talk to me!)} 18:29, 28 February 2009 (UTC)

I support this—but leave a link behind. Thanks for offering, Graham. Graham Colm ^Talk 18:40, 28 February 2009 (UTC)

Infected?

How can I find out if I am infected with Herpes? I've never had an outbreak so I wouldn't know. --86.121.67.118 (talk) 14:55, 28 January 2009 (UTC)

You have to go to a doctor and get an expensive test. There's usually no need for that.

Perhaps this article didn't clearly distinguish between being infected with a virus (which can be harmless), being a carrier who transmits a virus, and having a disease caused by a virus. There was a good article in the NEJM about that which I'll have to look up. Nbauman (talk) 16:25, 30 January 2009 (UTC)

herpes/ gums

i have an infection in my gums, which I have treated with 1200 mg daily of zovirax for months now. they won't heal.. —Preceding unsigned comment added by 99.152.74.8 (talk) 12:49, 23 March 2009 (UTC)

herpes/ gums

i have an infection in my gums, which I have treated with 1200 mg daily of zovirax for months now. they won't heal.. —Preceding unsigned comment added by 99.152.74.8 (talk) 12:52, 23 March 2009 (UTC)

herpes/ gums

I have an infection in my gums, which I have treated with 1200 mg daily of zovirax for months now. they won't heal.. frnacis murphy.... fpm77581@sbcglobal.net —Preceding unsigned comment added by 99.152.74.8 (talk) 12:55, 23 March 2009 (UTC)

Maybe if you spam your message a few more times they will heal. 24.222.96.138 (talk) 17:49, 23 March 2009 (UTC)

Why writing about zoster here?

Do we need this in this article? I moved the following texts here, because they appear to deal with herpes zoster, which is caused by varicella zoster and not herpes simplex:

Cimetidine, a common component of heartburn medication, has been shown to lessen the severity of herpes zoster outbreaks in several different instances. This is an off-label use of the drug.

Zostavax is a live vaccine developed by Merck & Co. (September, 2008) which has been shown to reduce the incidence of herpes zoster (known as Shingles) by 51.3% in a pivotal phase III study of 38,000 adults aged 60 and older who received the vaccine.

Mikael Häggström (talk) 18:14, 16 April 2009 (UTC)

squeeze herpes pimples

I found different internet forums. Some support the idea, that the fluid within herpes "pimples" is highly infectious, others disagree. What is right? Is there any scientific support for either hypothesis which could be included in the article? 78.53.44.105 (talk) 20:52, 2 June 2009 (UTC)

Percentage

I've read on the Reykjavík Grapevine that something like 70% of Icelanders (or was it Reykjavík people?) are estimated as herpes-carriers. Is that true? How common is herpes in society? Siúnrá (talk) 18:07, 19 July 2009 (UTC)

How common is HSV-1?

I wanted to know how common HSV-1 is but couldn't find the answer in this article. I did a search at Yahoo Answers and some people say that between 50 and 90% of the human population carries this virus, is that figure factual? Dionyseus (talk) 00:08, 24 July 2009 (UTC)

See Epidemiology of herpes simplex -- Astellix (talk) 11:41, 12 April 2011 (UTC)

HSV-1 infection is extremly variable based on race, geography, age, sex, and socio-economic factors. Over the last few decades HSV-1 childhood/adolescencnt sero-prevalence has been dropping in all industrialized countries as a result of better hygiene, less overcrowding, and smaller family sizes. While a lower rate of infection may sound like a good thing, there is a "boomerang effect" when it comes to herpes. Since herpes infection at one site will innoculate the body from infection at other sites, a childhood oral infection would immunize a person against further HSV-1 infections. However if a person enters adult hood sero-negative for HSV-1, oral sex with a discordant partner may cause a primary genital HSV-1 infection, which in turn could cause a newborn to contract a potentially fatal HSV-1 infection at birth. Likewise, healthcare professionals, particularly dental and oral practitioners that have not had a childhood oral infection are at risk for herpetic whitlow, or keratitis should infected sputum enter the eye. Highschool and college wrestlers are at risk for herpes gladitorium. That said, infection among females is always higher in all STDs, lower education, lower socio-economic status, higher age, are all risk factors for infection. In the United States adolescence seroprevalence (age 15 and younger) is about 38% for Blacks, 17% for whites, and 90% for immigrants from undeveloped countries which would include Mexico and the former Soviet Union. Between the ages of 50 and 70 seroprevalance among all groups levels off at about 90%. In sub- Saharan Africa childhood HSV-1 seroprevalence is close to 100%. Search pubmed for "NHANES" and "HSV" for specific papers with U.S. statistics, and "HSV seroprevalence" for others statistics worldwide. pikipiki (talk) 05:43, 25 August 2009 (UTC)

How does one know which version of Herpes they have? Can somebody have both?

Edmund Schluessel (talk) 02:26, 26 August 2009 (UTC)

Summary of stuff I learnt that isn't in this article: - T-Cells patrol the latent virus and look for gene activation - how does the virus get past this? - PowderMed had a vaccine called pPJV7630 in 2005. What happened to this?

some info for you to read and add to the article; don't paraphrase: vaccine type2: http://www.highbeam.com/doc/1G1-119964883.html good intro and chilli pepper reactivation: http://vir.sgmjournals.org/cgi/content/full/84/5/1071 IFN-beta prevent: http://www.highbeam.com/doc/1G1-110407203.html types, lots of detail: http://pathmicro.med.sc.edu/virol/herpes.htm pic: http://www.virology.net/Big_Virology/BVDNAherpes.html type 1 prevent latency: http://lib.bioinfo.pl/pmid:2986288 latent vaccine work: http://lib.bioinfo.pl/pmid:2986288 vaccine 2005 only in females not previously infected: http://lib.bioinfo.pl/pmid:16221064 vaccine aides immune system: http://lib.bioinfo.pl/pmid:18653222 latency: http://lib.bioinfo.pl/pmid:12551990 rDNS interference: http://www3.niaid.nih.gov/topics/genitalHerpes/research/genitalHerpesVirus.htm

pPJV7630 trial? why herpevac not effective in men?? arginine, echinaceia t-cells patrol the latent virus; how does the virus get past them? you can prevent with by making another herpes virus —Preceding unsigned comment added by Jago25 98 (talk • contribs) 17:04, 3 October 2009 (UTC)

Citation check?

Citation 32 does not obviously support the claim in the Prevention section that the female-male annual transmission rate is 4%. — Preceding unsigned comment added by 76.24.220.193 (talk) 22:11, 23 August 2009 (UTC)

herpes simplex type 1, it reoccur on different areas of body?

If you have hsv1 with oral out breaks. Can it reoccur in a different area of the body,

follow a different nerve if you will,like the siatic nerve? —Preceding unsigned comment added by 207.203.39.120 (talk) 15:37, 16 April 2010 (UTC)

Edit request from Cjc22, 2 May 2010

{{editsemiprotected}} There is a database of HSV-1 interacting host proteins at https://www.wikigenes.org/e/art/e/61.html which may be useful.

Cjc22 (talk) 21:36, 2 May 2010 (UTC)

Done; there were a lot of links; I removed a dead one, and some duplication - I'm sure others will revert if they disagree, but there were rather a lot. I've also created a category over on commons, as we have plenty of pics there. Thanks for the suggestion - in my opinion, that is a good external link.  Chzz  ►  22:58, 2 May 2010 (UTC)

Y Done

Primary research and animal studies

The treatment section has a bunch of primary research and animal studies that I have removed. It no longer appears to be a GA as does not follow WP:MEDMOS Doc James (talk · contribs · email) 22:49, 10 May 2010 (UTC)

Updating

• Chayavichitsilp P, Buckwalter JV, Krakowski AC, Friedlander SF (April 2009). "Herpes simplex". Pediatr Rev 30 (4): 119–29; quiz 130. doi:10.1542/pir.30-4-119. PMID 19339385. 

Doc James (talk · contribs · email) 01:31, 11 May 2010 (UTC)

Edit request from Musicalvegan0, 22 May 2010

{{editsemiprotected}} Signs and Symptoms: "In HSV-1 infected individuals, seroconversion after an oral infection will prevent additional HSV-1 infections such as whitlow, genital herpes, and keratitis. Prior HSV-1 seroconversion seems to reduce the symptoms of a later HSV-2 infection, although HSV-2 can still be contracted. Most indications are that an HSV-2 infection contracted prior to HSV-1 seroconversion will also immunize that person against HSV-1 infection.[5]"

Citation is not relevant; citation is a study of HSV outbreak during pregnancy and its effects on newborns. Nowhere does the source mention that having a manifestation of HSV-1 reduce or prevent HSV-1 herpes from being contracted in other parts of the body. On the contrary, it is quite possible to have outbreaks of HSV-1 on one's genitals and on one's mouth simultaneously, though I suppose this claim needs cited as well. Musicalvegan0 (talk) 02:53, 22 May 2010 (UTC)

Done. I have marked this claim as needing a citation. My recollection is that it is correct that an HSV-2 carrier is less likely to acquire HSV-1, but I agree that this citation did not support that claim. Tim Pierce (talk) 19:29, 23 May 2010 (UTC)

Comment from Ltfattems

Article stated that infection occurs between discordant partners, and that reinfection at a different site with same virus strain (in a seropositive person) does not happen (ie a person with type 1 oral herpes could not get type 1 genital herpes). While this type of infection is unlikely, it is not impossible.Ltfattems (talk) 13:46, 22 June 2010 (UTC)

Edit request from 124.169.84.35, 5 September 2010

{{editsemiprotected}}

The claim that "90%" of the population carry herpes simplex virus is false. It has been estimated that up to 90% of the human population may carry [i]some form[/i] of herpes virus, but this includes all herpesviruses, not just simplex. Claims such as this may seem soothing to the neurotics who overreact to simplex infection diagnosis, but they also promote the reckless spreading of the disease by those same people.

124.169.84.35 (talk) 13:34, 5 September 2010 (UTC)

Not done: please provide reliable sources that support the change you want to be made. The 90% figure specifically for HSV is well supported by the article's references. Tim Pierce (talk) 13:56, 5 September 2010 (UTC)

Antigenics

July 27, 2010

Antigenics company got positive results with AG-707, a vaccine being developed to treat HSV-2. The vaccine triggers a cellular immune response, stimulating both CD4+ and CD8+ T cells. GlaxoSmithKline is now testing it for a shingles treatment.

http://finance.yahoo.com/news/Antigenics-Presents-Positive-bw-3861142869.html —Preceding unsigned comment added by 75.85.14.106 (talk) 21:54, 30 September 2010 (UTC)

This is owned by Agenus and I do not think GlaxoSmithKline is involved, in fact this company is facing some financial hardship I think. Agenus has been rumored to begin a phase II study sometime in 2012, this may be the only drug in the works as far as a complete cure for HSV is concerned or close to it. — Preceding unsigned comment added by Wwdamron (talk • contribs) 23:04, 29 August 2011 (UTC)

Edit request from Lionelcha, 6 November 2010

{{edit semi-protected}} Please add as the result of the following studie : http://www.cdc.gov/std/Herpes/herpes-NHANES-2010.htm

Please update the vaccine part with lateste news with the following : http://en.wikipedia.org/wiki/Herpes_simplex#Vaccine

GlaxoSmithKline (GSK) has made the decision not to pursue further worldwide development of Herpevac/Simplirir (Herpes Simplex Vaccine), an experimental vaccine intended to prevent genital herpes disease in women. The decision was made following receipt of the results of the Herpevac Trial for Women, a Phase III trial evaluating efficacy of Simplirix, which was conducted collaboratively with the US National Institute of Allergy and Infectious Diseases (NIAID), part of the US National Institutes of Health (NIH). http://www.gsk.com/media/pressreleases/2010/2010_pressrelease_10105.htm

AiCuris has presented Phase 1 data of its anti-HSV drug AIC316 and begins phase 2 testing. http://www.aicuris.com/10d44/News_Publications.htm

Antigenics is working on an investigational therapeutic vaccine designed to target HSV. AG707 program is in phase 1 and has been awarded under the IRS’ Qualifying Therapeutic Discovery Project (QTDP). http://www.antigenics.com/product/ag-707.shtml http://www.antigenics.com/news/2010/1104.pdf

Genvec is working on a HSV-2 vaccine and waiting for an SBIR grant from NIAID http://www.genvec.com/go.cfm?do=Page.View&pid=27

AuRx has completed a Phase I/II trial in Mexico City. Studies show a decrease in the occurrence of lesions by 86%. But without any funds, AuRx is seeking partners who have the ability to commercialize its therapy as well as equity investors who may provide funds for commercialization. http://www.aurx.com

- Bruschettini is selling a vaccine under the name of LUPIDON, made from heat-inactivated HSV. From year 1971, over 2.000.000 ampoules of Lupidon have been put on the market in Germany, Switzerland, Austria and Italy, with about 120.000 treated patients. Medical efficacy is discussed as the treatment must be renewed every 9 months. It is recommended only in extreme cases. http://www.bruschettini.com/versione_inglese/products/products.htm http://www.lupidon.info/Vyroba_EN.htm

Other academic searcher are working on the subject as: - Montana State University researcher, William Halford, who suggests in 2006 a new avenue for developing a vaccine against genital herpes and other diseases caused by herpes simplex viruses. the Virology Journal, MSU virologist William Halford

- Sahlgrenska Academy in Gothenburg reseacrhers, who developed in 2010 a vaccine which uses a protein produced by the type 2 herpes virus together with a substance which stimulates the immune system. http://www.allvoices.com/news/5422012-swedish-lab-develops-genital-herpes-vaccine

Lionelcha (talk) 14:54, 6 November 2010 (UTC)

Not done for now: Requests should be phrased in the form of "Please change X to Y" and not simply "Please change X." Rephrase your request and then resubmit it. elektrikSHOOS 16:49, 6 November 2010 (UTC)

Additional Images

I had provided additional images of Herpes breakouts from http://www.information-on-herpes.com but the links were removed by the editor. I thought that they would be helpful for anyone looking to see what an outbreak would look like. Much more comprehensive then any image references on this page now. —Preceding unsigned comment added by Davidandkimbenton (talk • contribs) 14:17, 17 November 2010 (UTC)

Undergarments as prevention

Preventing contact with these areas during sex, in addition to wearing a condom, should theoretically provide enhanced protection against herpes. Wearing clothing or undergarments such as boxer shorts that cover these susceptible areas but still allow access to the genitals through a small opening (such as a fly) should help prevent transmission and infection.

This implies that having sex while wearing boxer shorts helps prevent transmission and infection. I doubt there's any evidence of that in medical sources.

The previous sentence states the reason for condoms' limitations, which needs a citation. --Pnm (talk) 17:08, 22 December 2010 (UTC)

Lysine's role in supression

There is at least one older study from 1977 here of 45 patients that I found I could access here:
http://content.karger.com/ProdukteDB/produkte.asp?doi=10.1159/000250926 that supports the idea of Lysine's role in supressing outbreaks. There's also a few others out there which indicate some other scholarly work has been pursued, such as the References section here: http://www.herpes.com/Treatment.shtml

1. Kagan, C. Lysine Therapy for Herpes Simplex, The Lancet, 1:137 26 Jan 1974) 2. Griffith, R.S., A Multicentered Study of Lysine Therapy in Herpes simplex Infection", Dermatologica 156: 257-267 (1978)

3. Griffith, R.S., Success of L-Lysine Therapy in Frequently Recurrent Herpes simplex Infection, Dermatologica 175: 183-190 (1987) 4. Olshevsky, V., Becher, V. Virology, 1970, 40, 948.

5. Kaplan, A.S., Shimano, H., Ben-Porat, T. ibid. p.90.

I guess this is the most recent one of those: http://www.ncbi.nlm.nih.gov/pubmed/3115841
Abstract
A double-blind, placebo-controlled, multicenter trial of oral L-lysine monohydrochloride for the prevention and treatment of recurrent herpes simplex (HSV) infection was conducted. The treatment group was given L-Lysine monohydrochloride tablets (1,000 mg L-lysine per dose) 3 times a day for 6 months. A total of 27 (6 male and 21 female) subjects on L-lysine and 25 (6 male and 19 female) subjects on placebo completed the trial. The L-lysine treatment group had an average of 2.4 (p less than 0.05) less HSV infections, symptoms were significantly (p less than 0.05) diminished in severity and healing time was significantly reduced (p less than 0.05). L-Lysine appears to be an effective agent for reduction of occurrence, severity and healing time for recurrent HSV infection.

Is any of this sufficient to get it a passing reference in the treatment section? Or what I can look for that would help to be sufficient to get this treatment a mention? Thanks! — Preceding unsigned comment added by DerekBredensteiner (talk • contribs) 22:16, 23 January 2011 (UTC)

"90% affected with herpetic gingivostomatitis"

On herpetic gingivostomatitis, the article claims that "around 90% of the U.S. population is affected with this disease". I removed this claim, as it grossly contradicts work on the seroprevalence of HSV. It was restored with the message "restored legitimate info based on reliable source; justification for previous deletion was OR".

There is a reference to a page on dent.ucla.edu, which certainly is not a primary source. Under "PRIMARY INFECTION OR PRIMARY HERPETIC GINGIVOSTOMATITIS", the page does give the ambiguous and confused statement "Around 90% of the U.S. population is affected with this disease. Ninety-nine percent of affected individuals undergo a sub clinical infection which generally does not have any clinical manifestations". There is no inline citation for this, or anything else on the page.

These works are listed in a references-section at the bottom:

[1] Amir J et al. The Natural History of Primary Herpes Simplex Type 1 Gingivostomatitis in Children. Pediat Dermatol 1999;4:259-63.

Cengizlier R, Uysal G, Guven A, Tulek N. Herpetic finger infection. Cutis. 2002;69:291-2.

Siegel MA. Diagnosis and management of recurrent herpes simplex infections. J Am Dent Assoc. 2002;133:1245-9.

[2] Simmons A. Clinical manifestations and treatment considerations of herpes simplex virus infection. Infect Dis. 2002;186 Suppl 1:S71-7.

[3] Oh TJ, Eber R, Wang HL. Periodontal disease in the child and adolescent. J Clin Periodontol 2002;29:400-10.

I went through [1], [2] and [3] as these seem to be most relevant to the claim made. None of them appear to mention this mythical "90%" figure. Also, the title of [3] is cited erroneously.

[2] does say that "worldwide, 60%–95% of the population is infected by one or more viruses of the herpes viridae family", sourced from World Health Organisation. Prevention and control of herpesvirus diseases. Part 1. Clinical and laboratory diagnosis and chemotherapy. A WHO meeting. This is not directly relevant, given that the prevalence of viruses like HHV-6 and HHV-7 certainly overwhelms HSV-1 and HSV-2.

Xu et al. Trends in Herpes Simplex Virus Type 1 and Type 2 Seroprevalence in the United States. JAMA, Vol. 296, No. 8. (23 August 2006), pp. 964-973. states that "Seroprevalence of HSV-1 decreased from 62.0% [...] in 1988-1994 to 57.7% [...] in 1999-2004". This is consistent with other work on the prevalence of HSV. It is very inconsistent with the "90%" figure, which is an unjustified, unsourced claim. — Preceding unsigned comment added by Haikz (talk • contribs) 07:22, 27 January 2011 (UTC)

I just checked Diagnosis and management of recurrent herpes simplex infections. This article does state that "HSV-1 serum antibodies can be found in up to 90 percent of Americans who have been tested", cited from Regezi JA, Sciubba JJ. Vesiculobullous diseases. In: Oral pathology: Clinical pathologic correlations. 2nd ed. Philadelphia: Saunders; 1993:1–33.

I don't think I have access to this work on the spot, but it contradicts generally established literature, which put HSV-1 seroprevalence in the U.S. around 60% (the paper I previously mentioned, for one). Additionally, the page Wikipedia references is using the number in a confused and misleading manner, which led to this number somehow being connected to herpetic gingivostomatitis in particular on Wikipedia, even though originally the number refers to seroprevalence. This surely justifies removing that piece of nonsense.

Haikz (talk) 08:03, 27 January 2011 (UTC)

Dear Haikz, this is all very interesting but it is WP:OR and therefore cannot form the basis of a Wikipedia entry. The UCLA web page is indeed not a primary source, but Wikipedia is supposed to be based on secondary or tertiary sources, not primary sources, see WP:Sources. And the UCLA page is clearly a secondary source. And it would seem to me to be a reliable source in the sense that at least one of the primary sources that you cite supports the 90% statement. So I don't think that it is legitimate to delete the statistic because your OR shows that it is incorrect. However, I do wonder whether the statistic should be deleted because it isn't sufficiently relevant, see WP:Notability. If others think that the statistic should be included, we can do that with language (and references) to the effect that it has been challenged. But I'd like to read what others think before proposing specific language.--Gautier lebon (talk) 11:21, 27 January 2011 (UTC)

This is not original research. It is easily verifiable from multiple sources of higher quality. The 90% figure in the UCLA page's source refers to a different thing, the seroprevalence of HSV-1, as should be apparent from the quote, which can be verified easily. It's probably intended to refer to it as well in the UCLA page, but it is very misleadingly stated. It does not refer to anything having to do with gingivostomatitis in particular. Additionally, the article that the UCLA page references this from is again referencing it from what is already a tertiary source. I don't know what -ary source the UCLA page then works as, but it is not pretty. The low quality of referencing also makes it very nasty to verify.

The "90%" figure is irrelevant to the gingivostomatitis part since it refers to a very different thing, the seroprevalence of HSV-1. Additionally, even that figure is incorrect. I did mention one proper source for the 60% figure. Even the Wikipedia article on Epidemiology of herpes simplex shows several other sources for numbers around 60%. The consensus is clearly around 60%, which is very easily verifiable. The "90%" is a mystery number from a source far, far away.

The "90%" refers to a different thing and what it refers to contradicts verifiable published work anyway. It is nonsense squared. I don't know how to make it more clear than that. It is a mystery how a condition caused specifically by HSV could be more prevalent than HSV anyway. Haikz (talk) 12:42, 27 January 2011 (UTC)

Edit request from Wildxat, 26 March 2011

 {{edit semi-protected}}

Alternative medicine

Careful attention to personal hygiene can effectively reduce the symptoms and discomfort of an outbreak, and speed healing. Dr. David Byck recommends, for genital herpes, treat an incipient outbreak as any fungal infection - keep the area as dry and clean as possible. Use personal hygiene wipes, rather than toilet paper. Ladies, wear a panty liner and change it several times a day.

Topical application of aloe vera on the affected area may also help. (Use live plant, or food quality for oral herpes. Commonly available gels may no t be suitable for consumption.) The aloe is a natural anesthetic, reduces the discomfort, and speeds healing of the lesion. Studies have shown positive effects of wound healing in the anal area See first reference, and positive effects on other infectious diseases See second reference . For more severe symptoms, take echinacea herb orally to boost your body's natural defenses. Some individuals have spent years self treating after diagnosis, with periodic active outbreaks. Bear in mind, that if herbal treatments don't work, seek medical treatment early for the antivirals to be most effective.

references

• Ref Eshghi, M.D., Fariborz; Seyed Jalal Hosseinimehr, Ph.D., Nasrin Rahmani, M.D, Mohammad Khademloo, M.D., Mohammad Sina Norozi, M.D., and Omolbanin Hojati, M.D. (2010). "Effects of Aloe vera Cream on Posthemorrhoidectomy Pain and Wound Healing: Results of a Randomized, Blind, Placebo-Control Study". The Journal of Alternative and Complementary Medicine, 16 (6). http://aloe.thesciencenet.com/2010/06/effects-of-aloe-vera-cream-on.html. Retrieved 03/25/2011. 
• Ref Tamura, Norimitsu; Tadashi Yoshida, Kazuhiro Miyaji, Yoshiko Sugita-Konishi, and Makato Hattori (23). "Inhibition of Infectious Diseases by Components from Aloe Vera". Biosci Biotechnol Biochem. 73(4): 950-3. http://www.ncbi.nlm.nih.gov/pubmed/19352017. 

Wildxat (talk) 11:28, 26 March 2011 (UTC)

Y Done with this edit. – Ajl^talk 20:35, 28 March 2011 (UTC)

N Reverted. First glance looked okay, but as I was about to click away, something my sub-conscious caught bugged me, though I'm not sure what. – Ajl^talk 20:42, 28 March 2011 (UTC)

Not done. Original research and lack of references. 1) The statements, "Studies have shown positive effects of wound healing in the anal area, and positive effects on other infectious diseases" appear to be as the studies referenced are really similar, but don't specifically address herpes outbreaks (rather the effect on "posthemorrhoidectomy... wound healing") and herpes viruses (rather the ability to eliminate Escherichia coli K-12 from the peritoneal cavity in the early stage of infection). Leaving aside the question of whether aloe can speed the healing of "any" wound, in the latter study the mice were given distilled water laced with a concentrated solution of aloe, which is rather different from topically applying aloe. 2) Who's Dr. David Byck? There should be a reference for what he has to say. If you'd like any further help, contact me on my user talk page. You might instead want to put a {{help me}} template up on your own user talk, or put the {{edit semi-protected}} template back up on this page and either way someone will be along to help you. :) Banaticus (talk) 20:45, 28 March 2011 (UTC)

Edit request from Astellix, 12 April 2011

{{edit semi-protected}} In the US 17.2% of the population is HSV-2 seropositive with only 14.5% of the seropositive population aware that they are infected.
should be changed to
In the US 17.2% of the population is HSV-2 seropositive with only 14.5% of the seropositive population aware that they are infected.,
per the JAMA reference that immediately follows that sentence. The relevant text from the reference is: Results The overall age-adjusted HSV-2 seroprevalence was 17.0% (95% confidence interval [CI], 15.8%-18.3%) in 1999-2004 [...] Among those infected with HSV-2, the percentage who reported having been diagnosed with genital herpes was statistically different (14.3% in 1999-2004 [...]).

I'm not sure what you want changed.

• First, the two texts appear to me to be exactly the same.
• Secondly, it looks like the reference you're trying to cite states that the prevalence is 17.0%, not 17.2%; and that only 14.3% know that they are infected.

Please resubmit your request with this information.

Astellix (talk) 10:49, 12 April 2011 (UTC)

@Jsharpminor (you forgot to sign): my bad, I copy/pasted the same thing twice. But as you did notice, the reference mentioned 17.0% instead of the current 17.2%, and 14.3% instead of 14.5%. Anyway, I found a more recent reference, the NHANES 2010 study, and will send a separate request. — Preceding unsigned comment added by Astellix (talk • contribs) 11:42, 12 April 2011 (UTC)

Edit request from Astellix, 12 April 2011 - update HSV-2 statistics with NHANES 2010 data

In Epidemiology, please replace

  In the US 17.2% of the population is HSV-2 seropositive with only 14.5% of the seropositive population aware that they are infected.

with

  In the US, 57.7% of the population is infected with HSV-1 and 16.2% are infected with HSV-2. Among those HSV-2 seropositive, only 18.9% were aware that they were infected.

Astellix (talk) 11:50, 12 April 2011 (UTC)

Edit request from Astellix, 12 April 2011

In Prevention, please add:

   Previous HSV-1 infection appears to reduce the risk for acquisition of HSV-2 infection among women by a factor of 3.

Admittedly, this is not a measure of prevention, but rather a cause, and could be added to Pathophysiology instead, or be left in Prevention because that's where most users are likely to look first. Astellix (talk) 12:26, 12 April 2011 (UTC)

Y Done Woody (talk) 19:42, 15 April 2011 (UTC)

Edit request from Astellix, 12 April 2011 - Herpes shedding frequency

In Pathophysiology, at the end of the "HSV asymptomatic shedding occurs [...]" paragraph, please add:

Herpes Shedding

HSV-2 genital	15-25% of days
HSV-1 oral	6-33% of days
HSV-1 genital	5% of days
HSV-2 oral	1% of days

Astellix (talk) 13:08, 12 April 2011 (UTC)

Y Done Woody (talk) 19:42, 15 April 2011 (UTC)

Why don't you do your own editing? It is much more efficient and does not clog up the talkpage. II | (t - c) 18:08, 7 May 2011 (UTC)

"Society and Culture" section very misleading/POV

This section:

As late as 1975, a study of “Psychological morbidity in a clinic for sexually-transmitted disease” (Richard Mayou, The London Hospital) [83] does not mention herpes simplex because at that time, there was no significant morbidity problem (i.e. mental anxiety or illness) associated with the virus.

And this one:

In the Journal of Clinical Investigation,[84] Pedro Cuatrecasas states, “during the R&D of acyclovir (Zovirax), marketing [department of Burroughs Wellcome] insisted that there were ‘no markets’ for this compound. Most had hardly heard of genital herpes...” Thus marketing the medical condition – separating the ‘normal cold sore’ from the ‘stigmatized genital infection’ was to become the key to marketing the drug, a process now known as ‘disease mongering’ [85]

Both extrapolate too far and mischaracterize the references to suit this particular editors POV. Reference 84 refers to a doctor who says that there were no markets but goes on to state that this is BAD because it can have serious consequences. Reference 85 is only a reference for the phrase "disease mongering" but says nothing about herpes in particular.

I believe this whole section should be deleted or heavily revised. And no, I'm not from some drug company.

69.70.23.12 (talk) 18:44, 1 June 2011 (UTC)

Russian

Anybody change [[ru:Герпес]] to [[ru:Простой герпес]]. There are new expanded article about [[Herpes simplex]] in russian.--Radioxoma (talk) 23:58, 10 December 2011 (UTC)

Sorry for the delay in responding to this request. I have changed the link to the Russian article as suggested. Graham Colm (talk) 18:41, 4 February 2012 (UTC)

Edit request on 4 February 2012

I was wondering if you could add this page http://www.biogetica.com/is-there-a-herpes-cure-natural-treatment-of-herpes-symptoms to your great page about herpes as i think the info on the site is great value

Mattseo (talk) 18:01, 4 February 2012 (UTC)

No sorry, this is against out policies. See here, where it says, "Spam is the inappropriate addition of links or information to Wikipedia with the purpose of promoting an outside organization, individual or idea". Graham Colm (talk) 18:34, 4 February 2012 (UTC)