Genital herpes is usually caused by infection with herpes simplex virus Type 2, but some studies report increasing incidence of infection with herpes simplex virus Type 1. This disease is typically transmitted through sexual intercourse, orogenital sexual activity, kissing, and hand-to-body contact.
Pregnant women may transmit the infection to neonates during vaginal delivery if an active infection is present. Such transmitted infection may be localized (for instance, in the eyes) or disseminated and may be associated with central nervous system involvement.
An estimated 86 million people worldwide are thought to have genital herpes. Herpes zoster results from reactivation of varicella virus that has lain dormant in the cerebral ganglia (extramedullary ganglia of the cranial nerves) or the ganglia of posterior nerve roots since a previous episode of chickenpox.
Exactly how or why this reactivation occurs isn’t clear. Some believe that the virus multiplies as it’s reactivated and that antibodies remaining from the initial infection neutralize it. However, if effective antibodies aren’t present, the virus continues to multiply in the ganglia, destroy the host neuron, and spread down the sensory nerves to the skin.
Herpes zoster occurs primarily in adults, especially those older than age 50. It seldom recurs. It’s also seen in patients with human immunodeficiency virus and other immunodeficiency disorders.
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