Herpes pandemic added to covid and flu

No sooner had the pandemic ended than the twindemic began – in the new epidemic season, which started in Russia on October 3, 4 flu strains joined covid. Infectionists characterize the situation as very difficult, and dermatologists warn that we also need to prepare for a pandemic of recurrent herpes virus infections (HVI). Various acute respiratory viral infections of this season significantly weaken the immune system, literally disrupt the defense mechanisms and cause the reactivation of herpes viruses, the prevalence of which in Russia is very high. Experts spoke about this during the II Conference “Integrative Dermatovenereology and Cosmetology. New standards of interaction”.

The attitude to herpes infections among the people has developed frivolous. Many understand them as “colds on the lips”, which spoils life for only a few days. Meanwhile, the herpes family is represented by 9 species, each of which can lead to serious health problems, including meningitis, encephalitis, pneumonia, hepatitis, pancreatitis, etc. The herpes family includes varicella-zoster virus, Epstein-Barr virus, cytomegalovirus, etc. Herpes viruses, once in the body, remain dormant in it, but can be activated under certain circumstances: for example, stress or when the immune system is weakened. Now everything is in their favor.

The most common herpes simplex viruses are types 1 and 2. The first is manifested by rashes on the oral mucosa, the second – in the genital area. In most cases, infections are asymptomatic, but sometimes they cause serious complications. The diseases to which they lead are in 2nd place among the causes of mortality from all viral infections.

The suffering that herpetic infections bring to patients in the event of a severe or recurrent course can be extremely painful. Head of the Department of Clinical Dermatovenereology and Cosmetology of the Moscow Scientific and Practical Center for Dermatovenereology and Cosmetology DZM, Professor Andrey Lvov says that the complications caused by herpes zoster (every third encounters it during a lifetime) include lesions of the gastrointestinal tract, cardiovascular system, and also the eyes (for example, rapidly progressive herpetic necrosis of the retina, which in 80% of cases leads to blindness). And inadequate therapy and untimely start of treatment of the disease often leads to postherpetic neuralgia: a person suffers from frequent debilitating pain for many months and even years. “The reason is the reactivation of the virus in the nervous tissue and the delivery of the virus to the skin. The pains in such people are stabbing, shooting, arising from a light touch. The patient suffers sleeping only 20-30 minutes a day. It is very difficult to treat – this is a problem at the intersection of dermatology and neurology, it is often necessary to prescribe antidepressants and anticonvulsants. Pain is sometimes relieved with opioid drugs alone. The risk of developing postherpetic neuralgia is removed by timely prescribed antiviral drugs, which must be started when the first skin symptoms appear, ”says Professor Lvov.

Psychiatrists also deal with the problem of herpes. As Professor of the Department of Psychiatry and Psychosomatics of Sechenov University Dmitry Romanov says, herpes is one of the psychosomatic diseases: “In many patients, the manifestation of herpes viral manifestations begins under the influence of psychogenic factors, stress-reduced onset of the disease or its exacerbation are noted. Many diseases react to stress – atopic dermatitis, psoriasis. But an important feature of herpes in a chronic relapsing course, it remains with the patient for life, and this has an impact on the psyche. Under adverse circumstances, the virus gives reactions – localization in cosmetically significant or intimate areas and worsening of symptoms. Stress, acute or chronic, leads to the reactivation of the virus, and, most often, exacerbations are caused even by not the most severe psychological traumas – for example, worries at work. Up to 70% of patients report psychogenic exacerbations and debuts.

At the same time, as Dmitry Romanov says, there are often both patients who overestimate the disease, and those who underestimate it, and sometimes ignore it altogether. This leads to inappropriate medical behavior: some constantly take tests, increase the doses of drugs out of fear, while others do nothing at all.

Another unpleasant consequence of BBVI is the effect on the reproductive system. Herpes can lead to miscarriages, cause birth defects and fetal death. Professor of the Department of Obstetrics and Gynecology of the St. Petersburg State Pediatric Medical University Natalya Topilskaya, herpes viruses have a significant impact on the reproductive potential of a woman, primarily genital herpes. This problem is widespread – more than half a billion people in the world have an active infection caused by herpes type 2, localized in the genital area. “Diagnosing genital herpes is very difficult,” says Professor Topilskaya. – It is not easy to determine it by PCR: the replication of the virus has a short period, it can be detected in minimal cracks and wounds. Nothing can be said about the antibody titer either: 98% of the world’s population has antibodies to herpes types 1 and 2. All that’s left is history. Meanwhile, the course of a herpes virus infection is impossible to predict. For some, exacerbations occur more than 6 times a year, such a severe course brings mental, physical, emotional suffering. The herpes simplex virus often causes infertility in women. In addition, it can cause embryonic development to stop, symptoms of autism spectrum disorder in newborns, and lead to recurrent miscarriage. It often happens that in women who cannot become pregnant, we detect herpes. For example, recently there was a case: a 35-year-old woman who could not get pregnant for a long time came to IVF. During the examination, she was diagnosed with a severe course of BBVI – and she did not pay attention at all to the periodic burning sensation in the intimate zone.

… A recent study conducted by scientists from Tufts University and Oxford University showed that herpes viruses can act as the starting mechanism for the development of Alzheimer’s disease. And during the pandemic, a lot of evidence appeared that in many people, post-covid manifestations are associated with the activation of one of the representatives of this family, the Epstein-Barr virus. Doctors urge patients not to take herpes infections lightly – and be sure to be treated if they have made themselves known by the appearance of symptoms.