SEX LAB DETECHTIVE: HERPES SIMPLEX VIRUS (HSV)
Microbiology techs in the lab are occasionally asked by clinical out-patients and friends about this ubiquitous human pathogenic virus. They are often asked if they got it from their sexual partner. God only knows! Did not know what happened in the privacy of their home or hotel. Infection is commonly mild occuring in both adults and children having no HSV antibody and resulting in lesions anywhere in the body including the genitalia, around the oral cavity, the eye and the fingers. A primary infections can produce fever, adenopathy, and pharyngitis, sometimes followed by gingivo-stomatitis that may be associated with lip lesions.
Viruses are separated into groups on the basis of the type and form of the nucleic acid genome and the size, shape, substructure, and mode of replication of the virus particle. Subgrouping are usually based on antigenicity. HSV is the prototype of herpesvirus group which includes varicella-zoster virus (VZV), cytomegalovirus (CMV), Epstein-Barr virus (EBV) and a number of subhuman animal viruses. The central core is symmetrical (icosahedron) with 162 capsomeres, 100 nanometer in size, and contains DNA.
HSV occurs as types 1 and 2 which are closely related. They are biologically and serologically distinguishable. They share common antigens and both can be neutralized by antisera produced to either type. The 2 serotypes also have specific antigens and differ from each other in many biological characteristics, mostly quantitative in nature. HSV1 is associated with skin lesions above the waist and HSV2 is found primarily in and on the genitalia and surrounding areas - venereally transmitted and the cause of generalized infection of the newborn. HSV2 is reported to be associated with cervical carcinoma and may be the cause of human cancer.
Viruses are somewhat like snowflakes - the structure are always ever-changing. Therefore, there is no cure. Pharmaceutical companies can only make vaccines. Genital herpes drugs like Valtrex caplets could be quite expensive in case of genitalius herpecus eruptus (I made this up).
Original Publication 6/8/07 ALT MSN Groups
Web Page: Lab Detechtive
____________________________________________________________________
----- Original Message -----
Sent: Tuesday, June 05, 2007 7:09 PM
Subject: Culture Club Case
| New Message on Association of Laboratory Technologists | |
Culture
Club Case
Reply
Recommend Message 1 in Discussion
From: supertech1
CULTURE CLUB CASE: THE TB TIME
BOMB
My Fellow Lab Culturists and TB
Bug-ologists: This one is a most baffling case due to
what we have just learned from what is reported in the mainstream
media. There are many unanswered questions - the who, the
what, and the when???
HISTORY The target
person or patient in this new case was very much in the news
lately: he's a male, 31 year-old lawyer from Atlanta,
Georgia. For unknown reason at this time, he was infected
with a multi-drug resistant (MDR) type of Mycobacterium
tuberculosis (M. tb). How he got
TB is very mysterious. He traveled for his wedding to the
romantic volcanic island of Santorini in Greece and flew to other
European destinations and entered the U.S. by way of Canada.
Since he's a health risk, let's discuss his
circumstances:
Question 1: His physician and
health authorities knew he has TB. Why is he not put on
isolation?
Answer 1: All hell break
loose when we get hospital patients testing positive
reaction for Tuberculin Skin Test (TST); everyone is concern
of the health risk to family, friends and hospital
personnel. we, microbiology techs, get tested for TST every
year. We are monitored constantly for work-related
contamination with pathogenic organisms. Why the
lackadaisical attitude with this guy and not warning him of the
consequences is hard to discern Active pulmonary TB is an
isolation essential! Patients should be isolated in a single
room, not cohorted. Older observations on infectivity of
susceptible and resistant M. tb before and after rx may not be
applicable to MDR M. tb or to HIV+ individual. Extended
isolation may be appropriate. Patient with active TB should
have HIV antibody test.
Question 2: What is the time span
and how long did he have TB?
Answer 2: Mycobacteria
detection by C14 radioactive assay is about 4-7 days.
The growth rate of M. tuberculosis in routine
culture slants of Lowenstein Medium and
Middlebrook 7H11 Medium is about 6-8 weeks;
Mycobacterium susceptibility testing is another 6-8 weeks.
We are assuming he's taking initial drug therapy (INH
(Isoniazid), RIF (Rifampin), PZA (Pyrazinamide), for more than 4
months since there was an alert two weeks ago about him in the
news that he's a walking time bomb! Click on the ALT web
page http://groups.msn.com/AssociationofLaboratoryTechnologists/altbooks.msnw.
Furthermore, it is safe to assume that his M. tb in vitro
drug suceptibility lab report became final while he was
abroad. CDC folks contacted him in Greece and told him to
return to the U.S. How did it come about he was not
prevented in leaving the U.S. in the first place? And this
is hard to conceive - his new father-in-law is a
microbiology researcher at CDC (Centers for Disease Control &
Prevention) - either he's ignorant that his son-in-law has active
TB or not. O' love is a many contagious thing!
His darling daughter must be very much in love with the TB
guy.
We will never know what we want
to know because of patient confidentiality.
End of discussion
then.
ALT Health
& Lab Technology web page 06052007
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