Herpesviruses capable of causing human neurological disease include herpes simplex, varicella-zoster, cytomegalovirus, and the Epstein-Barr (EB) virus. They are DNA viruses that contain a glycolipid envelope and replicate in the nucleus of the host cell. Members of this group share the property of causing primary (initial) infection and subsequent reactivation of latent infections. There are two serological strains of herpes simplex virus (HSV). The type 1 strains (HSV-1) cause almost all cases of herpes simplex encephalitis and meningitis in adults. Infections with the type 2 strains (HSV-2) occur as a vesicular eruption on genital mucosa, transmitted by sexual contact. Also associated with HSV-2 are disseminated disease of the newborn and occasional cases of viral meningitis in adults.
Type 1 HSV is the single most important cause of fatal sporadic encephalitis in the United States and England. All age groups are affected, and there is no seasonal predominance of incidence. In
Ho SU, Harter DH. Herpes Simplex Virus Encephalitis. JAMA. 1982;247(3):337. doi:10.1001/jama.1982.03320280057031
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