Herpetic Whitlow: An Occupational Hazard

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Herpetic whitlow, initially reported in 1909, is a herpes infection of the hand digits caused by either HSV-1 or HSV-2. It was not until 1959 that the said infection was reported to come about in health care specialists. Nurse anesthetists are just among the numerous health care specialists deemed to be at risk for contracting herpetic whitlow, thus making it an occupational yet preventable infection.

After a primary infection, the virus attacks the nerve tissue that supplies the affected area, therefore creating a stockpile for the virus to stay latent until triggered again. The herpetic whitlow recurrence implies that the infection carries on for life.

herpetic-whitlow Herpetic Whitlow: An Occupational Hazard

Pain, burning and tingling of the distal phalanx or phalanges are the primary symptoms. Vesicles and swelling on the erythematous base follow. Herpetic whitlow is self-limiting, typically resolving in approximately three weeks. Initial infections are extremely inflammatory and unrelenting. Numerous laboratory tests make and confirm the clinical diagnosis.

Initial recognition is most vital, and the treatment is indicative. Acyclovir, the drug, has been established to be an effective agent for suppressive therapy.

Herpetic whitlow is an infection by the herpes virus that takes in one or more hand digits. The first individual to recognize this type of herpetic lesion was in 1909 by Adamson when he defined herpes febrilis invading the fingers. Stern and Associates, in 1959, initially identified herpetic whitlow as a possible hospital-acquired infection as soon as they found out 54 occurrences among a neurosurgical unit’s nursing staff. That same year, Pascher and Blechman became the first persons to report a herpetic whitlow occurrence in a dental expert.

Herpetic whitlow, though initially uncommon, is getting more attention in the studies as it turns out to be a recognized occupational threat among health care specialists. Regrettably, there hasn’t been any mention of such hazard in the studies concerning anesthesia since 1970. Numerous anesthesia care providers aren’t acquainted with the infection nor their increasing exposure to it.

herpetic-whitlow-1 Herpetic Whitlow: An Occupational Hazard

There are over 100 varieties in the said virus group, a few of which are recognized to cause human diseases. These include the cytomegalovirus, Epstein-Barr virus, Varicella zoster virus, as well as HSV-1 and HSV-2. Herpetic whitlow is attributable to either HSV-1 or HSV-2 because humans are the single known natural hosts of the virus.

Numerous research has shown that more than half of the cases are the result of HSV-1, while the rest of the cases are caused by HSV-2. Furthermore, studies have shown that HSV-1 takes place more frequently on the digits of the medical staff, whereas HSV-2 is more widespread on the digits of the general population. Each herpes virus exhibits a potential for dormancy, so herpetic whitlow could be either an initial or recurring infection.

After the primary infection, the viruses attack the nerve tissues that supplies the affected area. The peripheral ganglia neurons and the sensory nerve Schwann’s cells function as reservoirs for the herpes virus until it’s retriggered. There are various factors that could activate the reappearance of the herpetic whitlow infection. A few of these are immunosuppression, stress, trauma, or nerve tissue surgery, severe illness and menstruation. However, the occurrence of the recurrence is individualized.