Epidemiology and clinical manifestations of herpesvirus infections in infants and children

Abstract

Herpesvirus infections are common in children. Close contact is necessary for transmission of herpesviruses, except varicella-zoster virus (VZV), which spreads predominantly by the aerosol route. For each human herpesvirus except VZV, which causes chickenpox, primary infection is more often subclinical than symptomatic. When disease does occur, however, the major syndromes are gingivostomatitis for herpes simplex virus type 1 (HSV-1), genital herpes for HSV-2, mononucleosis for Epstein-Barr virus (EBV) and cytomegalovirus (CMV), and roseola for human herpesviruses 6 and 7. Clinically significant reactivations are common only for HSV (recurrent oral or genital lesions) and VZV (shingles). Some herpesvirus infections are generalized by nature and can cause organspecific complications, such as hepatitis seen with CMV. Complications also can arise from dissemination of localized infection, such as encephalitis seen with HSV. Other complications are caused by bacterial superinfection, such as group A streptococcal sepsis in the setting of chickenpox. The pathogenesis of other complications, such as Reye's syndrome with chickenpox or aplastic anemia with EBV infection, is yet to be elucidated. This article reviews the clinical and epidemiological features of herpesvirus infections in healthy infants and children.