STUDIES OF THE NATURAL HISTORY OF HERPES SIMPLEX INFECTIONS

Abstract

In a detailed study of 12 individuals with primary herpetic stomatitis the virus was recovered from the mouth and stools during the acute stage, convalescence, and for varying periods of time thereafter. The average time period during which virus could be recovered from these sources was 23 days after the onset of the disease. Virus could not be recovered from the blood or spinal fluid, but patients were not available for study before the third day of the disease. Neutralizing antibodies to herpes simplex were first demonstrated in the serum from the fourth to seventh day of the disease. The antibodies attained a maximum level during the second or third week. Considerable differences in individual antibody levels were noted. The maximum antibody concentration was not maintained and dropped to relatively low levels over varying periods of time in each patient studied. Herpes simplex virus was recovered from the mouths of many individuals presenting no clinical evidence of herpetic infection. The virus was recovered from 7% of 571 normal individuals of various ages. It was recovered from 1 infant out of 97 under 6 months of age, from 20% of 72 children of 7 months to 2 years, from 9% of 199 children 3 to 14 years of age and from 2.5% of the 185 adults. The incidence of normal carriers was found to be highest (26%) in Negro children in the 7 months to 2 year age group. Neutralizing antibodies were demonstrated in the serum of 43% of white and 71.4% of Negro children in the 7 month to 2 year age group. The serum of 84.7% of white and 86% of Negro children in the 3 to 14 year age group contained antibodies to herpes. In adults 90% of white and 96% of Negro individuals had antibodies to herpes in the serum. Natural active immunity appears to be established at an earlier age in the segments of the population in which the highest carrier rate was demonstrated. Neutralizing antibodies were demonstrated in the serum of 76% of white infants and in 90% of Negro infants 6 months of age and under. The placental transmission of neutralizing antibodies was demonstrated. Approximately the same level of antibody was found to be present in the maternal serum and in the serum obtained from the placenta.