Foreword

Article Outline

• Copyright

It is highly unlikely that those of us who care for children will ever encounter a day where we fail to diagnose several cases of viral illness. Given the particular time of year, we have come to expect numerous calls from parents describing common complaints of acute onset. Fortunately, due to the child's complex and highly effective immunologic system, our patients and their parents generally weather, without significant medical intervention, the 3 to 5 uncomfortable and unpleasant days which disrupt their usual household schedules. In most cases, this transient infection usually fades into an insignificant memory relatively quickly.

Ironically, the weekend I was reviewing this manuscript, a toddler was scheduled to see me in our Saturday acute clinic due to the nurse's assessment of unusual parental anxiety over a friend's well-meaning comment. Their daughter, evaluated the preceding day by one of our residents and a continuity clinic attending, was assessed as having a viral infection; later that day their friend, a community dentist, had commented on their daughter's “herpes infection.” This labeling had generated such overwhelming concern in these college-educated parents, that the mother arrived in clinic crying and the father, in halting speech and near tears, described in anguished words their inability to even sleep that night due to the emotions produced by this diagnosis. Its implications for recurrent disease and the perception of herpes as only a sexually transmitted illness heightened their concern.

In this issue of Current Problems in Pediatric and Adolescent Health Care, Mark Schleiss presents a comprehensive and clear description of the 8 herpesviruses identified to date (which include in pediatrics the frequently encountered roseola and vaccine-preventable varicella), their presentation, diagnosis, available treatment and current plus potential prevention. The clinical findings of the primary infections produced by these viruses range from being completely asymptomatic in some patients to obvious fever, rash and even neurological findings in others. The unique feature of these herpesviruses rests in their ability to become latent and reactivate at a later time.

This overview by Dr. Schleiss captures the up-to-date information that all healthcare providers can incorporate into daily practice to hopefully prevent or diagnose and appropriately treat our patients. It also presents valuable clinical pearls to assist in determining when to refer to subspecialists and useful parental education tips. I was fortunate to have had the opportunity to refresh my knowledge on the herpesviruses in the nick of time. Hopefully you will find similar benefits from this issue of Current Problems in Pediatric and Adolescent Health Care.