{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T22:28:59Z","timestamp":1792448939951,"version":"4.5.0"},"reference-count":43,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2022,4,11]],"date-time":"2022-04-11T00:00:00Z","timestamp":1649635200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Human alpha herpesviruses herpes simplex virus (HSV-1) and varicella zoster virus (VZV) establish latency in various cranial nerve ganglia and often reactivate in response to stress-associated immune system dysregulation. Reactivation of Epstein Barr virus (EBV), VZV, HSV-1, and cytomegalovirus (CMV) is typically asymptomatic during spaceflight, though live\/infectious virus has been recovered and the shedding rate increases with mission duration. The risk of clinical disease, therefore, may increase for astronauts assigned to extended missions (&gt;180 days). Here, we report, for the first time, a case of HSV-1 skin rash (dermatitis) occurring during long-duration spaceflight. The astronaut reported persistent dermatitis during flight, which was treated onboard with oral antihistamines and topical\/oral steroids. No HSV-1 DNA was detected in 6-month pre-mission saliva samples, but on flight day 82, a saliva and rash swab both yielded 4.8 copies\/ng DNA and 5.3 \u00d7 104 copies\/ng DNA, respectively. Post-mission saliva samples continued to have a high infectious HSV-1 load (1.67 \u00d7 107 copies\/ng DNA). HSV-1 from both rash and saliva samples had 99.9% genotype homology. Additional physiological monitoring, including stress biomarkers (cortisol, dehydroepiandrosterone (DHEA), and salivary amylase), immune markers (adaptive regulatory and inflammatory plasma cytokines), and biochemical profile markers, including vitamin\/mineral status and bone metabolism, are also presented for this case. These data highlight an atypical presentation of HSV-1 during spaceflight and underscore the importance of viral screening during clinical evaluations of in-flight dermatitis to determine viral etiology and guide treatment.<\/jats:p>","DOI":"10.3390\/v14040789","type":"journal-article","created":{"date-parts":[[2022,4,12]],"date-time":"2022-04-12T22:48:45Z","timestamp":1649803725000},"page":"789","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["Dermatitis during Spaceflight Associated with HSV-1 Reactivation"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4198-3261","authenticated-orcid":false,"given":"Satish","family":"Mehta","sequence":"first","affiliation":[{"name":"JES Tech, Human Health and Performance Directorate, Houston, TX 77058, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9859-1678","authenticated-orcid":false,"given":"Moriah","family":"Szpara","sequence":"additional","affiliation":[{"name":"Center for Infectious Disease Dynamics, Departments of Biology, Biochemistry and Molecular Biology, Huck Institute for the Life Sciences, Pennsylvania State University, University Park, PA 16802, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5609-5526","authenticated-orcid":false,"given":"Bridgette","family":"Rooney","sequence":"additional","affiliation":[{"name":"GeoControl Systems, Human Health and Performance Directorate, Houston, TX 77054, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglass","family":"Diak","sequence":"additional","affiliation":[{"name":"Aegis Aerospace, Human Health and Performance Directorate, Houston, TX 77058, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mackenzie","family":"Shipley","sequence":"additional","affiliation":[{"name":"Center for Infectious Disease Dynamics, Departments of Biology, Biochemistry and Molecular Biology, Huck Institute for the Life Sciences, Pennsylvania State University, University Park, PA 16802, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Renner","sequence":"additional","affiliation":[{"name":"Center for Infectious Disease Dynamics, Departments of Biology, Biochemistry and Molecular Biology, Huck Institute for the Life Sciences, Pennsylvania State University, University Park, PA 16802, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Krieger","sequence":"additional","affiliation":[{"name":"KBR, Human Health and Performance Directorate, Houston, TX 77058, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayra","family":"Nelman-Gonzalez","sequence":"additional","affiliation":[{"name":"KBR, Human Health and Performance Directorate, Houston, TX 77058, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Zwart","sequence":"additional","affiliation":[{"name":"University of Texas Medical Branch, Preventive Medicine and Population Health, Galveston, TX 77555, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Smith","sequence":"additional","affiliation":[{"name":"National Aeronautics and Space Administration (NASA) Johnson Space Center, Human Health and Performance Directorate, Houston, TX 77058, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Crucian","sequence":"additional","affiliation":[{"name":"National Aeronautics and Space Administration (NASA) Johnson Space Center, Human Health and Performance Directorate, Houston, TX 77058, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1007\/s10875-012-9824-7","article-title":"Immune system dysregulation occurs during short duration spaceflight on board the space shuttle","volume":"33","author":"Crucian","year":"2013","journal-title":"J. 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