The facts about...

Genital herpes infection

What is genital herpes infection?

Genital herpes appears as clusters of blisters which progress to small areas of ulceration anywhere on the genital area or on the buttocks or upper thighs. The skin eruptions are sometimes particularly painful and redness, numbness and tingling are a common experience a few hours before these blisters and ulcers develop. The skin eruptions may appear once only and never recur or they may recur with changing frequency at different sites, but in the same body area, causing repeated distress. Sometimes when a person first has an attack of genital herpes, they may have severe back, neck and head pain and be so sore that they are unable to pass urine. The head and neck pains are often like meningitis.

How is genital herpes infection caught?

Genital herpes is caused by the herpes simplex virus. This virus is well known to us as the same virus that causes cold sores. Approximately 90% of the adult population carry this virus and once infected the virus remains dormant within the individual for life. Only about 10-15% of these people ever have evidence of virus activity and this is seen as recurrent cold sores. The same herpes virus or one very similar may infect the genital area. The virus may be transferred from mouth to genital area by hand transfer or may be transferred during sexual activity. Often the person transferring the virus may not be aware that they are carrying it and transmission may take place from one person to another, even when there are no skin lesions.

How do you diagnose the infection?

A doctor may recognise the skin blisters or ulcers, but to be sure of the diagnosis it is possible to take a swab from the ulcers and grow the virus in the laboratory. Another method for diagnosis is to take some of the fluid from one of the blisters and look at it under the electron microscope. In this way the virus may be seen and identified.

Is there a vaccine or other way to prevent this infection?

The use of condoms will reduce the risk of infection during sexual contact. There have been several attempts to produce a vaccine to prevent people becoming infected or to modify the severity of illness in those who have the problem. It has been very difficult to assess whether these vaccines have really made a difference, although in some people during research trials, the frequency of their attacks does seem to have improved.

These vaccines are not generally available and further research work is presently taking place.

Is there any effective treatment available?

Although there is no medicine at present which will prevent a person becoming infected with herpes virus for the first time, there are very effective medicines available for treating the skin eruptions and these may be applied to the affected area or taken as tablets or liquid. These medicines stop the virus reproducing, help shorten the period of blisters and ulceration and promote earlier healing. The medicine is equally effective against cold sores or genital herpes. Some people who suffer from recurrent attacks are able to predict the onset of an attack by the abnormal sensations they feel in the affected area and by taking the medicine at that time, they can stop the attack from breaking out. Others who have very frequent attacks, can take small doses of this medicine every day for a period of two to three months and this keeps the attacks at bay. Often after this period of taking medicine, the frequency of the attacks will lessen even after the medicine is stopped.

Are there any other diseases associated with this virus?

Some people have distinctive red skin lesions (erythema multiforme) which appear quite widespread on their bodies, associated with eruptions of either cold sores or genital herpes infection. There is also a severe form of brain inflammation (encephalitis), which is seen very rarely, but we do not presently understand the reason why this particular form of infection develops. It also responds to the same anti-virus medicines.

Women who suffer from genital herpes should inform their doctors about this problem if they become pregnant, so that precautions may be taken to prevent their babies from becoming infected at birth.