Genital herpes

This is a very unpleasant complaint which has recently become much more widespread. Il is caused by a virus usually transmitted by sexual contact vaginal oi” anal intercourse or through oral sex. A few days after such contact, a group of tiny blisters appears on the vulva or penis and sometimes around the anus: these burst and form shallow painful sores.

These are often accompanied by pain on passing urine, particularly in women, and by enlargement and tenderness of glands in the groin. The sores heal in 10 to 14 days, leaving the genital area normal. However, in a number of people the virus persists even though they feel per-fectly well.

Some people get recurrent attacks of genital herpes. These may occur only twice a year, but can happen as frequently as every few weeks. The attacks continue because the virus responsible for them lies dormant under the skin until it is reactivated and causes another attack.

While the virus is dormant, it is unlikely to infect others, but once reactivated it can do so, and the patient is often unaware when a new attack of genital herpes is starting.

The infection is diagnosed by taking-swabs from the sores to see whether the virus is present. At the same time other laboratory tests are carried out to discover whether any other germs are present.

There is no point in prescribing antibiotics for genital herpes because it is a viral, as distinct from a bacterial infection, and no existing antibiotic will kill the virus.

Generally the best treatment is for the patient to rest as much as possible, to bathe the sores with a saline solution (one teaspoon of salt in a pint of lukewarm water), and to take aspirin or paracetamol to relieve the pain. Some patients benefit from antiviral drugs in the form of a liquid or cream to apply to the sores. Although these drugs may reduce the length of time an attack lasts, they do not prevent the sores recurring.

Genital herpes during childbirth

Women who have genital herpes may, during childbirth, pass the infection on to the baby. This can have very serious consequences, as the virus may invade the child’s bloodstream or central nervous system, occasionally causing death. For this reason a doctor will watch very carefully a woman with recurrent herpes who becomes pregnant, or who develops herpes for the first time just before the baby is due. A Caesarian operation may be advised for the small number of women who are infected, just before or when labour begins, as the outlook for the baby is much improved by this form of delivery.

In Britain only a very small number of women encounter problems with herpes during childbirth, but it is important for a doctor to know if his patient has a history of this disease. Fortunately the infection doesn’t damage the baby in the womb.