Genital herpes is a contagious viral infection caused by the herpes simplex virus. Transmission is via sexual contact with the infectious agent, whether that be vaginal, oral or anal. Genital herpes can also be caught via oral sex with someone who has cold sores.

Symptoms usually appear within a week of contact with an infected person.

Infections can occur with or without symptoms. Symptoms of the first infection are generally more severe than recurrent episodes. Symptoms experienced include:

• red areas on the genitals that may develop into blisters
• discharge from the vagina or the urethra
• swollen lymph nodes in the groin
• flu-like symptoms
• tingling or irritation in the genital region
• pain when passing urine
• fluid retention.

In women, the main areas of the body involved are the cervix and the vulva in the initial infection, and the vulva, perineal skin, legs and buttocks in subsequent infections. In men, blisters generally appear on the end of the penis or the foreskin and in the anal and rectal area in those engaging in anal sex.

Once an individual has contracted the herpes virus it cannot be cured but stays with them for life. Antiviral treatments are given on the first contact with the virus to reduce the length and severity of the attack. If recurrent attacks are mild, generally no treatment is required. Antiviral drugs can be given to reduce the severity or duration of an attack. Those who suffer from frequent or severe recurrent infections may benefit from long term antiviral therapy.

Further guidance on the management of genital herpes includes:

• 2001 National guideline for the management of genital herpes by the British Association for Sexual Health and HIV.
• Herpes simplex – genital PRODIGY guidance.

All sexual activity should be avoided when symptoms are present as this is when the virus is at its most contagious. Hands should always be washed after touching the blisters and towel sharing should be avoided during the symptomatic phases.

Incidence data are collected. Please refer to your local policy document for further details.

Patients may suffer urine retention due to the pain experienced when passing urine. Sometimes this can require a urinary catheter. Secondary infections can occur with Staphylococcus, and aseptic meningitis can develop during the initial infection. Encephalitis or disseminated infections are rare but they can occur in patients who are immunocompromised.

Practice safe sex and use a condom regularly and carefully. Sexual contact with an infected person should be avoided when they are showing symptoms of herpes, and oral sex with a person showing symptoms of cold sores is also not recommended.

None.

PRODIGY guidance
www.prodigy.nhs.uk

British Association for Sexual Health and HIV
www.bashh.org

NHS Direct
www.nhsdirect.nhs.uk

NHS Direct Wales
www.nhsdirect.wales.nhs.uk

BBC Health
www.bbc.co.uk/health

NetDoctor
www.netdoctor.co.uk

National Library for Health
www.library.nhs.uk

Society of Sexual Health Advisers
www.ssha.info

Male Health run by the Men’s Health Forum
www.malehealth.co.uk

Health Protection Agency
www.hpa.org.uk

Clinical evidence from the BMJ publishing group
www.clinicalevidence.com

Young People’s Sexual Health website run by Central Suffolk NHS Trust
www.ypsh.net

TheSite run by YouthNet UK with advice and support for young adults
www.thesite.org

Playing Safely
www.playingsafely.co.uk

Information for young gay men run by the Terrence Higgins Trust
www.ygm.org.uk

Teenage health information
www.teenagehealthfreak.com

Information for young people on sexual health and life
www.likeitis.org

Brook Advisory Centre
www.brook.org.uk

Department of Health
www.dh.gov.uk

Sexual Health InfoCenter
www.sexhealth.org

World Health Organization
www.who.int

Scotland’s Health on the Web provided by NHS Scotland
www.show.scot.nhs.uk

Gay Men’s Health
www.gmh.org.uk

Avert – an international AIDS charity
www.avert.org

Health Education Board Scotland
www.hebs.com

Health information relating to the National Curriculum and the National Healthy School Standard
www.wiredforhealth.gov.uk

NAM, Aidsmap (Aids information for patients and health professionals)
www.aidsmap.com

Herpes Viruses Association
www.herpes.org.uk

International Herpes Alliance
www.herpesalliance.org

CHIN J, ed (2000) Control of communicable diseases manual. 17th ed. Washington: American Public Health Association.

NAM, AIDSMAP (2004) Treatment and care [on-line].
Available at: http://www.aidsmap.com/en/docs [Accessed 17 April 2005].

NHS DIRECT (2002) Genital herpes [on-line]. NHS Direct online health encyclopaedia.
Available at: www.nhsdirect.nhs.uk/en.asp? [Accessed 14 April 2005].

PRODIGY (2004) PRODIGY guidance – Herpes simplex – genital [on-line]. London: Department of Health.
Available at: www.prodigy.nhs.uk/guidance.asp? [Accessed 14 April 2005].