Genital herpes Other name Cold sores Cause Virus - Herpes simplex virus (HSV) type 1 (20% of cases) Herpes simplex virus (HSV) type 2 (80% of cases) Distribution Worldwide, especially in the West Transmission Sexual contact. Mother to child - This usually occurs during delivery. Incubation 5 - 14 days Symptoms A group of small blisters which developinto painful ulcers and then crust over and heal. In men, it may affect the foreskin and head of the penis and in women, the labia, the skin around the vaginal opening and on  the cervix (neck of the womb). The first attack of herpes is known as the primary infection. Following the primary infection, the herpes virus travels up a nerve branch in the skin to the nerve ganglion (nerve  station) on the spine where it lies domant (inactive). From time to time, it becomes active and travels down the nerve into the skin to cause a recurrent attack. The primary infection heals after 2 - 3 weeks but  recurrent attacks heal in a shorter time of 5 - 10 days. Symptoms are also milder in recurrent attacks. Recurrent attacks may be triggered by stress, fatique, other illnesses, fevers, sunlight, menstruation and skin  trauma. Diagnosis Physical examination Microscopic examination (T-zanck smear) Culture NB Blood tests are generally not useful for diagnosis. Treatment Genital herpes may be left to heal on its own or antiviral drugs such as acyclovir can be used to speed up healing. The symptoms may be eased by frequently bathing the area with saline (prepared by dissolving one teaspoonful of table salt in one pint of  water) and by taking analgesics (painkillers).  Remember that antiviral drugs speed up healing but do not prevent recurrent attacks. Complications Herpes does not pose any dangers to the adult sufferer. The main danger is during pregnancy when an attack of genital herpes during delivery may lead to neonatal herpes (herpes in the newborn). Neonatal herpes may  cause death and survivors may be left with permanent brain and eye damage. This may be prevented by Caeserean section (delivering the baby through the abdoman so that it does not come into contact iwth infected  secretions in the birth canal). Comments Genital herpes cannot be permanently cured. Recurrent attacks occur on an average of four attacks every year and generally gets less frequent with time. recurrent attacks may be prescipitated by factors known as  triggers. Examples of triggers and measures to negate effcts include: Trigger Preventive measures Stress Learn how to manage stress. Fatigue Keep physically fit, take regular exercise. Other infections and fevers Increase resistance by taking adequate nutritionand exercise. Sunlight Avoid sunbathing in the nude. Trauma Reduce skin trauma during sex by using lubricants such as KY jelly. Wear loose fitting clothes and cotton underwear which facilitate sweat evaporation. Sweaty skin surfaces rubbing against each other may traumatise the skin. Menstruation Not possible to modify.   Suppressive treatment with acyclovir tablets may be considered in those who suffer very frequent attacks in spite ofthese measures. Herpes may be transmitted through sex during an attack so it is vital to avoid sexual  contact. Pap smears are performed yearly because of a possible link between cancer of the cervix and genital herpes.