Monique Rainford

Genital herpes is a sexually transmitted disease caused by the herpes simplex virus (HSV). The two types of this virus are HSV 1 and HSV 2. Generally, HSV 1 causes infections above the waist such as the common fever blisters, or night fever and HSV 2 causes infections below the waist and thus is the main cause of genital ulcers. However, HSV 1 may also cause genital ulcers. Herpes is a recurrent infection which like all viruses cannot be cured but fortunately effective treatments are available.

Genital herpes is a very common infection affecting an estimated 50 million persons in the United States. The prevalence in Jamaica is unknown, but it is likely to be very common here as well. Most persons with genital herpes are unaware of their diagnosis and this combined with the fact that it is highly contagious somewhat explains its high prevalence.

Highly contagious

The virus can be spread whether or not the person has symptoms and shedding of the virus can occur at frequent intervals. It is most frequently transmitted when a person has no symptoms and does not even realise that they are infected. It can even be transmitted within a long-term, monogamous relationship. The annual transmission rate between couples is 10 per cent and women are more susceptible to infection than men.

About 60 per cent of people who are infected with herpes for the first time will have no symptoms. However, for some women, it can be an extremely difficult and painful experience. It most often occurs in women between the ages of 15 and 35. Between three and seven days after infection, the woman will start experiencing symptoms.

Some symptoms may include fever, malaise, headache and muscle aches. In addition, she may have multiple ulcers on both sides of her vulva (the lips around the vagina) as well as in her vagina and on her cervix. Lesions may also occur on her bottom and around her anus. She may develop new ulcers during the course of the infection. Most women with symptoms have a great deal of pain in their vulva and tenderness in the lymph nodes of their groin.

Symptoms last between two to six weeks without treatment. For some women, the initial infection can be so severe that they have to be admitted to the hospital. When herpes recurs it is usually much less serious than the initial infection. About half of women will have a recurrence within six months, with an average of four recurrences during the first year after infection. Recurrences usually occur on one side of the vulva and it lasts about seven days. She may often experience burning, tenderness and itching before the ulcer appears.

Feelings of depression

Often when a woman is diagnosed with herpes, she feels isolated socially and is afraid to embark on a new sexual relationship. It tends to lower her self-esteem and she may feel depressed. She may also experience a feeling of loss of control because of the uncertainty of the timing of her recurrences. While it is never pleasant for her to be labelled with this disease, there is hope for her and all who have been infected.

The two medications available in Jamaica for the treatment of herpes are acyclovir (zovirax) and valacyclovir (valtrex). These medications shorten the duration of the primary infection as well as recurrences. Both have been shown to successfully reduce the number of recurrences. In addition, valtrex has been shown to effectively reduce the risk of transmission to sexual partners. She can most certainly continue to live a happy and healthy life despite her diagnosis.

Dr. Monique Rainford is a consulting obstetrician and gynaecologist; email: yourhealth@gleanerjm.com.