2. It is mostly acquired as a result of sexual activity; some cases are caused by simplex type
1. After initial infection the virus lies latent in the dorsal nerve root ganglion (of the spinal cord) which enervates the affected area of the skin. Latent virus is never cured and reactivation results in either a recurrence of symptoms or in asymptomatic shedding of the virus which then infects a sexual partner. Around 30,000 cases of genital herpes are reported annually from clinics dealing with SEXUALLY TRANSMITTED DISEASES (STDS) in England, but there are also many unrecognised (by either patient or doctor) infections. Patients may have a history of painful attacks of ulceration of the genitals for many years before seeking medical advice. All patients with a ?rst episode of the infection should be given oral antiviral treatment, and those who suffer more than six attacks a year should be considered for suppressive antiviral treatment. ACICLOVIR, valaciclovir and famciclovir are all e?ective antiviral drugs. If a woman in the ?nal three months of her pregnancy contracts herpes genitalis, this can have serious consequences for the baby as he or she will be at risk of herpes encephalitis after delivery.