July 16, 2007 / 4:26 PM / 12 years ago

Genital herpes in children may not reflect abuse

NEW YORK (Reuters Health) - While genital herpes in a prepubertal child raises the suspicion of sexual abuse, the current evidence is too weak to estimate the likelihood of sexual transmission of the virus, according to a report from the UK, published in the Archives of Disease in Childhood.

However, the findings do suggest the probability of sexual transmission among children older than 5 years of age who have genital sores alone and those who have had the presence of the herpes simplex type 2 virus confirmed.

Dr. Richard Reading, from the University of East Anglia in Norwich, and Dr. Yifan Rannan-Eliya, from the University Hospital of Wales in Cardiff, note that herpes simplex type 2 is strongly associated with sexual transmission in adults, but most cases of adult genital herpes in the UK are herpes simplex type 1, so viral typing is not definitive for sexual transmission.

The presence of oral and genital sores in a child, the investigators point out, may be caused by spread of the virus from the primary site. Also, infection may possibly occur during diaper changing by an infected adult.

The researchers came to these conclusions after they searched published reports to identify studies that investigated sexual transmission as a possible cause of genital herpes in children. Just five papers, published between 1968 and 2003, were identified.

More than half of the reported cases had evidence suggesting a sexual mode of transmission, the authors state. However, as noted, the evidence was just too weak to allow reliable estimations of risk. The papers did not describe any genital contact in much detail, and “physical findings which were taken to indicate abuse would not be seen as adequate or appropriate now.”

Reading and Ranna-Eliya conclude, “A larger, methodologically robust and more up-to-date study of children presenting with genital herpes is required in order to be more certain of the implications in a child who is not mature enough to engage in consensual sexual relations.”

SOURCE: Archives of Disease in Childhood, July 2007.

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