by Dr. Brian
Herpes is the luggage of sexually transmitted diseases. Once you’re infected it recurs over and over again and you carry it around with you for the rest of your life. Herpes is one of those infections that cause the uninfected to treat the infected like lepers. The point of this short article is to lay out some facts about Herpes, give people some strategies to minimize the risk of infection and to hopefully give people already infected strategies to minimize the risk of spreading the infection to others.
In the United States, one in six people in the 14 to 49 age range have a genital herpes infection (infection with Herpes Simplex 2 virus). This is approximately 16.2% of this age group. In the last 10 years the incidence of the disease has remained stable and the percentage of people infected has also remained stable. Looking at the incidence by gender, one out of five women in the 14 to 49 age range and one out of nine men in this same age range have a genital HSV-2 infection. The increased infection rate in women is reflective of the fact that transmission from an infected male to his female partner is more likely than from an infected female to her male partner.
There are two strains of the Herpes virus that cause infections in humans, HSV-1 and HSV-2. Generally, a person can only get HSV-2 infection during sexual contact with someone who has a genital HSV-2 infection. Transmission occurs from an infected partner who does not have a visible sore and may not know that he or she is infected.
HSV-1 can cause genital herpes, but it more commonly causes “fever blisters.” HSV-1 infection of the genitals can be caused by oral-genital or genital-genital contact with a person who has HSV-1 infection. Genital HSV-1 outbreaks recur less regularly than genital HSV-2 outbreaks. Infections of the fingers can cause Herpetic Whitlow and this can be a significant source of infection during digital to genital sex.
Many individuals that are infected with HSV-1 and HSV-2 have no or only minimal signs or symptoms. Initially infected persons have malaise, fever and may have general viral illness symptoms. In some sores appear within a couple of weeks of initial infection. The lesions appear as one or more blisters on or around the genitals or rectum. The fluid filled blisters break, leaving tender ulcers that may take two to four weeks to heal the first time they occur. Another outbreak can appear weeks or months after the first, but it is usually less severe and shorter in length than the first outbreak. The number of outbreaks decreases over a period of years
In a standard check for sexually transmitted infections testing for HSV is not typical. Therefore there are people that have asymptomatic disease and can spread the infection unknowingly to their partners. The consistent use of condoms has been shown to decrease the risk of transmission, although it does not eliminate it. In addition, the use of anti-viral medications has been shown to decrease transmission from known infected individuals to their uninfected partners. The major problem with spread of the virus is asymptomatic individuals. Even individuals that have recurrent symptoms will shed virus 2% of the days they do not have symptoms.
Finally, if you know you are infected ask your physician about suppression and use barrier methods of protection. If uninfected, take precautions to stay uninfected and when undergoing regular screening for STIs, ask to be tested for Herpes.