Herpes Is A Common Infection
Herpes is a super-common infection that stays in your body for life. More than half of Americans have oral herpes, and about 1 out of 6 Americans has genital herpes. So chances are a few people you know are living with herpes.
Theres no cure for herpes, but medication can ease your symptoms and lower your chances of giving the virus to other people. And the good news is, outbreaks usually become less frequent over time, and even though herpes can sometimes be uncomfortable and painful, its not dangerous. People with herpes have relationships, have sex, and live perfectly healthy lives.
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You Probably Have Herpes But Thats Really Okay
According to a recent report by the World Health Organization, 2 out of 3 people under the age of 50 have Herpes Simplex Virus 1 , more commonly known as oral herpes. Thats a staggering 3.7 billion people with a incurable virus.
But the thing about HSV-1 and HSV-2 the bad herpes is that theyre very poorly understood by the general public, and even by some physicians. So if the headline above seemed shocking or offensive to you, we need to have a little chat. Because if you think that people with HSV are icky deviants covered in oozing sores, youve got a lot to learn and you could very well be ignoring your own HSV status.
Heres what you need to know about the WHOs recent findings:
1. Yes, pretty much everyone has herpes and more and more of it is genital
HSV-1 is known for causing cold sores not real herpes, the STI that can cause sores around the genitals. This used to be pretty much true. In the past, most of the people who had HSV-1 got it as children, via dry smooches from infected aunties and the like.
But as people gained awareness of the contagious nature of cold sores, they became more cautious about exposing young children to a skin outbreak. That means more and more of us get to adulthood without any HSV immunity.
And even though HSV-1 prefers to live in mouths and HSV-2 prefers to live in genitals, theyre capable of swapping neighborhoods in a pinch. So considerate young lovers with HSV-1 can unwittingly spread genital herpes.
Genital Herpes By Age And Gender
In the United States, most new HSV-2 infections occur in people under 50 who tend to be more sexually active. Because genital herpes does not go away, the prevalence will increase with age.
Data from the National Center of Health Statistics demonstrates how the HSV-2 prevalence in the United States increases with age:
- Age 14 to 19: 0.8% prevalence
- Ages 20 to 29: 7.6% prevalence
- Age 30 to 39: 13.3% prevalence
- Ages 40 to 49: 21.2% prevalence
In short, the older you get, the more likely the odds of having herpes if you are sexually active and have risk factors for the disease.
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Eastern And South East Asia
HSV-1 seroprevalence in some Asian countries is low, relative to other countries worldwide, with only 51% women in Thailand, and between 50 and 60% in Japan possessing antibodies. HSV-2 seroprevalence in developing Asian countries is comparable to that observed in North America and Northern Europe. However, estimates of HSV-2 infectivity in Thailand are higher than observed in other Eastern Asian countries total HSV-2 seroprevalence is approximately 37% in this country. HSV-2 seroprevalence is low in women in the Philippines , although commencing activity while young is associated with an increase risk of acquiring HSV-2 infection woman starting sexual activity by the time they reach 17 are seven times more likely to be HSV-2 seropositive than those starting sexual activity when over 21.
In South Korea, incidence of HSV-2 infection in those under the age of 20 is low, only 2.7% in men and 3.0% in women. Seroprevalence levels increase in older South Koreans however, such that the population over 20 that has antibodies against HSV-2 is 21.7% of men and 28% of women.
Myth #: Herpes Is Only A Sexually Transmitted Infection
Fact: Not all cases of herpes spread through sex. HSV-1 often spreads through contact with the skin or saliva of a person who has the infection.
For instance, people can spread it by kissing, sharing utensils, touching an infected surface, or having skin-to-skin contact.
According to the CDC, who have HSV-1, which can cause cold sores, got it during childhood from nonsexual contact, such as receiving a kiss from a family member.
According to the WHO, however, HSV-2 is .
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How Do I Know If I Have Herpes
The best way for a clinician to determine if someone is infected with HSV-1 or HSV-2 is to perform a laboratory analysis on a sample from a fresh herpes sore. But, because not everyone with herpes has symptoms, your clinician may instead use a blood test that can detect antibodies to the herpes viruses. A blood test can show if you have herpes and, if so, determine whether you are infected with HSV-1 or HSV-2. However, a blood test cannot tell you what part of your body the virus will affect.
If you want to be tested for herpes, ask your clinician. A standard screening for sexually transmitted diseases may not include herpes unless you specifically ask.
Remember, however, that HSV-1 is a very common virus, and there is a 5060 percent probability that you will test positive for it. If you are a sexually active adult who has had multiple partners, there is a 1020 percent probability that you will test positive for HSV-2.
Here are some other things to consider before you get tested:
- If you test negative for one or both of these viruses, what will you do to prevent them?
- If you test positive for one or both of these viruses, will you tell potential partners before you engage in sexual activity or, in the case of HSV-1, before you kiss them or engage in oral sex?
Learning that you have herpes can be confusing and scary. We encourage you to have an in-depth conversation with your healthcare provider before you decide to get tested.
Most People With Herpes Are Asymptomatic
Despite its prevalence, a surprising number of people are asymptomatic and never know they have herpes! This puts them at higher risk of spreading the herpes virus to others unintentionally.
Up to 80% of all HSV2 infections are asymptomatic. However, a lack of symptoms doesnt always stop viral shedding in the genital tract. Its still possible for asymptomatic people to shed the virus and spread it through oral or sexual contact with a partner.
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What Are The Symptoms Of Genital Herpes
Most individuals infected with HSV are asymptomatic or have very mild symptoms that go unnoticed or are mistaken for another skin condition. 9 When symptoms do occur, herpes lesions typically appear as one or more vesicles, or small blisters, on or around the genitals, rectum or mouth. The average incubation period for an initial herpes infection is 4 days after exposure. 10 The vesicles break and leave painful ulcers that may take two to four weeks to heal after the initial herpes infection. 5,10 Experiencing these symptoms is referred to as having a first herpes outbreak or episode.
Myth #: People Cannot Spread Herpes To Others Unless They Have Sores Or Blisters
Fact: People can spread herpes to others at any time, including when they do not have any symptoms.
People with herpes may experience outbreaks and remissions. During an outbreak, a person has active sores or blisters, but in remission, they may have no symptoms at all.
The virus is usually more contagious when a person has an outbreak, but it can also spread when it is in remission.
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Screening And Early Detection
Unlike some STIs, routine blood testing is not recommended for people who don’t have symptoms of herpes. However, if there is concern about exposure or new symptoms, this testing may be recommended. People should talk with a healthcare provider to determine whether blood testing is necessary.
Although blood testing is not routinely done, screening for STIs should include a thorough exam to check for herpes lesions on the genitals .
The CDC recommends blood testing if you have symptoms of genital herpes. Testing should also be pursued if you are pregnant and are having sex with someone with herpes.
Testing may also be useful if:
- You are not pregnant but are having sex with someone with herpes.
How Can I Best Learn To Cope With Herpes Simplex
Some people feel distressed or embarrassed about their herpes simplex infection. Its important to understand that the herpes virus is common. For most people, herpes doesnt significantly interfere with daily life.
To cope with negative feelings, you may consider:
- Connecting with others through support groups or online forums.
- Sharing your feelings with a trusted friend or loved one.
- Speaking with a therapist.
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Understanding Herpes With H Hunter Handsfield Md
Herpes expert H. Hunter Handsfield, MD, explains the basics about genital herpes, including the difference between genital HSV-1 and HSV-2 infection, testing options and the importance of knowing virus type, and the three-prong strategy for prevention. See more herpes videos at sexualhealthTV.com.
Have a question about herpes youd like Dr. Handsfield or our other experts to answer? Visit our Ask the Experts page to learn how.
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How Do You Get Herpes
The skin on your genitals, mouth, and eyes can be infected easily. Other areas of skin may get infected if theres a way for the herpes virus to get in, like through a cut, burn, rash, or other sores. You dont have to have sex to get herpes. Sometimes herpes can be passed in non-sexual ways, like if a parent with a cold sore gives you a peck on the lips. Most people with oral herpes got it when they were kids. A mother can pass genital herpes to a baby during vaginal childbirth, but thats pretty rare.
You can spread herpes to other parts of your body if you touch a herpes sore and then touch your mouth, genitals, or eyes without washing your hands first. You can also pass herpes to someone else this way.
Herpes is most contagious when sores are open and wet, because fluid from herpes blisters easily spreads the virus. But herpes can also shed and get passed to others when there are no sores and your skin looks totally normal.
Most people get herpes from someone who doesnt have any sores. It may live in your body for years without causing any symptoms, so its really hard to know for sure when and how you got it. Thats why so many people have herpes its a pretty sneaky infection.
Because the virus dies quickly outside the body, you cant get herpes from hugging, holding hands, coughing, sneezing, or sitting on toilet seats.
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What Are The Symptoms Of Herpes Simplex
Many people with the infection never experience any herpes symptoms. If you do notice symptoms, youll experience them differently depending on whether youre having your first herpes outbreak or a repeat outbreak. Recurring symptoms are usually milder than the first outbreak. Symptoms dont last as long with later outbreaks. Some people may only have one or two outbreaks during their lifetime. Others may have as many as four or five outbreaks a year.
People who do have herpes symptoms may experience:
- Cold sores around their lips, mouth or tongue. They may look crusty or like fluid-filled blisters.
- Tingling, itching or burning.
- Pain while urinating.
Myth: Giving Birth Always Transmits The Virus To Babies
If you are pregnant and have genital herpes, you may believe the myth that youll definitely transmit the virus to your newborn baby. Fortunately, with the right precautions, your baby faces a very small risk of contracting the herpes virus. Nearly 30% of pregnant women have genital herpes, but only 0.1% of babies born in the U.S. each year contract neonatal herpes.
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How Herpes Is Transmitted
Herpes is most efficiently passed via direct genital contact with a herpes lesion, but it can also be passed through skin-to-skin contact with someone who has an active infection but no symptoms.
The latter manner of transmission, referred to as asymptomatic genital shedding, occurs when the virus reactivates and literally sheds viruses out of the part of the body where the initial infection occurred.
In people with asymptomatic HSV-2, shedding can occur in episodes throughout the year, silently passing the infection without the person even realizing it.
Herpes also can be passed to a child during childbirth or shortly after birth if the baby comes into contact with lesions present on the birthing parent. This is otherwise referred to as maternal transmission or perinatal transmission. Less commonly, the virus can be transmitted while the fetus is still in the uterus.
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What Treatment Options Are There
Currently, there is no treatment to cure herpes however, there are medications to treat symptoms and control outbreaks.
Three antiviral medications are approved by the Food and Drug Administration for the treatment of herpes: acyclovir, famciclovir, and valacyclovir. All of these medications, which are taken orally, work by attacking the herpes virus and disrupting its ability to multiply. Each of these medications can be used during a recurrence to help speed the healing process of an outbreak.
All three drugs are FDA-approved for daily, suppressive therapy to help reduce the frequency of outbreaks. Acyclovir is also available in the form of an ointment, but the medication has been proven to be much more effective for genital herpes when taken orally as a pill. Valacyclovir, when taken daily by a person with recurrent genital herpes, can reduce the risk of transmission to a partner.
Using medication to treat genital herpes is not required. However, if a person would like to use antivirals, speaking with a healthcare provider can help determine which treatment may be right for them.
For more information on treatment and alternative therapies, see the treatment page.
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What About Chlamydia The Most Common Std
Chlamydia is caused by bacteria, whereas herpes is caused by a virus. This is why chlamydia is easily treated and cured with antibiotics. However, many people have chlamydia and dont know it because they dont have any symptoms. Thats why people who are at higher risk of chlamydia, including sexually active young women and men who have sex with other men, are advised to get a test for chlamydia every year.
If you dont treat chlamydia, it can increase the chances of both men and women getting or giving HIV and AIDS, according to Medline Plus. Untreated chlamydia can also cause serious pelvic inflammatory disease in women, which can lead to infertility, and in men it can spread to the testicles and the tube that carries sperm, causing inflammation.
Screening for chlamydia is usually done by taking a urine sample or a swab from your genitals. Results of these tests are usually found quickly. Different testing methods are used for infections of the rectum and throat, and these take more time.
While the only way to completely avoid getting chlamydia or herpes is to not have sex, you can reduce your chances of getting both by being in a long-term, mutually monogamous relationship with a partner who is not infected with an STD and by using latex condoms every time you have sex.
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What Are The Signs And Symptoms Of Hsv
Most commonly, HSV-1 causes sores around the mouth and lipsoften called cold sores or fever blisters. HSV-1 can cause genital herpes, but most cases of genital herpes are caused by HSV-2. Typically, someone with HSV-2 will have sores around the genitals or rectum.
Symptoms are usually the most intense during the first outbreak and become less intense over time. Symptoms can last 2-4 weeks before resolving on their own without medicine, and even longer during the initial infection.
Some of the symptoms associated with HSV include itching, tingling or burning sensation, tiredness, swollen lymph nodes and flu-like symptoms, but many with HSV may have no symptoms at all.
While there are some tell-tale signs of HSV, not everyone may show visible signs or symptoms, resulting in them unknowingly transmitting it to a partner via contact, Dr. Gelow said. Unfortunately, there are no studies that show how often this happens, but we do know that the virus sheds 10-20% of the time in those who are asymptomatic.
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Myth #: A Blood Test Is The Best Way To Know If You Have Herpes
Blood tests are not always accurate and testing for herpes can be tricky. It can take two weeks to six months after being exposed to herpes before it is detected in the blood. To make matters more complicated, if you are low risk for herpes and asymptomatic, it increases your risk of a false positive result. Because of this, the Centers for Disease Control and Prevention recommends against routine testing for herpes unless you or your partner have symptoms. The most accurate test is when you are able to take a swab sample from a new herpes lesion, but often times the diagnosis is made by a clinician based on your history and report of symptoms.
Because the blood test can be expensive and inaccurate, it is not typically included in a sexually transmitted disease evaluation unless you ask your provider for it specifically.
In short, if you dont have symptoms, you dont necessarily need a blood test. If you do experience an outbreak, a skin swab not a blood test is your best bet for confirmation.