STD Awareness: How Common Is Herpes?

Those of you with an eye for weird news might have noticed recent headlines about wild monkeys in Florida suffering from a herpes epidemic.

Two things in that sentence might have tripped you up. One, Florida has wild monkeys? Yup. In the late 1930s, after a Tarzan movie was wrapped, three male and three female rhesus monkeys were released into the Florida wilds, giving rise to an estimated 1,000 monkeys roaming the Sunshine State today.

Both oral herpes and genital herpes are on the decline.

The second thing that might have given you pause: Monkeys can get herpes? Yes again! The Herpesviridae family is huge, with at least 100 members infecting mammals, birds, reptiles, bony fish, amphibians, and oysters — even dinosaurs are thought to have been infected by herpesviruses! The virus has been evolving alongside us since before the dawn of humanity, so it knows us like the back of its hand (metaphorically speaking), allowing it to stow away in our bodies and hide from the immune system.

The “Tarzan” monkeys suffer from a type of herpesvirus called herpes B, which can be deadly in humans, though it’s rare — just try not to find yourself on the receiving end of a monkey bite or scratch. Not so rare in humans are human herpesviruses, of which there are eight types. Types 1 and 2 — aka herpes simplex virus (HSV) 1 and 2 — can both cause genital herpes, one of the most common sexually transmitted diseases (STDs). HSV-1 mostly causes cold sores, but can also infect the genitals to cause genital herpes, while HSV-2 mostly causes genital herpes, but can also infect the facial area to cause cold sores. (A little confusing, I know.)

Genital herpes is most famous for its symptoms — despite the fact that most people with genital herpes infections won’t have any symptoms at all. The most easily recognized symptom of genital herpes is a cluster of blisters in the genital or rectal area. However, symptoms might be so mild that they escape notice. Another possibility is that the sufferer notices symptoms, but doesn’t connect them to herpes. These “nonspecific” symptoms can include vaginal discharge, rashes, pain, or itching — occurrences that are common enough to dismiss as something else.

Some good news about herpes is that it’s thought to be on the decline. HSV-1 is the most common of the two, and is usually acquired during childhood via nonsexual transmission. Nowadays, an estimated 48 percent of Americans between the ages of 14 to 49 are infected with HSV-1, compared to 59 percent in 2000.

HSV-2 usually doesn’t affect people until they become sexually active. These days, 12 percent of Americans between the ages of 14 to 49 are infected with HSV-2, compared to 18 percent in 2000. An estimated 16 percent of women in this age group have HSV-2, while 8 percent of men have it — possibly because, during vaginal sex, it’s easier for men to transmit it to women than it is for women to transmit it to men.

Genital herpes is transmitted by vaginal, anal, or oral sex — as well as by skin-to-skin contact, for example by rubbing genitals together. Barring total abstinence from all sexual activity, you won’t be able to protect yourself completely from acquiring HSV — but there are measures you can take to help prevent transmitting the virus to your partner(s). Studies on discordant couples — in which one partner has HSV and the other does not — show that viral transmission can be reduced with condoms, antiviral herpes medications, practicing abstinence when symptoms are present, and patient education.

An HSV vaccine would be a blockbuster, given how common herpes is and how many discordant couples there are. It would also be a cost-cutter, given that Americans spend nearly $1 billion each year to manage genital herpes infections. Genital herpes infections pose risks during pregnancy and increase the chances of HIV transmission, so a vaccine would have indirect health benefits as well. Unfortunately, very few herpes vaccine candidates have made it to clinical trials, and, so far, none of them was found to prevent infections in recipients — and a couple of them have resulted in scandal rather than scientific successes.

There are many reasons we don’t have a herpes vaccine yet — mostly boiling down to how complicated the virus is compared to others. Whereas viruses like measles make us very sick almost immediately upon infection, HSV can stealthily enter the body, hide from the immune system, and lay dormant for years. So our immune systems will rally when it sees an overt threat like measles, but might not even notice HSV — and we’re just not sure how to make a vaccine that will train our immune systems to notice HSV. To unravel HSV’s secrets, we’ll need to invest a ton of money into research — and most pharmaceutical companies won’t want to make such an investment, pointing to the importance of publicly funded scientific research.

If you have herpes, you can visit a Planned Parenthood health center to learn about living with the infection and get antiviral medications to suppress outbreaks and decrease transmission risk. We can also test for herpes if you’re concerned you’re showing symptoms. The test for herpes involves a test of fluid taken from a suspected herpes sore, or a blood test if you don’t have symptoms. A blood test cannot tell you if you have an oral or genital herpes infection — it can only tell you if you have been exposed.

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2 thoughts on “STD Awareness: How Common Is Herpes?

    • Health departments don’t keep track of herpes, so you wouldn’t “report” herpes to them. If you’re talking about revealing her health status to her employer, coworkers, community, friends, or family, you’re talking about an appalling violation of someone’s privacy. There is no reason to “report” someone else’s herpes infection to anyone, and her infection poses no danger to children. Please let this one go.

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