Thirty years ago the media were clear. The next major disease to strike America would be herpes. The freelove decade had resulted in a sexually transmitted plague that would strike without warning.
Shortly after that, HIV and AIDS were discovered and the media promptly forgot about an illness that does not kill you for having sex.
Herpes simplex viruses type 1 and type 2, HSV-1 and HSV-2, cause an illness called genital herpes. The illness is characterized by the appearance of painful sores or ulcers in and around the genitals. It is a common infection with an estimated 45 million Americans age 12 and older testing positive.
The Centers for Disease Control and Prevention (CDC) report that there were about 19,000 initial doctor’s office visits for genital herpes in 1966. In the next decade, that number had risen to 57,000. In 1996, that number had again increased to 203,000. 2013 is the last year that the CDC has data for, and in that year there were 306,000 new visits.
HSV-1 is also called oral herpes. It is the virus that causes so-called “fever” blisters in the mouth. It can be transmitted to the genitals during oral sex but it is primarily an oral infection. The American Academy of Dermatology reports that most Americans contract HSV-1 as an infant or child, through skin-to-skin contact such as touch or kissing, or by sharing items like a spoon or lipstick with another person who has the viral illness. Adults do not need to have open lesions to spread the virus.
HSV-2 is the herpes type that is commonly found in genital outbreaks. It is transmitted through direct sexual contact, vaginal or anal, or via oral sex, since it can also live in the mouth. Per the CDC “In the United States, about one out of every six people aged 14 to 49 years have genital herpes.”
There is no cure for HSV infections, according to the May Clinic. Anti-viral medications may shorten an outbreak or reduce its severity. There are also suppressive medications, taken daily, that may reduce the number of outbreaks. Outbreaks can occur several times a year, or once and never return.
The HSV patient is contagious during an outbreak but it has also been shown that the virus is shed even when no ulcers are present. Patients with HSV are urged to use condoms to protect non-infected sexual partners.
Herpes outbreaks can be severe in patients with compromised immune systems, such as those with HIV. The open sores also increase the possibility of transmitting HIV or other blood borne infections to a sexual partner. Infants can contract a severe infection and precautions must be taken to ensure a safe delivery in pregnant mothers with HSV.
If either partner carries HIV or has AIDS, the other sexual partner is at greater risk for contracting HIV. They bleed easily and may be concealed in the vagina, mouth or rectum. The National Institutes of Health state that there is evidence that herpes sores may even “create an ideal scenario for the rapid spread of HIV infection.”