(Almost) Everybody Has Herpes
Now that I have your attention, I'll clarify: If you are sexually active, chances are you've encountered someone with it. If you've had chickenpox, you have a form of it. If you have shingles, you've got a form of it as well. If you've ever had a "cold sore," you definitely have it. Lots of people have it, including R&B singer Usher who allegedly infected a woman with genital herpes and paid her $1.1 million in damages. (Yes, in some states you can sue for STD transmission.)
So, let's talk about it.
What is "it"?
Oral (HSV 1) and Genital Herpes (HSV 2)
Infection rates (US) are as follows:
- 25% of women (1 in 4) have genital herpes
- 20% of men (1 in 5) have genital herpes
- 60%-90% of people have oral herpes
Both oral and genital herpes can cause blisters on mucous membranes (mouth and nose) and genital areas (anus, vulva, and penis). Sometimes, the viruses cause nerve pain or flu-like symptoms (fever, muscle aches). However, some people with herpes never show symptoms; the virus can lie dormant in the body for years.
Varicella Zoster aka Chickenpox
Chickenpox was commonly seen in children, causing an itchy rash that turned into fluid-filled blisters. Picking or scratching the blisters would result in scarring, so calamine lotion and oatmeal baths were encouraged to ease itching. Luckily, a vaccine was developed and became available in 1995 (too late for me, unfortunately). According to the CDC, "each year, more than 3.5 million cases of varicella, 9,000 hospitalizations, and 100 deaths are prevented by varicella vaccination in the United States."
Herpes Zoster aka Shingles
Shingles is actually caused by the same virus that causes chickenpox. It's most common in people over the age of 50 and presents as a rash that blisters (similar to chickenpox). Interestingly, shingles is a reactivation of the chickenpox virus a person may have experienced decades earlier. Shingles is spread when an uninfected person comes in direct contact with the rash while in its blister phase. A person who has had chickenpox will develop shingles, but a person who has not will develop chickenpox.
Do YOU Have Genital or Oral Herpes?
Many physicians won't actually give patients a blood test for oral or genital herpes. Generally, you have to assert that the test is medically necessary as it is NOT part of a standard STD panel. Most people think they've been "tested for everything," when the truth is, most people have NEVER been tested for herpes 1 and 2. Further, many people with herpes 1 (upwards of 80%) or 2 (about 25% of the population) don't know they have it because they show no symptoms.
The first time I attempted to have my physician test me, he resisted, saying "If you have it, you'll have to notify your partners." Wait, isn't that the point? I had to push him to order the test (and had to push my OBGYN to test me years later...sigh). Here are actual physician responses when HSV tests were requested by friends:
- "I'll add on the herpes antibody test. Just know that it lacks very much clinical meaning. It could mean you've been exposed to herpes and are cured, you've been exposed and have it hibernating but it's not contagious, or you've been exposed and it's hibernating and you're contagious even though you're asymptomatic. And it could be falsely positive or falsely negative." - Doctor #1
- "I actually think we should first discuss the HSV testing before you have the tests--there is limited utility to testing." - Doctor #2
Symptoms, though sometimes mild, may include:
- Blisters on the mouth or genitals
- Bumps that may look like ingrown hairs or pimples
- Flu-like symptoms such as fever, body aches, or swollen glands, especially during the first outbreak
- Nerve pain
If you have any of these symptoms and/or have engaged in sexual activity (protected or unprotected) with someone known to have HSV, you should implore your doctor to add HSV 1 and 2 to your STD panel, or pay out of pocket to be tested at an independent lab, such as STD Test Express. If you've ever been sexually active (protected - herpes can be transmitted even if you use a condom - or unprotected) and have never been tested, it's time to learn your status.
Herpes is Always on People's Minds
Cures, Treatments, and Vaccinations
Researchers are currently working on vaccines for HSV 1 and 2. It is difficult to develop a cure or vaccine for some of the following reasons:
- So many people are infected with herpes - particularly HSV 1 - that it is nearly impossible to find people on which to test potential vaccines.
- The word "herpes" comes from the Greek word "ἕρπης", which means "creeping" or "latent". The virus "hides" in the sensory and autonomic ganglia of the nervous system and is nearly impossible to "catch" and kill.
Herpes symptoms - oral or genital - can be controlled with suppressive therapy. We've all heard of Valtrex, but any number of medications of the same family can be used to prevent herpes outbreaks and transmission.
Herpes IS Treatable, But...
Genital herpes can cause serious complications, such as:
- Increased risk of miscarriage, premature delivery, and a potentially deadly infection (from mother to infant) called neonatal herpes (oral herpes can spread to infants, too).
- Increased risk of contracting HIV and other STDs.
Chickenpox can also be dangerous:
- Contracting chickenpox as an adult can be fatal.
- Childhood infections can recur as shingles in late adulthood.
Besides causing extreme pain, shingles can lead to:
- Hearing problems
- Brain inflammation (encephalitis)