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The STI Files: Herpes

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Stat: About one in five people in the United States over age 12 -- approximately 45 million individuals -- are infected with HSV-II, the virus that causes genital herpes. Around 50 - 80% of the adult population has oral herpes, which most people contract through nonsexual contact in childhood.

What is it exactly? There are two types of the Herpes Simplex Virus: Simplex I and Simplex II. Simplex I or oral herpes usually infects the mouth (cold sores are Herpes Simplex I), and Simplex II, or genital herpes, usually infects the genitals. However, both types can be transmitted sexually (through kissing and oral sex as well as through skin and genital contact), and HSV-I is not limited to the mouth area, nor is HSV-II limited to the genitals. So, HSV-I can affect the genitals, and HSV-II can affect the mouth area. It's also possible to be infected with both types of the Herpes Simplex virus.

About how many people have it? Herpes is one of the most common sexually transmitted diseases in the United States. About one in five people are infected with genital herpes.

How is it spread? Herpes viruses are spread by contact between an infected area of the body and an uninfected, susceptible area of an uninfected person's body. This means that herpes can be spread from ANY affected part of the body: penis, vulva, anus, mouth, lips/face, or other areas.
If virus from an active sore is on a hand or an object, it can also be transmitted that way -- for instance, a person with cold sores could wipe their mouth with their fingers, then perform manual sex on an uninfected person and infect them that way. It can even be transmitted from hand to eye. Ouch.

Sexually, it can be spread by vaginal, anal, or oral intercourse, manual sex, general touch or kissing. Unlike most other kinds of sexually transmitted infections, it is not simply spread through body fluids. Herpes can be spread through skin-to-skin contact. Herpes is most contagious when one person with the disease has an active sore, however it may also be spread when no sores are visible or perceived to be present. Shaving areas where there are outbreaks may also contribute to the virus spreading.

What are its symptoms? A rash or blisters that recur in small clusters that may be seen on the vulva, vagina or cervix, on the penis, buttocks or anus, or on the mouth and other areas of the body. It is generally itchy, sore or painful.

The first occurrence of herpes may also cause itching or burning while urinating, swollen glands, fever, headache, loss of appetite, and general lethargy or tiredness. These first symptoms usually occur within one month of the initial transmission, but a rash may not be visible or occur for years afterward.

How is it diagnosed? Herpes can only be accurately diagnosed by a doctor or clinicians sampling of an active sore, but there are other means of testing available, though they are less accurate.

Is it treatable? Herpes symptoms and outbreaks can be reduced with medication, but the disease still remains in the body and is contagious even when treated.

Is it curable? There is currently no cure for any form of the Herpes virus.

Can it affect fertility? Herpes generally does not affect fertility for either men or women. However, it is dangerous for people to contract herpes when pregnant. Herpes can cause severe problems for newborns, especially if a vaginal birth, specifically, occurs during an outbreak of active sores or lesions. Herpes infection can potentially cause miscarriage or stillbirth, or chronic health problems and developmental disabilities in a live birth.

Can it cause death? No.

How can we protect against it? People with Herpes should NOT have physical sexual contact (vaginal or anal intercourse, oral intercourse, manual intercourse, kissing, etc.) with others when sores are present or when they can feel the sensations that signal an approaching outbreak. Because people can have herpes infections without having a visible rash or outbreak, and because condoms only offer limited protection from herpes (since herpes can infect areas of skin not covered by condoms), both sexual partners should be tested for Herpes BEFORE any sexual intimacy of any sort, and safer sex should always be practiced.

Want to find out about other STIs?

written 29 Apr 2007 . updated 28 Oct 2011

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