45 Million Have Herpes -- And Most People Don't Know

Herpes has been quietly spreading in the shadow of the AIDS onslaught. Since the late 1970s, the number of Americans with HSV-2 -- the herpes simplex virus that usually causes genital herpes -- has jumped 30 percent, to about 45 million. Herpes has become five times more common among American teenagers in that period, and twice as common among those in their 20s.

Herpes acts as a catalyst in the worldwide spread of HIV/AIDS. The presence of herpes at least doubles the chance of HIV infection through sex. But as many as 90 percent of people with herpes do not know they have it; they often have mild, misdiagnosed symptoms, or no apparent symptoms.

People with obvious symptoms generally have one or more blisters near the genitals and may have flu-like symptoms. The blisters break, leaving sores that can take from one day to three weeks to heal. Meanwhile, the virus hides in nerve bundles and erupts again periodically. The number and severity of outbreaks tends to decrease over time.

Many people who know they have herpes believe they cannot spread it unless they are having an outbreak. Unfortunately, that is not true, which is why public health officials encourage people with herpes to use latex condoms, even when they do not have symptoms, to reduce the risk of transmission. The closely related HSV-1 commonly causes cold sores, but it can be transmitted to the genitals via oral sex, and HSV-2 can cause cold sores by way of the same route. Antiviral drugs can shorten an episode or, if taken regularly, prevent future outbreaks.

Neonatal herpes can cause illness and even death in newborns. It is rare, occurring in one in 2,000 to 5,000 births a year, but on the rise, said one expert. Mothers who contract herpes before they get pregnant do not usually transmit the virus to their children. However, women who become infected during pregnancy and have their first outbreak near the time of birth can pass on the virus. A cesarean birth can be performed to protect the infant. The American Social Health Association would like to see neonatal herpes made a nationally reportable disease so better information can be collected

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