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If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
Let’s say you live in an apartment building. There could easily be 100 people living in your building, even if it’s only a couple of stories tall. But despite that large number of people living in a small building, you’ll still probably only see the same few over and over again because you’re on the same schedule. That’s a little like herpes. (Stick with me.) Herpes is actually a family of viruses with over 100 members (Whitley, 1996). But despite the massive family tree, only eight of these viruses routinely infect humans.
But even within that subset of neighbors you actually see in the hall, you probably only think about a couple. Maybe it’s your own Mr. Heckles downstairs a la Friends or, hopefully, someone you befriended. Whatever it is, they stand out. Herpes is also like that. Some types of herpes, like herpes simplex virus 1 (HSV-1) and herpes simplex virus 2 (HSV-2), get all of the attention because they cause sexually transmitted infections (STIs). The other types of herpes are way more common than you think, though. Other viruses from this same family can cause illnesses like chickenpox, mononucleosis (mono), and also shingles.
Prescription genital herpes treatment—right to your door
Talk with a doctor about how to treat and suppress outbreaks before the first symptom.
How many people in the US have herpes?
HSV-1 and HSV-2 are both known to cause genital herpes. It is estimated that, in the United States, 47.8% of people aged 14–49 have HSV-1, while 11.9% of Americans in the same age group have HSV-2 (WHO, 2017). Theoretically, this means that over 195 million people in the United States might have genital herpes. But we know the number must actually be somewhere lower than this. Not every herpes infection actually causes symptoms, and if it does, it isn’t always in the genitals. Herpes can cause a latent infection, meaning the virus can lie dormant in your system without causing any symptoms. Because of this, not everybody who has herpes knows it even though the Centers for Disease Control and Prevention (CDC) estimates that there are 776,000 new cases of genital herpes in the US each year (Satterwhite, 2013). And this means our estimations of how many people are infected could be way off.
How is herpes transmitted?
Herpes is a sexually transmitted infection and can be spread through sexual contact—be it vaginal, anal, or oral. But despite popular belief, herpes isn’t only spread those ways. HSV-1, like many of the other types of herpesvirus, can be transmitted through saliva. Because of this, children, for example, may become infected through contact with the saliva of their parents (e.g., goodnight kisses) or from other kids at daycare by sharing utensils, straws, or toothbrushes.
Both types of herpes are most contagious in the time around an outbreak when the person infected is experiencing a flare-up of symptoms or a prodrome that a flare-up is to come. But this doesn’t mean herpes can’t be transmitted when the person who has it is asymptomatic—it can, it’s just less likely.
How long does a herpes outbreak last?
How to prevent herpes transmission
First things first: There’s no way to protect yourself from HSV-1 and HSV-2 that’s 100% effective. Limiting sexual contact when someone is having a herpes outbreak is an important first step, which may reduce the risk of transmission. Although there’s currently no cure, daily antiviral medication can be prescribed by a healthcare provider following a herpes diagnosis that helps manage and prevent outbreaks. Currently, herpes infections are treated with antivirals that are prescribed by a healthcare provider, such as acyclovir (brand name Sitavig, Zovirax), valacyclovir (brand name Valtrex; see Important Safety Information), or famciclovir (brand name Famvir). Using condoms and dental dams can also help reduce the chances of transmission.
Getting yourself and your partner/s screened for herpes can be one way to help prevent the spread of the virus. Herpes isn’t usually part of routine STI screening, so make sure you tell your healthcare provider that you are interested in being checked for herpes as well, which would require a blood test. Keep in mind, however, that blood test results may not be able to accurately detect a recent infection. It’s also important to remember that it is possible to have an active, healthy, and safe sex life if you or a partner has herpes.
- Holmes, K. K., Sparling P. F., Stamm, W. E., Pilot, P., Wasserheit, J. N., Corey, L., et al. (Eds.). (2008). Sexually Transmitted Diseases (4th ed., pp. 399–437). McGraw-Hill. Doi: 10.1036/0071417486. Retrieved from http://opac.lib.idu.ac.id/unhan-ebook/assets/uploads/files/9f48a-sexually-transmitted-diseases-4th-ed-by-king-holmes-p.-sparling-walter-stamm-peter-piot-judith-wasserheit-lawrence-corey-myron-cohen_compressed.pdf
- Looker, K. J., Magaret, A. S., May, M. T., Turner, K. M. E., Vickerman, P., Gottlieb, S. L., et al. (2015). Global and Regional Estimates of Prevalent and Incident Herpes Simplex Virus Type 1 Infections in 2012. Plos One, 10(10). doi: 10.1371/journal.pone.0140765. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/26510007
- Satterwhite, C. L., Torrone, E., Meites, E., Dunne, E. F., Mahajan, R., Ocfemia, M. C. B., et al. (2013). Sexually Transmitted Infections Among US Women and Men. Sexually Transmitted Diseases, 40(3), 187–193. doi: 10.1097/olq.0b013e318286bb53. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23403598
- Whitley, R. J. (1996). Herpesvirus. In Medical Microbiology (4th ed.). Galveston, TX: University of Texas Medical Branch at Galveston. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK8157/
- World Health Organization (WHO). (2017, January 31). Herpes simplex virus. Retrieved Feb. 1, 2020, from https://www.who.int/en/news-room/fact-sheets/detail/herpes-simplex-virus
- Yura, Y., Iga, H., Kondo, Y., Harada, K., Yanagawa, T., Yoshida, H., et al. (1991). Herpes simplex virus type 1 and type 2 infection in human oral mucosa in culture. Journal of Oral Pathology and Medicine, 20(2), 68–73. doi: 10.1111/j.1600-0714.1991.tb00892.x. Retrieved from https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1600-0714.1991.tb00892.x
Dr. Mike is a licensed physician and the Director, Medical Content & Education at Ro.