People shamefacedly whispered questions about it in locker rooms 25 years ago; nowadays, ads for herpes medication showcase happy people riding bicycles into the sunset. What’s changed? Knowledge, new medications, and promise of even better therapies in the future. Here’s what you need to know.
What is Herpes?
Herpes is a virus, causing sores in whichever part of the body it infects. There are several viruses in the herpes group, including one best known as the cause of chicken pox and shingles, Herpes Zoster. Genital herpes comes from the Herpes Simplex virus. There are two types of Herpes Simplex, 1 and 2.Type 1 is usually the “above-the-waist” type, causing blisters and sores around the mouth. This type is very common; better known as “fever blisters” or “cold sores,” it is spread through saliva. More than half of the U.S. population is infected as children, and many never have any symptoms. For most people, it isn’t a sexually transmitted disease. When type 1 is sexually transmitted, the symptoms are generally milder than type 2, and recurrences are less likely.Type 2 is the “below-the-waist” culprit, generally responsible for genital symptoms (see How do I know if I have it? below). This type is generally more severe, and also more likely to recur. Although the type 1 “above” and type 2 “below” the waist pattern is the most common, it isn’t quite that simple; either type can affect either location.
How does Herpes spread?
Despite popular myths, herpes isn’t spread through contaminated toilet seats or towels. The virus spreads with skin-to-skin contact, and sexual contact causes the overwhelming majority of genital cases. Someone with herpes can infect others most easily during the early part of an outbreak; but he or she may also pass along herpes when there are no symptoms or visible sores.Even after apparent healing, herpes hides in nerve cells close to the infected body part and periodically comes to the skin surface. This is called asymptomatic viral shedding, and is more common in the first six months after initial infection. After six months, asymptomatic shedding occurs on 5 to 20 percent of days.Herpes has spread widely because of this asymptomatic shedding, and because many infected people are symptom-free and don’t realize they are infected and contagious.