Herpes Statistics

June 21, 2004 7:51 AM

What do you know about herpes? I was reading some blog somewhere and in a comment somebody said condoms don't do a great job protecting against herpes. That didn't sound right to me since that's pretty much the only reason I was wearing the things, so off I go to dig up some research. And, I found some statistics that curdled my blood. Hypochondriacs may want to stop reading now, because after reading some of this, I'm afraid to even touch myself. It seems that:

* More than 45 million people in the US have genital herpes
* One in five people in the US over the age of 12 has genital herpes
* One in four women in the US over the age of 12 has genital herpes
* One in two African American women over the age of 12 has genital herpes

What?!

Seriously, as you might imagine, that raises many, many questions, not the least of which is -- could that possibly be true and how is it that I and my circle of friends had never heard those statistics before? Because that's just insane and I would expect a lot of people to be shouting that from the treetops and wearing ribbons and running marathons for the cure.

So, those stats come from somebody named Fleming who conducted a national study back in 1997. Those numbers are cited by the CDC and pretty much every other internet site that talks about herpes, so I think they're generally accepted as true.

Now, I know this is a disease characterized by stigma so everyone I meet isn't going to be coming up to me and telling me they have herpes. Still, if it's as prevalent as that study suggests, I would have expected to know a few more people than I do. I guess most people who have it don't know they have it because they never have symptoms and I get the impression doctors don't test you unless you have symptoms present.

The study gets it's numbers from finding antibodies which it takes as proof that the people have it. But if most people never have symptoms, then are their two different versions of this thing floating around. One really weak version that people have no problems fighting off, and one nasty thuggish version that makes people break out in lesions? Or is it just that some people are less able to resist so somebody who never had symptoms could infect somebody less able to resist and that person would break out in nasty lesions?

Of course upon hearing those numbers I became instantly convinced I had it and my helpful brain started creating all kinds of symptoms for me. I kept telling myself it was too convenient that I'd start noticing symptoms at the exact moment I started obsessing about it. It's hard to quite that hypochondriac voice though, so a few days ago when I noticed a rash, I figured I wouldn't be able to sleep until I had a doctor look at it.

The rash was just dermatitis (thank god), and the doctor told me in no uncertain terms I did NOT have herpes. But, he never ran any tests. Was he just being irresponsible (putting HMO costs ahead of public health) by not testing me for such a prevalent disease if no (real) symptoms were present? Or is it just that if no symptoms are present, it doesn't really matter if you have the disease, so the only think a test could do would be to give you a reason to worry?

posted by willnot to health & fitness (22 comments total)

AFAIK, herpes doesn't present as a rash; it presents as open sores or ulcers which are apparently very painful. There's no cure for herpes; many vaccines have been tried, but herpes viruses are hard to nab. I don't think your doctor was being irresponsible if neither your rash nor your history suggested herpes. I bet he or she has seen plenty of STDs as a physician.

It's estimated that even more people have the herpes virus that causes oral herpes (cold sores, around the lips). Not to be confused with chancre sores, inside the mouth.
posted by gramcracker at 8:13 AM on June 21, 2004

*dives into Betadine-filled tub*
posted by matteo at 8:43 AM on June 21, 2004

the genital herpes numbers are freaky, but it explains why such inappropriate-seeming commercials are run in prime time...
posted by o2b at 8:43 AM on June 21, 2004

AFAIK, herpes doesn't present as a rash; it presents as open sores or ulcers which are apparently very painful.

Initial infection is often accompanied by flu-like symptoms, such as fever, headache, swollen glands, muscle aches, and generally feeling like shit. Per here and here. So, willnot, that's probably another reason why your doc didn't think your rash was herpes.
posted by jennyb at 9:04 AM on June 21, 2004

If you want some of the best information in a concise summary, emedicine is one of the best sites I've found. (A Google site: search lets you find articles that you can view for free; if you search from emedicine.com, you have to register or pay.)

Medlineplus.gov is also great.
posted by gramcracker at 9:10 AM on June 21, 2004

It's the asymptomatic bit that I'd worry about if I were you. An ex who had the disease got it from a man who flatly denied any exposure at all (to the extent that mutual friends actually beleived the ex was slightly demented...), because he never had symptoms. This is clearly how it spreads so well. A responsible partner will refrain from action during an outbreak - others may not.

Why the condoms are not effective baffles me - what other evidence do you have of this part of your worries?
posted by dash_slot- at 9:24 AM on June 21, 2004

dash_slot- Sites I read said the virus can be spread through simple touching or oral, and I don't know anybody that uses condoms (or rubber gloves) for that kind of thing. I think that's why they say condoms aren't always all that effective. Plus, I know I've had the things break on be from time to time.

I don't have any idea how frequently it gets passed through casual touching or oral or just anything that isn't unprotected intercourse. They may just be trying to scare people. Some message forum I read did have one little girl saying she got it from a tanning bed. Don't know if that was true or just what she needed (people) to believe though.

My big question (to the docs in the house) if you've never had seaping sores, is it something you should worry about passing to a partner? That is, is it something that you should be tested for even if by all accounts you're fine?
posted by willnot at 9:39 AM on June 21, 2004

Perhaps this Vice Magazine Guide to STDs will ease your mind. Probably not, since others might take it more seriously than they should.
posted by shotsy at 9:48 AM on June 21, 2004

It's my understanding that condom's don't prevent herpies or HPV (warts) very well because often the condom doesn't cover the entire penis -- or, I should say, isn't rolled out as far as it possibly could be. If even a 1/4" is left exposed during intercourse, well, there you go.
posted by herc at 10:19 AM on June 21, 2004

In the late 90's, as the only person in my circle that had access to 'that internet thing', I was asked by a friend to help do some research as he was too embarassed to go to the library to research his new-found condition. Some of the things I remember from then include:

Like willnot, surprise at the number of USians with the virus.

You can only pass on the virus when you have the blistering or just before, or just after. Referred to as 'an attack'. Condoms are not a barrier to the virus - but the virus is only passed on from the blistering.

The virus lives in the body & only becomes active (the blistering) when the immune system is low. ie Partying hard can bring on attacks. Similar to oral herpes.

Oral herpes is a similar virus with similar effects but, of course, orally.

Oral herpes can infect someone gentially & vice versa. However it is thought that people with one type of herpes are less likely to be infected with the other.

There are 'herpes dating services' (!)

Some guy was producing some herbal mixture designed to boost the immune system & slow down the frequency of attacks. To order it the guy wanted people to phone his answerpnone & leave a message about 'the special herbs'. Not sure if he's locked up yet ;-)


If it's any help, I got a bit freaked & my friend got very depressed when we first started looking around but after reading some firsthand experiences & the like it wasn't so bad. He got married & lived happily ever after (so far!) so it wasn't the end of the world by any stretch.
posted by i_cola at 10:29 AM on June 21, 2004

I think the stats don't get more publicity because there's no point in bringing about a worldwide panic. Many people have it, but the spread is relatively hard to stop, and it isn't fatal.

If you want to be sure, you can always fork out the money for a specialist, or fake symptoms that will get your primary care doc to refer you to one.
posted by bingo at 10:42 AM on June 21, 2004

Condoms aren't wholly effective because there's lots of skin-to-skin genital contact during sex, and herpes lesions are often on areas not covered by condoms. Additionally, virus can be shed during times there are no visible lesions, which is why it's so often transmitted by people who don't know they have it.

Considering the stats, it is pretty likely that all of us know people with herpes who aren't talking about it - which makes the wide-ranging stigma a bit overly dramatic for what is basically a propensity for cold sores.
posted by judith at 10:45 AM on June 21, 2004

Yeah, the "ribbons" and "marathons" thing is, um, more than a little inappropriate because herpes doesn't kill healthy people. Are you freaked out about oral herpes? If not, why not? The stigma and fear about herpes is because it's an STD, not because it's inherently that bad of a disease. (I'm not saying it's good, mind you, and I'm not saying that it doesn't have its share of severe victims.)
posted by Ethereal Bligh at 10:45 AM on June 21, 2004

Are you similarly freaked out by the fact that 95% of the population has had the common cold? Herpes, like genital warts, is a very common disease. I read somewhere that if you have slept with more than 3 people, you have almost certainly been exposed to warts. 90% of those with herpes are asymptomatic.

Going by the numbers, it is likely that at least 3 of the people posting in this thread so far have HSV. Most likely none of them know they have it. You or I could have it, and could have had it for years, and may never know it.

And that Vice Magazine guide is hilarious. :)
posted by eas98 at 11:05 AM on June 21, 2004

Hmmm.

- One in five people in the US over the age of 12 has genital herpes.
- I don't have it, and neither do my wife or two kids.

That leaves you, willnot.
posted by Daddio at 11:37 AM on June 21, 2004

Sure but, how do you know that you and your wife don't have it? :)
posted by eas98 at 11:48 AM on June 21, 2004

My virology professor, while studying herpes, said matter-of-factly. "Herpes, yea, you most likely all have that" We were sorta surprised. But really. Especially oral, it's not always symptomatic at all, and it's very contagious. Also remember one-in-five over 12 is a huge demographic, I'd imagine in the age range more likely to read metafilter that number is much higher.
posted by rhyax at 12:07 PM on June 21, 2004

i was surprised to find the word herpes used for cold sores in spanish.

i suspect "herpes" was (is?) used to scare schoolchildren into not having sex - presented as some terrible disease at school to scare people away from going behind the bike sheds and doing naughty things. now, of course, we have aids (yeah, my theory doesn't account for syphilis, i know).
posted by andrew cooke at 12:47 PM on June 21, 2004

This is a big deal, simply because women with herpes can transmit it to a child while giving birth to it. And to a newborn baby herpes is a VERY BAD THING. If I recall correctly women with active lesions have to have c-sections.
posted by konolia at 1:06 PM on June 21, 2004

If I recall correctly women with active lesions have to have c-sections.

Not necessarily. See here:

"If you already had recurring genital herpes before becoming pregnant:
In this situation, the risk to your baby is low. Even if you have a recurrence of blisters during childbirth, the virus is passed on in less than 3 in 100 cases. (It is not clear why the risk is low, but it may be because you pass on some immunity to the baby.) This low risk is different to the high risk if you have a first episode or blisters during childbirth - before immunity has had a time to develop.

However, as there is a small risk to the baby, some doctors advise antiviral medication for the last 4 weeks of pregnancy to help prevent a recurrence during childbirth. Also, a caesarean section is an option if a recurrence develops just before childbirth. But, the risk of the operation should be weighed against the small risk of infection to the baby. A specialist can advise."
posted by judith at 1:59 PM on June 21, 2004

The herp is no big deal for many (although it is for some). Most of the people I've known who have it (and I've known quite a few) get outbreaks once a year or so, when stressed, and it just involves being a bit itchy and uncomfortable for a few days while the blisters raise, burst, and dry.

The rest of the time, it's forgotten about. Some have more frequent outbreaks, of course, but they have decent medications to limit the frequency and intensity these days. Back in the '80s it was a different story.
posted by stavrosthewonderchicken at 4:32 PM on June 21, 2004

i actually know a large group of people that all caught herpes from one another. gives me the creepy crawlies
posted by bob sarabia at 7:30 PM on June 21, 2004