Do I have Herpes?

Vox.com posted an article by Susannah Locke with the provocative (click-bait?) headline: "You probably have herpes and don't know it". Well do you?

There is oral herpes and there is genital herpes. Oral herpes is manifested as cold sores or fever blisters on the face or mouth. Genital herpes is manifested as genital sores (or in the anal region). Oral herpes is mainly caused by Herpes simplex virus type 1 (HSV-1); genital herpes is typically caused by Herpes simplex virus type 2 (HSV-2). Oral herpes is transmitted by non-sexual contact such as sharing a toothbrush, cup, or towel; genital herpes is transmitted through sexual contact. People usually acquire oral herpes as a young kid (between ages 1 and 5); people acquire genital herpes after they become sexually active typically through sex.

Neither herpes infection is considered dangerous with a couple of caveats. There is some concern for a pregnant Mom passing genital herpes on to her child during childbirth. Infection can lead to neurological impairment or even death in a newborn. The risk is greatest for a primary (initial) infection as opposed to a recurrence (because of the absence of maternal antibodies against HSV-2). Second, genital herpes sores can increase the risk of contracting AIDS by about 3-fold (because of greater accessibility to the blood).

Symptoms for both oral and genital herpes are mild. In many cases, infected individuals are asymptomatic (i.e. do not have sores). Sometimes the symptoms can be more severe in terms of the number of sores, pain from the sores, and the frequency of their recurrence. People can be asymptomatic but still shed (i.e. transmit) the virus.

There is no cure (or vaccine) for herpes. Antivirals such as Zovirax can stop the growth of the virus, and thus significantly reduce the severity of an outbreak. They will not, however, rid the body of the virus.

But back to the original question: Do I have herpes? From Wikipedia:

"In the US, 57.7% of the population (aged 14 to 49) is infected with HSV-1 and 16.2% are infected with HSV-2. Among those HSV-2 seropositive, only 18.9% were aware that they were infected."

In other words, by testing for the presence of antibodies against either HSV-1 (mainly oral herpes) or HSV-2 (mainly genital herpes), researchers determined that more than half of the population has oral herpes, and about 1 in 6 has genital herpes. Interestingly, only about 20% of people with genital herpes are aware that they have it (and hence could pass it on to others without knowing).

It should be noted that the risk of genital herpes goes up with age and your sexual activity. For example, the Vox article cites a study which estimated that 50 to 70 percent of single women aged 45 to 50 have genital herpes.

Finally, the CDC does not recommend testing for herpes issuing the following statement:

"For the majority of people with herpes, the infection causes them no physical problems, and there's nothing they could do to cure themselves if they found out that they had it."

In summary, it is likely you have oral herpes which you probably contracted as a kid. Depending on the quantity of your sexual activity (or lack thereof, e.g. if you got married early), you probably don't have genital herpes. On the other hand, if you have had many sexual partners, your chance of having genital herpes is higher. If you do have genital herpes there is a good chance you don't know it because many do not have symptoms (i.e. genital sores) and can unwittingly pass it on to others. Women should avoid contracting herpes while they are pregnant.

Figure 1. You probably have oral herpes but (depending on your sexual activity) you probably don't have genital herpes.