November 1997
ATLANTA - One in five Americans is infected with herpes, and the prevalence of this sexually transmitted disease has increased 30% since the late 1970s, according to the results of a national survey released recently by the Centers for Disease Control and Prevention (CDC).
What is particularly alarming is that the fastest rate of infection is occurring among teenagers, according to Helene Gayle, MD, MPH, director of the CDC's National Center for HIV, STD and TB Prevention.
The findings, reported in the New England Journal of Medicine, document that nearly 22% of the population overall (45 million Americans) and almost half of African-Americans are infected with herpes simplex virus type 2 (HSV-2).
Since the last national survey of HSV-2 prevalence conducted between 1976 and 1980, prevalence has increased most dramatically among young white teens. HSV-2 prevalence among 12- to 19-year-old whites is now five times higher than it was in the late 1970s. And young people from 20 to 29 are now twice as likely to have HSV-2.
"Herpes is perhaps the most common sexually transmitted disease in America today. It continues to spread across all economic and social boundaries and is spreading fastest among teens," Gayle said.
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In addition to ongoing STD prevention activities, the CDC is now working with other public health experts to develop a national plan to address the prevention of herpes. The plan will address development of comprehensive national prevention guidelines, outline enhanced monitoring of herpes rates in the United States and propose new educational activities for health care professionals and the general public.
HSV-2 is usually transmitted sexually and is believed to be most infectious when lesions are present, but can be transmitted even when there are no symptoms. With or without visible lesions, the disease can be transmitted between sex partners and from mothers to newborns. Newborns are particularly at risk for serious disease.
Herpes can greatly increase a person's risk of becoming infected with HIV. "We believe that herpes plays a major role in the heterosexual spread of HIV in this country. Herpes can make people more susceptible to HIV infection and make HIV-infected individuals more infectious," said Judith Wasserheit, MD, MPH, director of the division of STD Prevention at the CDC. "Preventing herpes can help us stop both epidemics."
The study also found that HSV-2 is more common among women (about 1:4 women) than men (almost 1:5). This may be related to the higher efficiency of transmission from men to women and to higher prevalence of infection in sexual partners.
Between outbreaks or with a partner whose herpes status is unknown, the consistent and correct use of latex condoms is the best protection. Because condoms do not cover all areas where herpes could be present, people should also avoid any direct contact with herpes lesions. For people with frequent or severe outbreaks of herpes, antiviral medications may help to relieve or suppress outbreaks.
For more information:
- Fleming DT, McQuillan GM, Johnson RE et al. The evolving epidemiology of herpes simplex virus type 2 in the United States, 1976 to 1994. N Eng J Med. 1997;337.
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