Two-thirds of the world's population under 50 have herpes | Hacker News Reader

Two-thirds of the world's population under 50 have herpes

reuters.com

38 pointsFuturebot52 comments

Herpes is said by some to be an early example of "disease mongering" to sell medication.

https://en.wikipedia.org/wiki/Herpes_simplex#Society_and_cul...

Herpes simplex was not always stigmatised. It was merely a cold sore in an unusual place until the 1970s. As late as 1975, a study of "Psychological morbidity in a clinic for sexually transmitted disease" does not mention herpes simplex because at that time, no significant morbidity problem (i.e. mental anxiety or illness) was associated with the virus.[98]

Pedro Cuatrecasas states, "during the R&D of acyclovir (Zovirax), marketing [department of Burroughs Wellcome] insisted that there were 'no markets' for this compound. Most had hardly heard of genital herpes..." Thus, marketing the medical condition – separating the 'normal cold sore' from the 'stigmatized genital infection' was to become the key to marketing the drug, a process now known as 'disease mongering'.[99][100]

Since the creation of the herpes hype, some people experience negative feelings related to the condition following diagnosis, in particular if they have acquired the genital form of the disease. Feelings can include depression, fear of rejection, feelings of isolation, fear of being found out, and self-destructive feelings.[101] These feelings usually lessen over time. Much of the hysteria and stigma surrounding herpes stems from a media campaign beginning in the late 1970s and peaking in the early 1980s. Multiple articles were worded in fear-mongering and anxiety-provoking terminology, such as the now-ubiquitous "attacks", "outbreaks", "victims", and "sufferers". At one point, the term "herpetic" even entered the popular lexicon. The articles were published by Reader's Digest, U.S. News, and Time magazine, among others. A made-for-TV movie was named Intimate Agony. The peak was when Time magazine had 'Herpes: The New Scarlet Letter' on the cover in August 1982, forever stigmatizing the word in the public mind.[81] Herpes support groups have been formed in the United States and the UK, providing information about herpes and running message forums and dating websites for sufferers. People with the herpes virus are often hesitant to divulge to other people, including friends and family, that they are infected. This is especially true of new or potential sexual partners whom they consider casual.[102]

If you get the cold sores, get the Abreva®. That magical balm knocks 'em out like Tyson deckin' your grandmother.

Can anyone explain this: "That is because improved hygiene in rich countries is lowering HSV-1 infection rates in childhood, leaving young people more at risk of catching it via oral sex when they become sexually active."

I read that several times. It still makes no sense to me.

So, in poor countries all children are infected, which means as they age there's no risk to them as teenagers, because there's nothing risky about already having it and messing around with someone else that already has it.

Welcome to the wonderful world of spin doctoring.

To restate in different words:

"In developing countries, kids will get herpes from playing in the mud or other things. In the developed world, we incubate kids in sterile bedrooms, so their first exposure to this pathogen is during sexual activity."

This seems very elitist to me - having grown up in a first world country, where I played in the mud and hit things with sticks.

Small children can also get HSV-1 from things like being kissed by an older relative with an active cold sore.

That kind of thing probably happens less in developed countries due to higher awareness. [citation needed]

I'm just making this up, but it seems possible that having oral herpes confers some resistance to getting genital herpes?

Yes, but only to getting the "oral kind of herpes" genitally...

That's my assumption. Once you have it, you have antibodies to it as well, which prevent new cases. But you're still stuck with it in the original place, because the virus's genome hides out where the antibodies can't get it, then from time-to-time it decides to go on a rampage.

IANAI (Immunologist)

I just read it as "improved hygiene increases the chance that young people are not yet infected when they inevitably become infected via oral sex." In other words, the improved hygiene has not lowered the adult infection rate.

They mean that because children aren't contracting HSV-1 from ordinary contamination and contact at early ages, as they typically do in developing countries, they are more likely to contract it from oral sex later in life. My guess is that if you contract the virus in childhood, there is less risk of a genital infection later in life because the antibodies would already be present.

If you get it above the neck, you are immune to it below the neck. So having occasional cold sores (being one of their two thirds) is actually a good thing....one less thing to worry about.

Citation needed.

Actually not. There are multiple strains for each type. A HSV-1 "above the neck" infection does not prevent a HSV-2 infection below the neck.

http://www.jci.org/articles/view/57148

I took gp to mean that HSV-1 "on top" renders one immune to HSV-1 below, not HSV-1 and 2 below. And that appears to be true. Interesting that 1 and 2 appear to be "assymetrically" related, from your link: "As HSV-1 and HSV-2 have similar pathogenesis and host interactions, many of the concepts for development of an effective vaccine are likely relevant to both viruses. In addition, infection with HSV-2 provides partial protection against HSV-1, although the reverse does not appear to be true, and thus there is potential for generation of cross-reactive immunity. The possibility that an HSV-2 vaccine may provide protection against HSV-1 increases its potential value and may shift the optimal time for immunization to early childhood, instead of the more problematic adolescent vaccination series." (My emphasis, references removed)

[ed: to add, I'm not entirely sure on how/if hsv-1 (the same strain of hsv-1) can "move" -- I recall sex. ed. stating that the most common cause of HSV-1 in the genitals and eyes were self-induced -- but that might have been the other way around (HSV-2 moving from the genitals to the eyes)]

This is 100% false. Per Mertz, Annals of Internal Medicine, 1992, previous oral HSV-1 infection reduces the acquisition of subsequent HSV-2 infection by 40%. That is not immunity.

I don't think that's true.

http://www.healthcentral.com/genital-herpes/c/86/6903/hsv1-o...

Far better, take 400 mg/day acyclovir to prevent breakouts.

Abreva is pretty useless. Its really expensive and only reduces the duration of a cold sore by 17.5 hours in clinical trials. That is not a noticeable timeframe to me.

I got it when I was a kid, and still occasionally get coldsores on my lips. I used to mess around with Zovirax and related creams, but now just leave them until they go away (usually a couple of days). No touching, or licking because that just makes them last longer, or worse, spread.

Herpes Simplex. If you get cold sores, you have Herpes Simplex. It's not the STD version.

Sort of. Oral HSV-1 can spread to genitals during oral sex. The article notes this is becoming more common.

As for HSV-2:

  -More than 80% of people with herpes are undiagnosed
  -Overall prevalence by the time people reach their forties is 26%.
  -In the general population, one-fifth of women and 11.5% of men are infected.

http://commonhealth.wbur.org/2011/04/latest-genital-herpes

The CDC considers Herpes Simplex to be an STD if it involves the genitals [1]. According to the article, both HSV-1 and HSV-2 can cause genital herpes.

[1] http://www.cdc.gov/std/herpes/default.htm

You are right. HSV-2 is the infection mostly occurring in the genital area. However, HSV-1 (cold sores) can also transmit to the genital area for example via oral sex, even though such HSV-1 infection there is less likely than with HSV-2.

Addition: while oral sex often goes unprotected (HSV-1), HSV-2 transmits also with condoms during sexual penetration. Skin-on-skin contact in unprotected areas is enough for the virus to transmit. However, because of the motion and friction condoms protect women better than men.[1]

[1] http://www.guttmacher.org/pubs/journals/2721301b.html

There are two common strains of the herpes simplex virus, called HSV-1 and HSV-2. Both can cause genital sores, and both can be transmitted sexually. Here are some facts: http://www.who.int/mediacentre/factsheets/fs400/en/

I can never tell how worried I should be about HSV-1. If it's in the mouth it's relatively normal but if it spreads to the genitals, that's bad?

Yup.

And don't lick someone's genitals if you have it in your mouth.

And before you let someone lick your genitals, ask them if they have it.

How does one diagnose whether they have it orally?

AFAIK the highest risk of transmission is when there is an outbreak, so you can fairly easily see it.

Look, I don't care about the karma, but does this downvote mean that HPV-1 is equally transmissible during an outbreak as in latent phases? Because if so, those 2/3rds of the world's population would all need to cut out oral sex from their lives.

First, HSV, not HPV.

Second, you're being downvoted because oral outbreaks can be very mild and may just look like acne, or a razor burn, or any number of other normal dermatological conditions. "Just looking for it" is perhaps the worst way to possibly think about any STD.

Presumably a dental dam would prevent transmission of HSV-1 during oral sex.

AFAIK risk of transmission is highest before an outbreak. Ie: before it's easier to diagnose visually (and as others have mentioned, not all outbreaks get to a stage where they're easy to diagnose).

In response to another question in this thread, the safest way to "diagnose" herpes in others, is probably to ask them. If they don't know (haven't been tested lately), assume they're infected. And if you can't trust them to tell the truth, you probably have no business being (physically) intimate with them... (Not meant as a moral judgement, just as an observation).

re: roel's post

Herpes outbreaks are not necessarily apparent visually, which is true for both hsv-1 AND hsv-2 ("genital herpes").

The only way to really know if you are infected is to get tested during an outbreak, which is not always easy to do as outbreaks do not always correspond to visual cues. So you either need to trust the person you're intimating with or you need to take precautions, which also don't always prevent infection. Condoms reduce the transmission rate, for example, but don't preclude transmission to areas of the body not covered by the condom.

You can get a blood test for IgG antibodies without an outbreak that will differentiate between HSV-1 and HSV-2.

It can be bad, but if you're the type of person reading HN, it means you probably can afford Valtrex if you have a really bad outbreak. You may never have a bad outbreak. You may have one and it will clear up in a day.

The hardest part of any STI for someone with access to health care is the fear and the disclosure, but here's one of the best written articles on the subject to say why disclosure isn't so bad: http://thehairpin.com/2012/04/the-perks-of-herpes/

The source of this news article:

http://www.who.int/mediacentre/news/releases/2015/herpes/en/

My fiance has it, should I worry about it?

Is there any proper cure?

I dnt want that me or our future baby gets it.

(This is being heavily downvoted, I'll try to edit but may end up deleting.)

So I don't have herpes (EDIT: SIMPLEX, what nearly everyone has), and I realize it's not a big deal whether I do or don't. I do know I'm in a minority of adults who are in situations to regularly hook up with strangers, people who don't happen to have Herpes, and it's probably due to the fact that I don't actually do so; I'm very picky and basically don't hook up with strangers, just people I happen to know already or be introduced to, OR hitting it off in very rare cases, by really sharing something personal. In the past this included colleagues! (not very serious work.) What I mean is that if I hooked up wtih strangers even a few times - let's say 10 times in 4 years - then I'd probably have it by now.

My reasoning is that given like 80% infection rate, pretty much if I'm going to hook up with people who experience even the tiniest element of network effect, then I'd expect to get it fairly soon.

so far my strategy is just to hold out until I meet the right person, who is similar to myself and has had just a few sexual partners and longer relationships. I was married previously, for example, for several years. (I'm in my very early 30s.)

But I do feel like I might be missing out.

What do you guys suggest I do for more casual dating, other than starting from the pool of people I happen to know or coincidentally run into, or meet at parties or clubs but really, really share something with; rather than the pool of strangers ready to hook up? Given that nearly everyone has it, I'm just not ready for it.

By the way I'll go ahead and get it from someone if they're interesting enough to be in a long-term relationship with; big deal, luck of the draw.

But if I don't have such a specific person in mind, I'd rather apply that filter first . . . (or my version). maybe there should be a dating site for people who happen not to have it! we're certainly a minority.

This article is about the HSV-1 virus that causes cold sores, not genital herpes. It has nothing to do with being "attractive" or "interesting".

I'm talking about cold sores!

Also, I didn't realize that was what was causing the downvotes. What I mean is that it's easy for me to hook up with strangers, and if someone is attractive and interesting I'd assume it's easy for them to hook up with strangers as well; so the only question is whether they want to. (or I want to.)

The reason I mentioned that is that I thought the main vector was open-mouthed kissing.

I've had cold sore since before I could remember and certainly before I ever open mouth kissed anyone. Kids often get them from being germy kids. There's really no point in worrying about it because you probably already been exposed.

Take it from me, I have chronic cold sores and while they suck there really isn't much use in worry about it. Most people don't get chronic cold sores, I am in the slim minority.

-"I don't have herpes. I do know I'm in a minority of attractive and interesting people who don't happen to have Herpes, and it's probably due to the fact that I'm very picky and basically don't hook up with strangers"

Who the hell has been stroking your ego? Seriously!!! You assume that people only get herpes from fucking other people who have the virus unbeknownst to them!

I've edited that part. I thought open-mouthed kissing was one of the main vectors, are at least an important vector. I don't know why you add "unbeknownst."

so keep doing it

> it's probably due to the fact that I'm very picky and basically don't hook up with strangers, just people I happen to know already or be introduced to

It seems the pool of people you're interested in having sex with is roughly the same as the pool of people you say you would still be with even if they had herpes, so I don't know what the problem here is apart from feeling the need to share a lot of uninteresting personal info.

This is why downvotes are a stupid idea. So many mixed signals to misinterpret. Anyone downvoting this guy is part of the problem, because you're just locking him in his own cage of ignorance, without explaining to him why he's getting downvoted.

Anywho, the main error in your post really has to do with the fact that you'll catch this kind of thing from water fountains, silverware, accidentally sipping from the wrong glass, touching a paper cup against a fountain soda dispenser, after someone else did the same, and then drinking from said cup, sitting on toilet seats. Et cetera, et cetera, et cetera.

Now, instead of being locked in a prison of ignorance, you'll be locked in a prison of germophobia. Ah well...

Thanks, this is useful, but isn't that a straw man? Aren't I basically just guaranteed to get it from kissing people who have it for long enough? I'm not a germaphobe in other cases, I don't mind lightly washing and sharing silverware or drinking out of a glass someone has drunk from. Maybe if they're a stranger I won't put my mouth to it.

I think "locked in a prison of ignorance" is quite strong phrasing. Unless I'm wrong about how it's transmitted, if I regularly kissed total strangers I'd have it by now.

are you saying I just shouldn't mind at all? (Like, I shouldn't even consider it?)

It's not just a kissing disease. The direct, evident exchange of bodily fluids is not a prerequisite. You can get it from a hand shake. Sexual transmission is only incidental, or rather more or less nomenclature, indicating the rough interpersonal proximity required for transmission, and not the specific acts that precipitate transmission.

People who spread it won't readily display symptoms while contagious. People have it and don't realize it. Doctors don't even test you for it, unless you specifically ask, since it's not life threatening, and most people who would test positive may have had it since infancy.

Simplex I is the more common infection, that even your grandma probably has by now. Simplex II is the skeevy version that your cousin picked up in middle school. Technically speaking, it has to do with the tendency for each species to proliferate in different mucous membranes. The differentiation probably has something to do with the way the human body operates the immune system at different levels in different parts of the body, and over millions of years, each species has adapted to colonize one orifice more readily than another.

Furthermore, HSV I can show up on the mouth or anywhere else. HSV II can ALSO show up on the mouth or anywhere else. You can have both on the mouth simultaneously or both on your junk simultaneously, or one on your junk and the other on your mouth. Each species of virus has a tendency to reside in one area and transmits from that area more readily than the opposing area, but it's really just a liklihood, not hard rules that one only happens here and the other there. That tendency to colonize the mouth is what makes HSV I so common and transmissible because our mouths are exposed to more environments and come into contact with various situations and aren't covered behind clothing nearly as often as elsewhere.

You might already have it. Many people who are infected are asymptomatic. General STD screens also don't test for herpes because so many people have it that the stress of finding out is more harmful that actually knowing you have it (or so the logic goes. I've also heard that it's because the test has high false positive rates).

I spent a long time freaked out about this... then I realized that it's basically an inevitability. We'll all be dead in 80 years anyways :)

Somebody some day may lie to you, despite being "introduced."

You're not that interesting though, judging from your post.

You're bound to get it, or maybe even have it already without knowing it, so why worry about it? It's just cold sores, not HIV.

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