Comment by minikites | Hacker News Reader

Comment by minikites | Hacker News Reader

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Reminder that the stigma against herpes is a pharmaceutical marketing creation from the mid 1970s:

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

>Pedro Cuatrecasas states, "during the R&D of acyclovir, 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'.

>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.

Note also though that Wikipedia claims that genital herpes infection rate increased dramatically during the 1970s. If true, it's not surprising that it would be relatively unknown before the increase and stigmatized after. HIV wasn't stigmatized in the 70s either.

"The stigma against" is exclusively a US bound thing. I consume a lot of media (Plus memes) from the US, and people make a real fuss about it.

In my country people give it the same importance as a simple cold.

"In my country" with no context and not even a name for your country? I'm disinclined to believe that your anecdote accurately describes any country.

I like how you've inverted the common "US represents the world" fallacy by literally asserting that your herpes-blind nation is representative of the entire world exclusive of the US.

Judging from the content on the linked wikipedia page for Herpes Simplex it strikes me as absurd that one would categorize it with the simple cold.

Although it's not curable, there are a lot of good, cheap treatments available, and many people can go long periods of time with no symptoms.

Consider the line from the Wikipedia page:

"Worldwide rates of either HSV-1 or HSV-2 are between 60% and 95% in adults."

If infection rates are that high, it's probably not that big of a deal for most people.

Most of that 60-95% is oral, though. Genital infection rates are far lower, at <20% in the US.

It's also associated with Alzheimer's disease, which is a horrible way to die. It can cause blindness and death, particularly in newborns. I don't think it wise to dismiss herpes as just something mild or inevitable.

Gingivitis is associated with Alzheimer's disease, too.

Everyone gets it. It just goes away, often for years. There's no cure. Like colds.

> There's no cure. Like colds.

Colds resolve in a few days to a week. There is absolutely a cure, just not one in pill form.

Most HSV outbreaks also resolve in a few days to a week, and either never recur at all or recur extremely infrequently.

The outbreak resolves. The infection does not. And recurrence of HSV is quite common.

Speak for yourself, I don't have any form of HSV. One advantage to being a quiet friendless nerd throughout my youth was never catching chickenpox.

Not having chickenpox (and not being vaccinated for it) isn't really an advantage. Chickenpox as an adult is serious business: complications like pneumonia and encephalitis are much more common, and there's a significantly higher risk of death or hospitalization (75% of deaths from chickenpox are in adults, despite < 10% of the cases being in adults). You're also at higher risk for shingles if you catch it as an adult than as a child. Chickenpox is extremely contagious; it's airborne, can be transmitted just from being in the same area as someone with the disease for 15 minutes, and over 90% of people exposed will come down with the illness.

If you didn't get it as a kid you really should get vaccinated for it as an adult. Being exposed to the attenuated form of HHV-3 in the vaccine is way safer than actually catching the disease.

How do you know? Have you had HSV blood tests?

In my 20s. I suppose it's remotely possible that I contracted HSV since then without ever having any symptoms, but my understanding of HSV is that with all forms the initial infection is obvious so that's quite unlikely.

We're not talking about HPV, which I (and you) very likely have wether we know it or not, without vaccination.

It's more likely than you think.

"Oral herpes infection is mostly asymptomatic, and the majority of people with HSV-1 infection are unaware they are infected." [1]

[1] From https://www.who.int/news-room/fact-sheets/detail/herpes-simp...

>I suppose it's remotely possible that I contracted HSV since then without ever having any symptoms

It actually is. Most people are asymptomatic, or their symptoms are so mild that they confuse them for a pimple.

https://www.cdc.gov/std/herpes/stdfact-herpes-detailed.htm

I'll announce my scarlet letter to make a point. I was recently tested for HSV and came back positive for HSV-2. I've never been tested before so I have no idea how long I've had it, but it was a surprise because I've had zero symptoms. In fact, I figured it was a false positive so I got re-tested.

No, almost 40% of us do not get it. This is not something inevitable. I don't have any family member with the symptoms.

You realize most people don't get any symptoms, right? Many people contract it as a kid (a kiss from a relative) and their immune system suppresses it. Unless you get an HSV blood test you will not know.

Even blood tests are unreliable. IIRC, IgG tests are quite reliable but not every clinic does them. Many clinics default to an IgM test, which are useless[0]. The gold standard here is the Western Blot test

[0]: https://drjengunter.wordpress.com/2013/06/17/igm-blood-test-...

widespread cold sores in a given society i think have 2 pronged effect:

1. a something widespread does usually have naturally higher societal acceptance

2. [IANAD] kind of "de-facto" vaccination/immunization. For example i (like many many Russians) have occasional cold sores (once in a 1-4 years, in CA seems to be less frequently than back in Russia) since childhood. I've had it on both sides of my lips which probably means that i have both - HSV1 and HSV2. That also means that i never going to get it anywhere else on my body (once any one site in the body gets infected with herpes the rest of the body develops immunity)

From descriptions genital herpes seems to be worse than lip cold sores. In US (at least in CA) i see no people with cold sores, so the majority of the population is most probably susceptible to the infection. Given that sexual contact is a frequent transmission method in adulthood (while not a factor in childhood), i'm not surprised that for US population "herpes" statistically means and happens as "genital herpes" (while i haven't heard about such a thing back in Russia where we get it early in the childhood as cold sores on lips).

>I've had it on both sides of my lips which probably means that i have both - HSV1 and HSV2. That also means that i never going to get it anywhere else on my body (once any one site in the body gets infected with herpes the rest of the body develops immunity

This is all contrary to my understanding.

You can definitely spread either strain to other areas of your body. You can spread it around your mouth more and transfer it from your mouth to your genitals.

Thinking you can't get it more will not lead to pleasant outcomes.

To clarify: you don't spread herpes around your mouth or genitals, because that's not where herpes takes up latency.

HSV takes up latency in usually either the dorsal root ganglion (which typically presents with lesions in the genital region), or in the trigeminal ganglion which typically presents with oral lesions.

You are right that infection with one strain does not necessarily grant immunity to infection with another strain.

It is also not true that oral lesions necessarily indicate HSV1 infection, and that genital lesions necessarily indicate HSV2 infection.

Source: https://www.ncbi.nlm.nih.gov/books/NBK47447/

>That also means that i never going to get it anywhere else on my body (once any one site in the body gets infected with herpes the rest of the body develops immunity)

Do you have a source for that? I have somewhat suspected that was the case based on some other things I've heard, but I have been unable to find any real sources on it.

not really - it was some years ago that i just sat down and googled around exploring the issue. Similar conclusions:

https://www.washingtonpost.com/news/speaking-of-science/wp/2...

"But as people gained awareness of the contagious nature of cold sores, they became more cautious about exposing young children to a skin outbreak. That means more and more of us get to adulthood without any HSV immunity.

On the one hand, that makes the younger generation more susceptible to HSV-2 -- one won't 100 percent protect you from contracting the other, but they have some antibodies in common. On the other hand, it means that more and more people get their first exposure to HSV-1 not through kissing, but through oral sex."

"I've had it on both sides of my lips which probably means that i have both - HSV1 and HSV2"

This is definitely not true. HSV2 showing up on lips is extremely uncommon. I've had HSV1 for my entire life and any area of my mouth is fair game, as so is the inside of my nose.

I find this fascinating. Never heard the claim before that lip herpes grants immunity to genital outbreaks.

Also, whats source of such common early childhood herpes in Russia? Kissing from infected relatives? Given lethality of neonatal herpes it seems unlikely to be interuterine transmission.

I've heard that claim, and I have subsequently heard it disproven.

The peak was when Time magazine had 'Herpes: The New Scarlet Letter' on the cover in August 1982

It's was actually "Today's scarlet letter: Herpes."

https://goo.gl/images/hVd6um

Sad when people can't do a simple Google search to verify most easily verifiable claims.

Did you update the wikipedia article with the correct citation? Its easy to complain on HN, takes a little more effort to correct misinformation for future internet users.

I've never been able to successfully alter a Wikipedia article, even for something as simple as a typo correction.

Bots always revert my changes within seconds.

Did you update the wikipedia article with the correct citation?

Nope. And for reasons I've outlined elsewhere on HN.

https://news.ycombinator.com/item?id=19400846

I updated it.

Why so confrontational? It's a simple mistake, and relatively harmless since the meaning is not at all changed.

Agreed, but the article itself from that issue is titled "The New Scarlet Letter"[1]. The statement from Wikipedia seems to conflate the cover line with the article itself.

[1] http://content.time.com/time/subscriber/article/0,33009,1715...

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