| There’s nothing like sitting around on a Saturday morning staring at floor-to-ceiling slides of herpes-infected genitals to start your weekend off right. But who can resist a seminar with a name like, "What’s new in herpes?" Not me. Which is how I found myself at Toronto’s Primary Care Conference listening to Dr. Michael Silverman, Director of Infectious Diseases at the Lakeridge Health Center in Oshawa tell me, well, what is new with herpes.
For example, did you know that of the estimated 20 per cent of adult Americans who have herpes simplex virus-2 (HSV-2, the herpes strain that causes genital herpes, as opposed to HSV-1, the strain that causes cold sores on the mouth), about 90 per cent don’t even know they have it? (Widespread statistics for Canada aren’t available but at least one Alberta study produced similar stats.) This is partly because, says Silverman, 60 to 90 per cent of those with herpes don’t show symptoms, don’t recognize the symptoms or are told it’s something else.
Apparently, while most of us have been taught to look for blister-like lesions as a sign of herpes, additional symptoms are often mistaken for other conditions like urinary tract infections. Or a latex allergy, razor burn or jock itch. "A woman with a yeast infection will treat it and the symptoms will go away reinforcing that was the problem," explains Silverman. "But if it’s actually a herpes symptom, they often heal on their own after a few days anyway, so she wouldn’t know the difference." And, if that’s not complicated enough, even if symptoms do show up and are identifiable as herpes, have fun figuring out if it’s HSV-1 or HSV-2 because HSV-1 can show up genitally while HSV-2 can break out orally.
However, if your primary outbreak is severe and obvious (for example, it hurts like hell, looks like a bomb went off on your face or genitals, you have a high fever and you’re puking your guts up), chances are you’ve got the corresponding strain. If the first outbreak is less severe it may be that it’s genital herpes showing up for the first time on your face or vice versa. And then, it usually only happens once at this site. Subsequent outbreaks tend to stick to their designated region. It’s not known why this is. It’s just one of the many, maddeningly complex things about the ironically named herpes simplex virus. Like the fact that 70 per cent of all transmission happens with no visible symptoms. Meaning you can have it, not know it, and pass it along without ever knowing.
There is some good news. Testing for herpes is improving. Traditional herpes culture tests – done by swabbing an active lesion – require, well, an obvious lesion to swab. New blood antibody tests are more effective, but most doctors don’t offer them, they aren’t easily available, and the $150 cost isn’t usually covered by medical insurance.
Before you all run out in a panic and start shelling out money to get tested, Silverman suggests you may wish to be tested, if: 1) you have symptoms but haven’t been able to get a diagnosis through a culture test 2) you’ve been in contact with other sexually transmitted infections or have HIV 3) your partner has genital herpes and you’re wondering if you may already have it. This is particularly important if a woman is pregnant, and her partner has herpes, as acquiring herpes for the first time during pregnancy can cause things like blindness and mental illness in the baby.
Before you think your partner’s a big old cheatin’ ’ho because you suddenly get herpes after 10 years together, Silverman says there’s an eight per cent chance of transmission per year between monogamous partners not using condoms making getting the virus a bit like Russian roulette. "You can get it for the first time after 15-25 years with the same partner," he says.
There is good news, however. New anti-viral drugs offer added protection and some welcome relief from the "I’ll die alone" despair experienced by so many sufferers who worry their herpes will be a relationship killer. Of course, adds Silverman, "while putting everyone on drugs would do wonders for the pharmaceutical companies, it’s not practical." Luckily, condom use alone can bring transmission rates down by an estimated 50 per cent. If one partner has repeated outbreaks, the combination of condom use and drug therapy can reduce transmission rates by 75 per cent. Armed with the proper information, improved diagnoses, prevention strategies and follow-up, one day, herpes may be old news. |
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