What Is Genital Herpes?

Genital herpes is one of the most common sexually transmitted diseases (STDs) in the world. The World Health Organization (WHO) estimated in 2020 that about half a billion people worldwide were living with genital herpes. Although it’s not fatal, it has no cure and it can be very difficult to detect. According to the Centers for Disease Control and Prevention (CDC), 11.9 percent of Americans aged fourteen to forty-nine years have the herpes simplex type 2 virus (HSV-2). A recent study by Statistics Canada estimates that as many as one in seven Canadians aged fourteen to fifty-nine may be infected with HSV-2. These numbers may be much higher since many people don’t even realize they are infected. In the United States, an estimated 81.1 percent of fourteen–forty-nine year olds infected with HSV-2 have never received a clinical diagnosis. The Statistics Canada study found that more than 90 percent of people who had HSV-2 were unaware of their status.

Teenagers represent the fastest-growing group of people with genital herpes. This may occur because, even though the disease is so common, there are many myths about how it spreads and who can get it. The fact is that anyone who is sexually active is at risk. Whether you have had a number of sexual relationships or just “fooled around” with one person, all it takes is one contact with the herpes virus to contract the disease for life.

Caused by a Virus

Virus particle View Larger Image From http://nobelprize.org/nobel_prizes/medicine/laureates/1993/illpres/genes-in-pieces.html

Like many diseases, genital herpes is caused by a virus. Other STDs caused by viruses include genital warts, hepatitis, and the human immunodeficiency virus (HIV), which causes acquired immunodeficiency syndrome (AIDS).

Viruses are the smallest living things in the world. They are so small, in fact, that even two million of them lined up in a row would measure less than a half inch (about 1.3 centimeters). The “host cells” of larger organisms, such as animals and people, provide the food and energy that viruses need to survive.

Viruses also use host cells for another important function—reproduction. On their own, viruses are not able to multiply. But they can use structures within a host cell to produce more viruses. When an infected cell bursts open, it can release hundreds or even thousands of virus particles. And what do all these particles do? They look for other cells to infect.

The Herpes Virus

Viruses cause each of the eight different kinds of herpes. These include diseases such as mononucleosis (“mono”) and cytomegalovirus (CMV). One virus even causes shingles, a disease that’s related to chicken pox. These aren’t STDs, however. The kind of herpes that is caused by the herpes simplex virus (sometimes shortened to “HSV”), however, can be passed through sexual activity.

Herpes simplex actually refers to two different viruses: herpes simplex 1 (HSV-1) and herpes simplex 2 (HSV-2). The fact that there are two different herpes simplex viruses causes a lot of confusion. The structure of the two viruses is extremely similar—only complicated tests can tell them apart. Still, people view the two viruses very differently.

HSV-1

Herpes simplex blister View Larger Image CDC/Dr. Hermann

Have you ever had a cold sore or fever blister? If so, then you most likely have had HSV-1 (sometimes called oral herpes because it affects the area around the mouth). Almost all people get cold sores at one time or another. Since cold sores are so common, most people don’t see HSV-1 in a negative light. In fact, many don’t realize it’s a disease at all or know that it’s a form of herpes. An increasing number of genital herpes infections are caused by HSV-1 through oral sex. HSV-1 can be spread genitally even when a person doesn’t have a visible cold sore. The American Sexual Health Association (ASHA) reports that genital herpes infections caused by HSV-1 are more common in females than in males.

HSV-2

The other kind of herpes, HSV-2, is passed through vaginal, anal, or oral sex. This is the kind that’s typically called genital herpes. In general, HSV-1 affects the mouth and HSV-2 affects the genitals, but people can get HSV-1 on their genitals and HSV-2 in their mouth. Since HSV-2 is passed through sexual contact, people are more likely to attach a stigma to the disease. This means that people may assume that someone with genital herpes has poor morals, or that they are “easy” or have had many sexual partners. But that is not necessarily the case. The truth is that anybody who has any type of sex can get genital herpes. Even condoms are not 100-percent effective in stopping the spread of the disease.

Is There a Cure?

The good news is that genital herpes isn’t fatal. And it doesn’t automatically get worse over time. The bad news is that genital herpes can’t be cured. Once you’re infected, you have the disease for the rest of your life. The virus lives in your body’s nerve endings. This is a place where the immune system is unable to detect and fight the virus. Every once in a while, the virus is reactivated—it “wakes up,” travels through the nerve pathways in your body, and causes an outbreak. That may be how herpes got its name. The word “herpes” is Greek for “to creep.”