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Health

Half of the World Has Herpes

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In fact, just over a half of the world has herpes. Over the course of the last year, the WHO released two articles exploring the prevalence of herpes infection worldwide and offering some hard numbers for an often overlooked viral infection. The WHO study uses the most recent estimates from 2012 and is the first attempt to calculate and identify the preponderance of herpes in the global population (1). What they find is that herpes is dang near everywhere and infects dang near everyone.Herpes is caused by two related and incurable viruses, herpes virus simplex 1 (HSV-1) and herpes virus simplex 2 (HSV-2). HSV-1, most commonly associated with orally transmitted blistering infections of the mouth, infects 3.7 billion people around the world who are under the age of 50 - that’s a staggering two-thirds of the world’s population in that particular age group.

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The characteristic cold sore caused by herpes. Image: CDC / Dr. Herrmann. The WHO’s study also finds that 140 million people have an HSV-1 infection of the genitals, reflecting the bio-cultural evolution of this particular virus from an above-the-waist pest to a below-the-waist one, due to the increased practice of oral sex among people in their teens and early adulthood (1).HSV-2, which typically infects the genitals and anus and is more commonly sexually transmitted, infects 400 million people under the age of 50 worldwide (2). The WHO's research finds that 19 million people are infected with the virus every year.Despite its overwhelming ubiquity, herpes doesn’t get much attention from the public like other common diseases like the flu, Alzheimer’s, and diabetes. Herpes rarely kills anyone, mostly causing a painful bother of a skin infection, and yet is generally heavily stigmatized for its association with sex.Herpes, however, cannot even be cleanly categorized as a sexually transmitted disease like gonorrhea or chlamydia. The HSV-2 strain of virus is spread through intimate sexual contact, yes, but HSV-1 is most commonly transmitted orally, say from kissing. And for centuries, herpes was considered an annoying but inevitable viral infection swapped from mother to child or between loving couples via a tender kiss. In fact, the herpes spectrum of disease both above and below the waist wasn’t even considered a medical problem until the late 1970s. In a British report published in 1975 examining the “psychological morbidity” caused by STDs, there was zero mention of herpes (3). But as an epidemic of herpes blossomed among sexually active teens in the late 70s and early 80s, newspapers were soon crowning herpes as “the virus of love” and “the venereal disease of new morality”(4).

Herpes would get its first public scolding in a piece by current New York Times op-ed columnist Maureen Dowd in Time's August 1982 issue, the cover of the popular magazine dubbing it “the new scarlet letter” and the word “herpes” outlined in a crimson red slashing font above a concerned and contemplative couple in business attire

. The article tsk-tsks our society’s mores, arguing that herpes had been “spurred on by two decades of sexual permissiveness” and that “the herpes counterrevolution may be ushering a reluctant, grudging chastity back into fashion.” Dowd’s article may well have marked the birth of the herpes stigma in our collective consciousness, drawing a direct line between liberal sexual attitudes and the growing pervasiveness of a sexually transmitted infection.Soon, though, the public hand-wringing over herpes would dissolve in the face of a global epidemic of a newly emerging disease, what we now understand to be HIV/AIDS. The social response to the herpes problem would be described as “shallow and transitory,” unable to muster much social concern compared to the frightening specter of the HIV virus (5).

The taboo against herpes, however, persists to this day. If anything, the story of herpes illustrates that our perceptions of infectious diseases are socially crafted and that the public’s response to an emerging disease serves to “reduce the threat of randomness while articulat[ing] social values and status relationships”(5). In other words, in the face of a virus that appears to infect at random, irrespective of class, we fall back on moral sanctions in an attempt to recalibrate and restore order to our chaotic world. Stigmas and taboos operate on the premises of an us versus them opposition, relying on the marginalization of the infected. It's a defense mechanism that works particularly well with STDs. 

But as the WHO bluntly put it, “the global burden of HSV-1 infection is huge.” All together, half a billion people have genital herpes, whether caused by HSV-1 or HSV-2. Herpes is today without a doubt one of the most common infections known to man, infecting billions of people worldwide and causing, for the most part, little other than some blistering sores on occasion. And yet so heavy is the stigma that herpes infection bears that it is regarded with a deep aversion and, for many of those infected, a sense of shame. This reluctance to address herpes openly is a factor in our overall ignorance about the realities of herpes infection, the attitude of fear we maintain towards the disease, and its status as taboo, a “scarlet letter” that more than half of all humans on earth bear hidden.Resources Get the facts on herpes from the CDC. Herpes most commonly causes a painful blistering infection, but it can rarely infect the brain causing a life-threatening infection. Read more here. From the Body Horrors archives: Herpes Gladiatorium: Full Contact Infectious DiseasesReferences 1) KJ Looker et al. (2015) Global and Regional Estimates of Prevalent and Incident Herpes Simplex Virus Type 1 Infections in 2012. PLoS One.10(10): e0140765 2) World Health Organization (Jan 21, 2015) Call for more research and greater efforts to prevent and control the spread of herpes simplex virus. World Health Organization, Sexual and Reproductive Health. Accessed online on 02/19/16 here. 3) R Mayou. (1975) Psychological morbidity in a clinic for sexually transmitted disease. Br J Vener Dis. 51(1): 57-60 4) JS Miller The Past and Future of a “Herpes Identity.” The Helper Newsletter. Accessed online on 02/20/16 here. 5) E Fee & DM Fox, editors. (1988) AIDS: The Burdens of History. Berkeley: University of California Press. Available online here.

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