(19 Jul 2001)

Eighty percent of Americans are unaware of the widespread nature of herpes infection, 65% are ‘not at all’ concerned about contracting genital herpes and only 26% realise that effective treatments are available. These findings, from a recent survey by the Center for Survey Research and Analysis (CSRA) at the University of Connecticut, contrast sharply with the incidence of genital herpes.

A staggering 50 million people in the USA have genital herpes and each year this figure rises by an extra 1 million, according to statistics from the American Social Health Association (ASHA).

Linda Alexander, PhD, FAAN, president of the American Social Health Association (ASHA) and chairperson of the International Herpes Alliance (IHA) commented:

‘The fact that so many people have genital herpes, yet virtually everybody underestimates the pervasiveness of the disease and their own personal risk, is what I call the "herpes disconnect". This disparity needs to be addressed because 90% of those who have genital herpes remain undiagnosed. People should feel comfortable discussing STDs like genital herpes with their healthcare provider to ensure that they get the correct diagnosis and treatment.’

The CSRA survey also revealed that the most nonchalant attitude towards infection was shown by women, with 70% of female respondents saying they were ‘not at all concerned’ with contracting genital herpes compared with 58% of men. This is perhaps surprising considering that the incidence rate of contracting genital herpes is actually higher in women than in men (in the USA, one in four women have genital herpes compared with one in five men). It is believed that transmission may be more efficient from males to females than from females to males.

The fact that only 26% of the people surveyed were aware that effective treatment is available was also worrying, indicating that many people could be suffering painful and frequent outbreaks unnecessarily.

Worldwide burden of herpes infection

Although alarming, the infection rates in the USA are by no means exceptionally high compared with other countries. New epidemiological data from over 20 countries have recently come to light confirming that herpes is one of the most widespread STDs worldwide.[1–6] These studies, which were presented at the recent International Congress of Sexually Transmitted Infections in Berlin (24–28 June 2001), show that greater differences in the pattern of infection exist between countries than previously thought.

The researchers were able to collect information about herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2). HSV-1 is the virus usually associated with oral/facial herpes (or cold sores) and HSV-2 is the virus that most commonly causes genital herpes.

For some countries, no substantial epidemiological data existed prior to this work. These countries include Korea, where 41% of women with herpes were reported to be infected with HSV-2 and 97% with HSV-1.[2] Data such as these can be used to help develop more effective and targeted strategies for the prevention of herpes infection.

‘There is a huge educational job to be done to help people understand how to reduce the risk of transmitting the infection to others. We see a need for greater and more widespread patient information and support. We are concerned about the wide discrepancies across countries in both the quantity and quality of information available. Although some countries have established herpes resource organisations and support groups, like the USA, New Zealand and France, other countries have none.’ explained Linda Alexander.

References
1. Smith JS et al. Herpes simplex virus seroprevalence and associated HSV-2 risk-factors among cytologically normal, middle-aged women from six countries (abstract). ISSTDR/IUSTI, Berlin, June 2001.

2. Smith JS et al. Population-based herpes simplex virus seroprevalence in seven countries (abstract). ISSTDR/IUSTI, Berlin, June 2001.

3. Pebody RG et al. Multi-centre HSV-1 and HSV-2 seroprevalence study (abstract). ISSTDR/IUSTI, Berlin, June 2001.

4. French RS et al. International multi-centre HSV-1 and HSV-2 seroprevalence study (abstract). ISSTDR/IUSTI, Berlin, June 2001.

5. Howard M et al. Canadian serosurvey of herpes simplex virus (HSV) in Ontario residents (abstract). ISSTDR/IUSTI, Berlin, June 2001.

6. Uusküla A et al. and the HSV Seroepidemiology Multi-Centre Study Group. HSV-1 and HSV-

2 seroprevalence study in Estonia (abstract). ISSTDR/IUSTI, Berlin, June 2001