HSV/Cold Sores

OK, so my ex recently got in touch with me and was really worried – a guy she was dating was developing first symptoms of cold sores and he was getting upset at her for “giving her an STD”. I had my first outbreak several years ago (and I think I gave it to said ex) and, initially, I was quite traumatized – I mean, WTF, I have an STD now?  So I did some research and realized it’s not a big deal and almost everyone I know has it already so it’s surprising it has taken so long for me to get infected (or perhaps I was infected all along and now I just have symptoms).  But, this probably wouldn’t calm that guy down.  So I got in touch with a friend of mine, Anna Kushnir, who did research on HSV at Harvard, and here is what she wrote.  Anna, you are awesome.

I was not aware that there is social stigma around cold sores! That’s
a little sad. I get them too, though I have no current plans to feel
ashamed about it 🙂 You do mean HSV-1, right? Not HSV-2? Because there
is a difference in the prevalence rates between the two viruses. The
literature on the prevalence and reactivation rates of HSV-1 is really
kind of old. It’s just accepted in the field that most people
have it, and approx 50% of those have recurrent infections. Most
people become infected within days of birth, usually from
parents/caretakers (you don’t have to have a cold sore to be
infectious – the virus is constantly shedding. Though if you kiss your
baby with an active cold sore, it will likely die of the infection.
Fun herpes facts).

This is an excerpt from my thesis about HSV-1 prevalence, with the
relevant citations:

“Recent epidemiological data suggest that 60-90% of the world’s
population is HSV-1 seropositive with 30-45% of those infected
experiencing recurrent HSV-1 disease (260). Initial infection is
generally asymptomatic, though it can be associated with febrile
headache, febrile pharyngitis, and gingivostomatitis (43). In the
course of primary infection, HSV-1 enters the termini of sensory
neurons innervating the site of infection and is transported to the
cell body of dorsal root ganglion (DRG) and trigeminal ganglion (TG)
neurons by retrograde transport, where it establishes a life-long
latent infection.”

43 : Cesario, T. C., J. D. Poland, H. Wulff, T. D. Chin, and H. A.
Wenner. 1969. Six years experience with herpes simplex virus in a
children’s home. Am J Epidemiol 90:416-22.

260 : Smith, J. S., and N. J. Robinson. 2002. Age-specific prevalence
of infection with herpes simplex virus types 2 and 1: a global review.
J Infect Dis 186 Suppl 1:S3-28.

Hope this helps!

Tell your friend there is no need for concern or embarrassment. And if
you really want to freak him out, tell him there are 8 human herpes
viruses, and he likely has at least 5 of them!

Just in case you doubt her credentials, her profile on Nature Network and proof that she indeed exists and was indeed at Harvard.

So…  in case you just had your first breakout, relax, take a deep breath, and don’t worry about it.  If you need some perspective, check this blog out: http://mevsalieninvaders.blogspot.com/.  Just to prep you, this is my friend Dana who was recently diagnosed with breast cancer.  Awesome girl.  Doubly so given how awesome a writer she is and the way she is dealing with the crappy circumstances she found herself in.  So, if the girl/guy you are dating won’t take the time to understand what’s going on, dump em and apologize to them…  for being unable to tell they are not quite dating material to begin with.