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How Do You Get Herpes?

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Causes and information about how you get herpes and how herpes is transmitted from one person to another.

Herpes is an incurable virus that affects the genitals and the mouth. While there are two different types of herpes (HSV-1 and HSV-2), both can affect either the mouth or the genitals, and both result in similar herpes symptoms.

Herpes transmission is a serious health problem in the United States and abroad. According to the National Health and Nutrition Examination Survey, roughly 54% to 65% of all men and women have HSV-1 (traditionally oral herpes, but may spread to the genitals), and 21% of men and women have HSV-2.

Some articles state that 80% of the population has HSV-1. There is no evidence this is the case, and the research most articles cite used only a 50 participant sample. But at 65% and 21% respectively, it's clear that herpes is a highly transmittable, highly contagious disease.

How You Get Herpes

Herpes spreads through direct skin to skin contact when the person with herpes is "shedding" the disease.

Once you have contracted herpes, it remains dormant in your body.

Then at times (often with no trigger, or triggered by stress), the virus comes to the surface and "sheds." How you get herpes from shedding is that the virus wakes up, and moves up toward the surface of the skin.

That is when it is contagious, and if that area comes into contact with the skin of someone without herpes, that person will catch the virus.

In the past, it was believed that herpes only sheds when the person has an outbreak because in nearly 100% of all herpes outbreaks there is viral shedding.

According to research at the University of Washington, 85% of those shedding herpes show no signs or symptoms of the disease.

Thus it is possible to spread herpes even when no symptoms are present.

Why Are So Many Infected?

Herpes is highly transmittable, but the population is becoming more and more aware of herpes and other sexually transmitted diseases, and yet herpes continues to spread. There are several possible reasons that herpes prevalence remains high:

Why Herpes Spreads

HSV-1, while still a sexually transmitted disease, is often transmitted as an infant. A parent or stranger with HSV-1 will kiss a young child, and spread HSV-1 to the new infant. As the child ages, they may kiss other children, and the virus spreads.  By the time the child is an adult, their likelihood of a recurrence has been cut dramatically, and they may not be aware that they have HSV-2.

Not all cases of either HSV-1 or HSV-2 have symptoms. It's possible to catch herpes without any symptoms at all. The American Medical Association states that 85% of all those with genital herpes do not know they're infected, either because they are asymptomatic or because the symptoms manifested in such a way that it did not appear to be traditional herpes and goes ignored. Without symptoms, it's possible to both be unaware you have herpes and spread herpes without any outbreak. 

Condoms help prevent spreading herpes but they cannot prevent the virus entirely, because they do not cover the entirety of the skin. It's possible to spread herpes to an area of the skin that isn't covered. (Note: Condoms do protect against other sexually transmitted diseases, like HIV, and can make it less likely to get herpes so condom use is still recommended). 

Herpes spreads when the person sheds the virus. Often that shedding occurs when the individual has a recurring outbreak, which is why those with herpes are advised against any skin to skin contact before, during, and even a short time after an outbreak. But the herpes virus can shed without any symptoms, so those that believe they're being careful by avoiding any skin to skin contact are still at risk for catching the disease. In fact, it's estimated that 70% of partners that get herpes did so when their partner had no signs or symptoms of an outbreak. 

According to Dr. Peter Leone of the University of North Carolina, 50% to 75% of unwed women between the ages of 45 and 50 have genital herpes. This suggests that as people age, they either become a bit more reckless with their sexual habits because of menopause or that because herpes is prevalent in such a large portion of society, your risk will increase the longer you're sexually active.

Many people believe that HSV-1 is a type of "lesser herpes." They refer to it simply as "cold sores" and some people do not even know that HSV-1 is also herpes. Also, most people believe that HSV-1 is only "oral herpes" which is not the case. While HSV-1 primarily oral herpes, it can spread to genitals and even the eyes if not treated. In fact, HSV-1 is considered more dangerous than HSV-2 (traditionally genital herpes), yet many people treat HSV-1 as though it is not as important, and possibly behave more recklessly.

Female birth control allows more people to have unprotected sex without worrying about pregnancy. Herpes is not a standard STD test without any symptoms. So many people that take precautions and get tested find that they have no sign of an STD have unprotected sex. Unfortunately, because herpes may be present without symptoms, it's possible to spread herpes unknowingly. 

The exact reason behind the widespread outbreak cannot be truly known, but these all stand as potential reasons that herpes may be such a widespread virus.

Knowledge also plays a key role. In countries like Turkey, studies show that as many as 97% of all pregnant women in Turkey had HSV-1, with 42% of these women also diagnosed with HSV-2.

Can You Get Herpes through Indirect/Non-Sexual Contact

Herpes generally affects only the mouth and the genitals (and on rare occasions, the eyes). This is because the herpes virus often struggles to travel through the thick skin in the other areas of your body, and its genetics all the virus to thrive in those two areas of the body.

But herpes can spread to other areas of the body.

One of the greatest risks is autoinoculation or infecting another area of your body with herpes when you already have herpes. It's most likely to occur during the primary infection if you touch an open sore (for example, on your mouth), and then immediately touch your eyes or genitals. Luckily, autoinoculation is rare after the primary infection, even when the virus is shedding.

It may also be possible to contract herpes in an area of your skin not typically associated with the herpes virus.

Recall that the reason herpes is primarily on the genitals and mouth is that the skin there is smaller and the virus can pass through more easily. If the herpes virus comes into contact with an open wound, it may be possible for the herpes virus to pass through that skin. If you get herpes in some area of your body other than the genitals, mouth, or eyes, this is known as "Herpetic Whitlow."

It is common on the fingers of dentists and thumb-sucking children. Herpetic whitlow is less likely to recur or shed than typical herpes.

It may be possible to spread herpes by touching the skin when the virus is shedding and then touching someone on the lips or genitals. This type of transmission is rare, but theoretically possible if the individual touches the other person quickly enough, and there is enough of the virus still present on the fingers.

Can You Get Herpes from Objects?

One popular myth is that you can get herpes infections from a toilet seat or a water fountain.

This is not necessarily the case.

Herpes is a fragile virus, and once it is exposed to the air outside of the body, it tends to die very quickly. Studies have shown herpes to die within 10 seconds of being left on a toilet seat, and while it can survive a bit longer on a drinking fountain (due to the moist conditions), it's much more likely that the virus will die long before the mouth touches the fountain.

However, it may possible to contract herpes, especially HSV-1, from sharing objects meant for the mouth in a very limited amount of time. For example, if you share a straw when someone is shedding, it may be possible to contract HSV-1. Same with razors, forks, etc.

But the science on this is fairly split. Most doctors do not believe it is possible to catch herpes through sharing straws or utensils, and the National Herpes Hotline specifically states that most potential objects cannot spread herpes, but the University of Maryland Medical Center claims that it is possible.

Little research has been done in this area, and more is needed before one can conclusively state whether or not the virus can be transmitted.

Still, the longer you wait before placing these objects in or near your mouth or genitals, the less likely transmission can occur.

Gender Differences and How You Get Herpes

Several studies have shown that women are more likely to get herpes than men. If both an uninfected male and female have sexual intercourse with someone that has a herpes infection, women appear to be more likely to catch the virus.

Why this occurs is less clear. Some possible reasons include:

  • Female genitalia may be made up of thinner skin than male genitalia.
  • Female genitalia has a larger surface area of mucus membrane.

It may also be due to differences in the immune system or what the virus needs to create the infection. Open wounds that occur during intercourse may also increase this risk.

Herpes and Cheating

One of the biggest issues that occur with how you get herpes is that many people find that their partner either had a herpes outbreak or seemed to give them herpes when they did not believe they were infected.

The problem is that because most herpes is asymptomatic, the person that had herpes may have had herpes all along, but showed no signs or symptoms before spreading it through unprotected sex.

Similarly, it's possible to have recurrent herpes symptoms without a primary outbreak, so the partner that "caught herpes" and believed their spouse was cheating may have had herpes all along.

Because over 50% of all herpes infections have no symptoms, there is a greater likelihood that the partner did not cheat, but that one or both of the people in the relationship already had the herpes virus and were unaware of it.

Can You Get Herpes When You Already Have Herpes?

Herpes is a virus, and it is a virus that cannot be cured.

As a result, if both you and your partner are infected with the same strain of herpes (HSV-1 or HSV-2), you cannot re-infect each other, even during an outbreak.

The only exception is if one partner has HSV-1, while another partner has HSV-2. In these cases, it is possible to spread herpes back to your partner. Still, because your partner already has herpes, it is unlikely that they will notice the difference.

Precaution should be taken if either you or your partner (or both) do not have herpes in another area (for example, those that have genital herpes but do not have oral herpes). It may be possible to spread the disease to each other with unprotected sex.

Furthermore, during an outbreak, the herpes virus can create sores that may burst and become infected, so refraining from unprotected sexual contact during these outbreaks is still important.

Spreading Herpes and Remaining Safe

Herpes is a highly contagious disease, and the statistics on herpes infections are fairly staggering. Most people in the United States and abroad already have HSV-1, and nearly 25% or more have HSV-2.

You can get herpes easily through skin contact, and potentially through some moist objects, although this is still being debated.

Once you have contracted herpes there is no cure. But there are several ways to reduce the severity of the symptoms and live more comfortably with the herpes simplex virus. 

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