Herpes: The Sneak Attack

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News & Views on Women's Health

YOU'VE HEARD THE NUMBER' One in four Americans has genital herpes. But another figure may surprise you: Just about four out of four Americans think they don't.

According to its reputation, herpes brings lifelong bouts of pain. And it's true that a flare-up is generally accompanied by blisters and itching, and sometimes a flulike malaise. Some people, though, have such mild symptoms, they don't even realize they've got herpes. Now research suggests that these folks can just as easily infect their partners as those who are painfully aware that their virus is active.

Epidemiologists at the University of Washington in Seattle tracked 90 men and women who knew they had herpes, along with 53 who came into the study mistakenly thinking they didn't. As expected, those who were prone to symptoms shed virus (meaning they could infect a partner) during flare-ups. But they also shed virus on a significant number of days when they had no blisters or other signs. So did four out of five of those who'd been unaware of their infection. One bit of good news: When people in the low-symptom group were told what to watch for, all but one began to identify signs they'd previously missed.

The researchers demolished one other assumption. Most people, including most doctors, think that although a woman might sometimes have hidden herpes sores, with a man what you see is what you get. Instead, men and women proved equally likely to be infectious in the absence of symptoms.

Their findings are "not comforting," say the researchers. No kidding. The herpes epidemic continues to explode, says study leader Anna Wald, and the tendency of doctors and patients to ignore mild symptoms is a big reason.

Women should talk to their doctors about being tested, Wald says. If you're infected, you'll need to learn to notice symptoms to protect your partner. Skip sex when you know the virus is active-and let this study goad you to use a condom at other times.

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By Treacy Colbert; Sally Lehrman; Paula Motte and Laurie Tarkan

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