Herpes: The New Sexual Leprosy

"Viruses of love " infect millions with disease and despair

Susan, 29, a Ph.D. in English literature from Harvard, knew her boyfriend had a herpes infection and consulted her gynecologist about the safety of having intercourse. The doctor reassured her that herpes was only contagious if her partner had festering sores. Susan slept with her friend, who had no obvious signs, and within a week got herpes.

Don, 47, an engineer, succumbed to the temptation of a local lady while on a job in Asia and woke one morning to find a cluster of ugly red sores on his penis. Subsequently divorced, he acquired a new lover and learned that he had given herpes to her. Says he: "I regard myself as a carrier of an invisible, incurable disease. I have a guilt trip that won't quit."

Such is the predicament--indeed, the pathos--of herpes, one of the most common venereal diseases in the U.S. today, possibly even more widespread than gonorrhea. This year up to half a million more Americans will develop the telltale genital blisters of herpes, adding to the 5 million to 14 million who already have the disease. When they seek medical help, they will often be given incorrect information or false hopes for cures. Most will suffer shame, guilt and even depression, and a few will become suicidal over what they feel is the "new leprosy."

Herpes, from the Greek "to creep," has been around for ages: the Roman Emperor Tiberius vainly tried to stamp it, or something like it, out by banning kissing. With the sexual revolution of the 1960s, herpes broke out of its confines as a venereal disease that was thought (incorrectly) to afflict only the "licentious" lower classes. Suddenly, "viruses of love" infected entire college dormitories and rode the waves of rising divorce and crumbling monogamy.

There are no precise figures: herpes is not reportable and few victims like to talk about it. But Dr. Paul Wiesner, director of the VD division at Atlanta's Center for Disease Control, estimates that as many as 30% of the sexually active U.S. population have been exposed to genital herpes, while not in all cases developing its symptoms. Doctors were talking of only 5% less than a decade ago.

The viruses after which the disease is named come in some 70 varieties, most of them noninfectious to humans. Those harmful to people cause birth defects, chicken pox and shingles, and mononucleosis (the "kissing disease"). The ones implicated in venereal disease are herpes simplex types 1 and 2. The first type triggers fever blisters, or cold sores, around the mouth: it is also an agent in various eye ailments that can, if untreated, lead to blindness. The second usually shows up in the genital area of both sexes, and sometimes on the thighs and buttocks. Both types can be transmitted between mouth and genitals by oral sex.

Usually from two to eight days after contact with the virus, most often through sexual activity, small red bumps may appear on the victim's genitals. These rapidly develop into tiny painful blisters; when they burst they can pour out millions of infectious virus particles. The victim may become feverish and, in the case of women especially, experience a sharp burning during urination. In about ten days the sores heal, but the viruses do not go away. They retreat to nerves near the lower spinal cord, remaining there for the life of the victim. Under pressure of stress, menstruation or sudden change in temperature, they can return without warning--weeks, months or years after the first occurrence. Sometimes they never come back.

Herpes has been linked to cancer of the cervix, which afflicts an estimated 16,000 U.S. women in its serious form and contributes to 7,400 deaths a year. But whether herpes actually causes cancer is a matter of debate. There is no doubt that herpes can be passed on to newborn babies if mothers have an active infection at the time of delivery. Each year several hundred babies are born with herpes simplex; more than half die, and survivors often suffer permanent neurological damage. One precaution being taken by some doctors is to order caesarean deliveries, a less emotionally jarring practice than segregating mother and baby behind doors marked ISOLATION: HERPES. Recalls Rachel, 29, a California nurse who was subjected to such treatment: "I felt so dirty. I had to figure out ways to keep the grandparents away from the hospital."

At least a dozen methods have been tried, without notable success, to cure herpes. Among them: vitamin C, injections of inactive herpes viruses, fluorescent light, ether, even zinc in the diet. An ointment containing 2-deoxy-D-glucose seemed promising a year ago, but researchers are not so optimistic now. Acyclovir (ACV), an antiviral drug, looks promising, but testing is far from complete or conclusive. Smallpox vaccine has been tried unsuccessfully, and vaccines in general are viewed warily: if herpes does in fact cause cancer, some vaccines could increase the risk by increasing the number of herpes viruses in the body. That leaves only such palliative measures as keeping the affected area clean and dry and acting decisively if herpes is suspected. Says Dr. Yvonne Bryson of U.C.L.A.: "A woman should have a viral culture done immediately."

One obvious way to control the disease is abstinence from sex or at the very least a high degree of sexual selectivity. Condoms may reduce the risk of infection. One thing that will surely help is better informed physicians. Says one Seattle doctor: "A lot of women and doctors believe everything down there is a yeast infection." To reduce misinformation about herpes, the American Social Health Association of Palo Alto, Calif, distributes a newsletter called The Helper and is setting up HELP chapters around the U.S.

One of their objectives is to eliminate the stigma of herpes, often more painful than the illness. It affects performance on the job, disrupts personal relationships and in not a few cases has resulted in cancellations of weddings when one of the partners is told the other has herpes. It also makes the victim something of a pariah. After being told by a doctor that he had herpes, Ray, 29, a reading instructor, turned on departure to shake hands. The doctor would not extend his. qed

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