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How do I protect myself from herpes?
My partner was diagnosed with herpes over a year ago. I felt excluded when he was diagnosed and treated, as I wasn't involved in any of it. What is the difference between the two varieties of herpes?
As I'm in a long-term marriage, how can I protect myself? Are there any tests that I can have to find out if I carry the infection? Also, can it be passed onto our children if he kisses them - and how can I keep them protected?
Dr Valerie Tagwira: The two viruses are closely related and are quite common. Herpes Simplex Virus Type 1 (HSV-1) commonly causes sores around the mouth and on the face. In the UK, almost 80% of people have the HSV-1 virus.
Around 25% of the adult population have antibodies to Herpes Simplex Virus Type 2 (HSV-2), which mainly causes infection of the genitals. Because of oral sex practices, HSV-1 may be found on the genitals. HSV-2 may also be found on the face and mouth, but it rarely causes cold sores.
Many people do not know that they have the virus because apart from causing obvious sores, the viruses may also cause very mild symptoms or none. The viruses stay in the body and cause recurrent symptoms, about two to four times a year or so on average. The frequency and severity does get less with time. There are treatments that are useful for reducing severity and duration of symptoms.
Unfortunately, it is not always possible to know when one is shedding the virus. If there are genital sores, the likelihood of passing the virus to an uninfected sexual partner is high. However, some recurrences do occur with very mild or no symptoms, and in these cases, viral shedding still occurs. In addition, almost half the people who acquire HSV-2 do not get obvious symptoms. This is called sub-clinical infection.
Because people do shed the virus without any symptoms, it is quite possible to get the virus from a partner who is not aware that they have it. Avoiding sex when an infected partner has sores and using condoms are both helpful, but protection may not be 100% because of sub-clinical viral shedding. Use of antiviral medication during a recurrence may also reduce viral shedding.
Although you have not had any sores, I cannot confirm whether or not you carry either virus. You could visit your local GUM Clinic for testing. Your blood sample can be checked for antibodies to the virus. Antibodies can be detected from three months after infection. If you happen to develop sores, fluid from the sores can be examined for presence of the virus. Childhood infection with cold sores is common. Yes, the virus can be passed to children during kissing. It is best to avoid kissing children when one has sores, particularly on day 1 to 4 from the start of symptoms. But remember, viral shedding can occur without symptoms, so avoiding kissing will not offer 100% protection. Do try not to worry about this too much because most people who acquire HSV-1 (including children) get no symptoms. When cold sores do occur, they are rarely serious. Only 20% of people who have the HSV-1 virus will continue to have recurrent cold sores throughout their lives.
It may be useful to discuss your concerns openly with your partner. If he has a recurrence and visits his doctor or GUM Clinic, you could go along with him, both to support him and to avoid exclusion as this is something that has a bearing on your relationship.
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