..A 'Simplex' Twist of Fate

Multiple Choice:

A) You have herpes and wish you didn't, or
B) You don't have it and never want to get it.

This pamphlet is for both kinds of people.

Because despite the emergence of AIDS as the most-feared sexual disease in history, the painful genital blisters and sores of herpes is still a problem for all kinds of people.

The disease has even been called the "New Scarlet Letter," after the 19th-Century Nathaniel Hawthorne novel.

That's because the physical and psychological discomfort it causes can place victims in a self-imposed exile as dramatic as that inflicted upon the adulteress heroine of the novel.

But it's a problem that can be prevented (or improved, if you've already got it) by the simplest tool that we know of: information.

So lend us your ears and a little of your time and we'll bring you up to date on what's known today about having -- or avoiding -- herpes.

That way, if you've got it, you can make the best of an unpleasant situation.

And if you don't have it, maybe you'll never have to get it.

..Old 'Cures,' New Ills

Two thousand years ago, the Roman emperor Tiberius banned kissing to stop the spread of a disease that caused blistering lip sores. Researchers today think the disease was a form of herpes simplex virus (HSV).

The ban didn't work. Couples kept on kissing, and herpes kept on herpe-ing, ban or no ban.

Since then, people and governments have tried everything they could think of to stop herpes. But it's still with us today-bigger and meaner than ever.

How big? 30-50 million Americans have genital herpes, according to a recent estimate.

And the numbers are growing: As many as 500,000 new cases are reported every year, with no end in sight.

No wonder herpes conjures up so much confusion and dread. And while the disease itself still can't be cured, the confusion and dread it inspires can and should be.

..Causes & Complications

Let's clear up some of the confusion first.

Herpes is caused by a virus that's spread by close physical contact (usually sexual) with an actively infected person.

Much of the confusion about herpes stems from the fact that there's more than one herpes simplex virus. We'll be talking about two of the most common, named (simply enough) Type 1 and Type 2.

Type 1 (labial herpes) is usually found around the lips and mouth and causes cold sores.

Type 2 (genital herpes) strikes most often on or around the penis or vagina. It can also occur on the mouth of victims, just as Type 1 can turn up in the sex organs, spread by oral-genital contact.

No matter how - -or where -- you get it, discovering you have herpes is no fun. Then it gets worse.

..Time After Time

Herpes starts as small sores or blisters that appear 2-20 days after infection. Where they appear depends on where the virus entered the body.

In women, Type 2 blisters usually turn up near the clitoris, vulva, or vagina. Men may first notice the fluid-filled sores on the penis or in the urethra. Both may suffer herpes sores on the thighs or buttocks -- even in the rectum, in the case of anal intercourse.

But blisters aren't a sure sign of infection. Other sexual diseases -- including syphilis and chancroid -- cause herpes-like sores, and the virus can be spread without blisters and other signs of infection. In fact, only about one-fourth of all herpes sufferers develop any symptoms at all.

If they do develop symptoms, pain - -or a burning, itching feeling -- is likely to lead the list. Others include flu-like fever, swollen glands, and general aches and pains.

The first herpes outbreak is often the worst, and about half of all victims never have another.

Still, while herpes sores come and go (often disappearing within three weeks), the virus always stays behind. It can linger in nerve cells -- for weeks or months or years -- before triggering another attack.

No one knows exactly why or when herpes symptoms reappear.

Research does show, though, that recurring outbreaks can be triggered by stress or fatigue, physical exertion, menstruation, even heavy exposure to wind or sunlight.

..Other Problems

But the pain and frustration of flare-ups are only two of the problems herpes sufferers face. There are others.

One of the worst is the higher risk of contracting another incurable -- and deadly -- disease: AIDS.

Studies in Africa and the United States show that people with herpes are more likely to be infected by the AIDS virus, which researchers believe enters the body through herpes sores.

Type 2 herpes is also linked with cases of meningitis and disorders of the throat, skin, and stomach. Both forms of the virus can cause a potentially-blinding eye infection.

Women are hit particularly hard.

Not only does herpes 2 boost their odds of cervical cancer, but pregnant women can pass the disease to their babies at birth. Since herpes is fatal to about half of exposed infants, most doctors recommend delivery by C-section to avoid infection.

..Treating It, Beating It

Think that's as bad as the news on herpes gets? Well, it isn't -- not quite. There's more: Herpes is still incurable.

But there's good news, too: We're closer to a cure than ever before.

Probably the best news is acyclovir (Zovirax™), a prescription drug that eases herpes symptoms and speeds the healing of sores. Sold as an ointment, an oral pill, and an injectable solution, acyclovir also blocks recurrent attacks in some users.

The drug does have drawbacks, though, including possible harmful effects during pregnancy and increased resistance by the herpes virus. Still, acyclovir offers one of the best and brightest hopes for herpes sufferers today.

A second ray of hope lies in research which suggests that some herpes sufferers literally worry themselves sick. Investigators now believe that stress and depression play a key role in lowering immune system response -- and in triggering herpes flare-ups.

The solution? Keeping anger, fear, and tension under control, they say, is one way victims can keep a handle on herpes. And joining a support group or learning a stress-reducing technique beats facing the loneliness and dread alone.

That's what you do if you've got it. But what's the best bet in avoiding herpes?The only really foolproof technique is celibacy, or giving up sex altogether.

Since that's not likely to become a fad any time soon, the next-best advice is taking care about whom you share your body with, particularly partners with sores near their sex organs. Always use a condom if you're unsure -- and with AIDS and herpes lurking around out there, you should almost always be unsure.

Other back-up measures provide only a small degree of protection: urinate before and after sex and wash thoroughly with soap and water (which kills the herpes virus). There's also evidence that sperm-killing agents in birth control foams and jellies may destroy the virus.

..Handling Herpes

Probably the best news in the war against herpes has been the progress we've made in understanding the disease -- and applying that knowledge to treating its symptoms.

And while reports of treatment breakthroughs and miracle "cures" have excited more than one sufferer, we should point out that any real cure is probably years away.

That means that the best way to handle herpes right now is to avoid it altogether.

And while the solution doesn't have to involve scarlet letters or a ban on kissing, you can minimize your risk by being careful about whom you do kiss -- and have sex with.

It's been said a few million times before, but it's worth saying at least one time more: An ounce of prevention really is worth a pound of cure.

And when an ounce of prevention prevents herpes, it may even be worth more than that.

Think about it.

..Sidebar | More Than Pain

Herpes victims suffer more than the pain of recurring outbreaks of the blistering disease. In a study by the American Social Health Association, other problems were reported by sufferers:

• 35% suffer impotence or reduced sexual drive
• 25% report a high level of anger or rage
• 18% blame a divorce or other break-up on the disease

And that's just for starters. More than half dropped the idea of having sex (at least for a while) after learning they had the disease, and all had to contend with bad feelings on top of their physical discomfort. Anyway, you look at it, herpes is a plain pain -- physically and emotionally.