The XX Factor

Most of the World Has Herpes, and There’s Little We Can Do About It

You’re in good company, anonymous stock-photo lady.

Aleksandra H. Kossowska/Shutterstock

If you are a human being living on planet Earth, chances are you have herpes.

So says the World Health Organization, which released its first estimation of the global incidence of herpes simplex virus type 1 on Wednesday. According to the report, two-thirds of the world’s under-50 population—more than 3.7 billion people—are infected with HSV-1, the incurable virus most known for the oral cold sores it causes.

Most people with HSV-1 catch it through mouth-to-mouth contact during childhood, but the WHO has found this transmission method to be less and less common in wealthier countries with better hygienic conditions. This should be great news, but the upshot is nothing to cheer about: When someone doesn’t contract the virus by mouth, she’s more likely to get it from receiving oral sex later in life, leading to an HSV-1 genital infection. (Usually, genital herpes is caused by a different type of herpes, HSV-2, which the WHO says affects 417 million people aged 17 to 49 worldwide.)

The nihilist’s takeaway is that herpes is everywhere and there’s very little anyone can do to prevent it or control its spread, short of avoiding oral and sexual contact entirely. HSV-1 is so inexorably communicable that researchers have accurately tracked the history of global human migration by the spread of the virus. Like most sexually transmitted infections, all herpes infections can be spread even when no symptoms are present, and the contagious area isn’t limited to what’s covered by a condom. Among unmarried women between the ages of 45 and 50, 50 to 70 percent have HSV-2. According to the American Sexual Health Association, more people in the U.S. have genital herpes than all other STIs combined.*

But HSV-2 transmission has far-reaching public health implications that would make a laissez-faire herpes strategy an act of extreme negligence. A person with HSV-2 is at higher risk of contracting and transmitting HIV, and HSV-1 can cause other complications like encephalitis and meningitis. The WHO is encouraging medical researchers to put more resources toward developing a herpes vaccine; trials funded by the National Institutes of Health and GlaxoSmithKline are currently studying the comparative benefits of a preventive versus remedial vaccine.

Wednesday’s report called for more education on both types of herpes viruses for young people, before they become sexually active. Still, it’s not clear what they’re supposed to do once they’re schooled. Some doctors have even recommended against widespread testing for herpes, since so many people have it and there’s not much they can do to keep themselves from spreading it. Without an accessible vaccine, we’re all stuck with the knowledge that we probably have herpes, but we’re in good—or, at least, crowded—company.

*Correction, Oct. 29, 2015: This post originally misidentified the American Sexual Health Association as the American Social Health Association. It changed its name in 2012.