Genital herpes is one of the most widespread sexually transmitted infections (STIs) in the world. According to the World Health Organization (WHO), over 846 million people aged 15 to 49—more than 1 in 5 in this age group—are living with a genital herpes infection. Each year, around 42 million new cases are reported, amounting to at least one new infection every second.
The Silent Epidemic
For many individuals, genital herpes infections remain asymptomatic or cause only mild symptoms. However, for others, the condition manifests in painful genital sores and recurring outbreaks that can significantly impact quality of life. In 2020 alone, more than 200 million people in the 15-to-49 age range experienced symptomatic episodes, often requiring medical intervention.
Dr. Meg Doherty, Director of Global HIV, Hepatitis, and Sexually Transmitted Infections Programmes at WHO, emphasized the burden of the infection, stating, “While most people with a genital herpes infection experience few symptoms, with so many infections, genital herpes still causes pain and distress for millions globally and strains already overburdened health systems. Better prevention and treatment options are urgently needed.”
Understanding the Herpes Simplex Virus
There are two types of herpes simplex virus (HSV) that can cause genital herpes:
- HSV-1: Primarily associated with oral herpes, causing cold sores and mouth ulcers, HSV-1 can also lead to genital infections when transmitted through oral-genital contact. In 2020, 376 million people were estimated to have genital HSV-1 infections.
- HSV-2: Typically transmitted through sexual activity, HSV-2 is responsible for most recurrent and symptomatic genital herpes cases. An estimated 520 million people were living with genital HSV-2 in 2020, accounting for about 90% of symptomatic episodes.
Unlike HSV-1, HSV-2 infections are more likely to result in recurrent outbreaks and have been linked to a three-fold increased risk of HIV transmission. Alarmingly, some individuals may carry both HSV-1 and HSV-2 simultaneously.
Shifting Trends in Transmission
Recent years have shown notable changes in herpes transmission patterns. While the prevalence of genital HSV-2 infections has remained steady since 2016, genital HSV-1 infections have seen an uptick. This shift is partly attributed to reduced childhood exposure to oral HSV-1 due to improved hygiene and less crowded living conditions. Consequently, susceptibility to HSV-1 infections has increased during adolescence and adulthood through sexual contact.
The Impact of Genital Herpes on Public Health
Although genital herpes is often stigmatized and under-discussed, it has profound health and societal impacts:
- Symptomatic Recurrences: Painful sores and blisters can recur throughout a person’s life, requiring ongoing management.
- Neonatal Herpes: A rare but severe complication occurs when the virus is transmitted from a mother to her baby during childbirth, particularly if the mother contracts herpes late in pregnancy.
- Economic Costs: Genital herpes infections result in an estimated $35 billion in annual healthcare expenditures and productivity losses worldwide.
The Need for Improved Prevention and Treatment
Currently, there is no cure for herpes simplex virus infections. However, antiviral medications can alleviate symptoms, reduce the frequency of outbreaks, and lower the risk of transmission. WHO highlights the importance of consistent condom use and avoiding sexual contact during active outbreaks to minimize transmission risks.
Promising Avenues for Vaccine Development
Dr. Sami Gottlieb, Medical Officer at WHO, has called for expanded research and investment in herpes vaccines and therapies. “Stigma around genital herpes means it has been discussed too little, despite affecting millions globally. Expanded research and investment in developing new herpes vaccines and therapies, and their equitable use, could play a critical role in improving quality of life for people around the world,” Gottlieb stated.
Vaccines could revolutionize the prevention and management of genital herpes, reducing the incidence of infections and mitigating the associated health and economic burdens.
WHO’s Global Health Strategy
Aligned with its 2022-2030 Global Health Sector Strategy, WHO aims to:
- Raise awareness about genital herpes and its symptoms.
- Enhance access to antiviral medications.
- Promote HIV prevention efforts linked to herpes transmission.
- Drive innovation in vaccine research and the development of new treatment options.
Key Recommendations for Prevention
- Condom Use: While not 100% effective, consistent condom use significantly reduces the risk of herpes transmission.
- HIV Testing: People with genital herpes symptoms should undergo HIV testing, as the infections are often interlinked.
- Pre-exposure Prophylaxis (PrEP): For those at higher risk, PrEP can help prevent HIV transmission.
- Education: Reducing the stigma around genital herpes through awareness campaigns can encourage early diagnosis and treatment, improving overall health outcomes.
Conclusion
The global burden of genital herpes underscores the urgent need for innovative solutions, including vaccines and more effective treatments. By prioritizing awareness, research, and prevention, public health organizations like WHO aim to alleviate the personal and societal impact of this prevalent infection.