Last year, in my Anatomy & Physiology class, the subject of herpes came up, which launched a few people into mini-tirades laced with judgmental language, describing it as “disgusting” and “gross.” My classmates might have been more sensitive, as statistically speaking, there were probably several people in that very room who were living with herpes. Given that most of my fellow students were pursuing careers in the health-care field, it was especially disheartening. Yet despite being relatively widespread, herpes is often stigmatized and misunderstood.
Herpes is caused by herpes simplex virus (HSV), which comes in two strains: HSV-1 and HSV-2. HSV-1 is most often associated with oral herpes, while HSV-2 is most often associated with genital herpes, though by no means is this association exclusive. For example, HSV-1 can cause genital herpes when the site of infection is the genitals. It is estimated that only 10 to 15 percent of those with herpes exhibit symptoms, and that millions of people unknowingly carry the virus. After infection, the virus enters a latent state in nerve cells, where it will remain for the rest of the host’s life – the same is true for other viruses in the Herpesviridae family, such as the virus that causes chickenpox.
Oral herpes is incredibly common – about 90 percent of U.S. adults have been infected with HSV-1, and most of them caught it as infants or children through nonsexual transmission. HSV causing oral herpes remains latent in the trigeminal nerve ganglia in the face. Cold sores, which appear on the outer margin of the lips, appear when the virus has been activated and it moves along the pathway of nerves from the ganglia to the surface of the skin. They can be triggered by sunburn, stress, or even menstruation.