The findings are reported in the October 16, 1997 New England Journal of Medicine. The report, "The Evolving Epidemiology of Herpes Simplex Virus Type 2 in the United States, 1976 to 1994," documents that nearly 22% of the population overall (45 million Americans) and almost 45% of African-Americans are infected with herpes simplex virus type 2 (HSV-2).

Since the last national survey of HSV-2 prevalence (conducted between 1976 and 1980), prevalence has increased most dramatically among young white teens. HSV-2 prevalence among 12 to 19 year-old whites is now five times higher than it was in the late 1970s. Young people aged 20 - 29 are now twice as likely to have HSV-2.

"Herpes is perhaps the most common sexually transmitted disease in America today. It continues to spread across all economic and social boundaries and is spreading fastest among teens," said Helene Gayle M.D., M.P.H., Director of CDC’s National Center for HIV, STD, and TB Prevention (NCHSTP).

In addition to ongoing sexually transmitted disease prevention activities, CDC is now working in consultation with other public health experts to develop a national plan which will specifically address the prevention of herpes. The plan will address development of comprehensive national prevention guidelines, outline enhanced monitoring of levels of herpes in the U.S., and propose new educational activities for health care professionals and the general public.

Although the exact number of individuals affected is difficult to assess, Utahns are increasingly being infected with genital HSV. While oral acyclovir has been proven to be an effective agent for the treatment of genital herpes infection, no known cure currently exists. However, scientists, including those from Utah, are concentrating their efforts in several areas of investigation. Most recently, scientists from the University of Utah have been researching possible triggers in the reactivation of herpes. These physicians have been attempting to understand how herpes is reactivated biochemically, so that a drug can then be developed that would interfere with the process and prevent repeated outbreaks.

With or without visible symptoms, herpes can be transmitted between sex partners, from mothers to newborn babies, and it can greatly increase a person’s risk of becoming infected with HIV.

The study also found that HSV-2 is more common among women (approximately one out of four women) than men (almost one out of five). This may be related to the higher efficiency of transmission from men to women and to higher prevalence of infection in sexual partners.

The consistent and correct use of latex condoms is the best protection. Because condoms do not cover all areas where herpes blisters could be present, people should also avoid any direct contact with herpes sores and blisters.

The Advisory Committee on Blood Safety and Availability at its most recent meeting in August 1997 recommended educational programs for providers, a public education campaign to notify and test recipients of blood and blood products transfused prior to 1992, and a targeted lookback program for prior blood and blood product recipients of donors testing positive for anti-HCV by second generation screening and supplemental tests. These recommendations will be forwarded to the Assistant Secretary of Health and the Blood Safety Committee.

In anticipation of recommendations for one or more of these options, and at the request of the PHS agency heads, CDC had previously drafted an outline of a broad nationwide prevention and control plan for hepatitis C which took into consideration the fact that most Americans infected with HCV had acquired their infection from sources other than blood transfusion. The objectives of this plan are early identification of persons with chronic HCV infection, including transfusion recipients, and reducing transmission in groups at high risk of infection. Identification of persons at risk for HCV infection provides them with the opportunity to seek testing to determine their infection status, undergo medical evaluation for chronic liver disease if infected, and receive therapy if eligible. It also provides them with the opportunity to obtain information about how they can prevent transmitting the infection to others. This plan includes: 1) public education to reach the population at current or past risk of infection; 2) educational efforts directed to health care and public health professionals to improve the identification of patients at risk of infection and ensure appropriate diagnosis, treatment, and counseling; and 3) the development of community-based prevention programs.

How can I protect myself from getting hepatitis C?

     - If you shoot drugs, stop and get into a treatment program. If you can’t stop, use a clean needle and works every time and don’t share them.
     - If you have sex with multiple partners, lower your number of partners and always use barrier precautions, such as latex condoms.
     - If you are a health care worker, always follow routine barrier precautions and safely handle needles and other sharps.
     - Do not share toothbrushes, razors, or other personal care articles that might have blood on them.

Could I already have hepatitis C? Ask your doctor for a blood test for hepatitis C, if:

     - You received a blood transfusion or solid organ transplant (e.g., kidney, liver, heart) before 1992.
     - You received clotting factor concentrates before 1987.
     - You ever injected street drugs, even once.
     - You were ever on long-term kidney dialysis.

Why should I be tested for hepatitis C? Early diagnosis is important so you can be:

     - Counseled about how to prevent transmission of HCV to others.
     - Checked for liver disease and get treatment, if indicated.

What can I do now that my hepatitis C test is positive? Contact your doctor. Additional tests may be needed to check your diagnosis and to see if you have liver damage.

What if I don’t feel sick? Many persons with long-term hepatitis C have no symptoms and feel well, but should still see their doctor. For some persons, the most common symptom is extreme tiredness.

How can I prevent spreading HCV to others?

     - Do not donate your blood, body organs, other tissue, or sperm.
     - Do not share toothbrushes, razors, or other personal care articles that might have your blood on them.
     - Cover cuts or open sores on your skin.
     - If you shoot drugs, stop and get into a treatment program. If you can’t stop, use a clean needle and works every time and don’t share them.
    - There is a very low chance of giving hepatitis C to a partner through sexual activity. However, if you want to lower the chance of spreading HCV to                        your partner, use latex condoms. Ask your doctor about having your sex partner tested.
    - If you have sex with multiple partners, lower your number of partners, inform them that you have hepatitis C, and always use barrier precautions,                        such as latex condoms.

What if I am pregnant? Five out of every 100 infants born to HCV infected women become infected. This occurs at the time of birth, and there is no treatment that can prevent this from happening. However, infants infected with HCV at the time of birth seem to do very well in the first few years of life. More studies are needed to find out if these infants will be affected by the infection as they grow older. Breast feeding does not spread HCV.

Hepatitis C is not spread by:

- Sneezing, hugging, coughing, sharing eating utensils or drinking glasses, food or water, or casual contact.

Is there a treatment for hepatitis C? A drug called interferon is licensed for the treatment of persons with long-term hepatitis C. About 2 out of every 10 patients who are treated get rid of the virus. You should check with your doctor to see if treatment would help you.