Herpes Is Infectious
And Contagious
Without Symptoms
By Gene Emery

BOSTON (Reuters) - A new study of people with genital herpes has found carriers can be contagious even if they have none of the symptoms of the sexually transmitted disease.
Nearly 25 percent of Americans and up to 18 percent of Europeans carry the herpes virus, but only 10 percent to 25 percent of carriers say they have had the genital ulcers, blisters, or crusts that are the hallmarks of the disease.
Until now, many doctors had assumed that people could only spread the disease when those sores were present. But the study appearing in Thursday's New England Journal of Medicine casts doubt on that notion.
A group led by Dr. Anna Wald of the University of Washington in Seattle tested daily cultures from 53 people who never remembered having herpes symptoms but were found, through random screening, to be infected with the virus. The volunteers were also required to keep a log of symptoms.
After three months, the logs of 87 percent of the volunteers showed that they did, in fact, regularly experience herpes symptoms. They apparently didn't realize it, in part, because those symptoms tended to arise less frequently and cleared up faster, compared to 90 volunteers who regularly experienced a reappearance of the infection.
More importantly, among 38 of the 53 volunteers, the virus was isolated from at least one of the cultures collected from the genital area. Among the 38 subjects, 36 were found to be potentially infectious ``on days on which lesions were absent,'' Wald and her colleagues found.
And although doctors now tend to think that it is implausible for a man to spread the disease unless he has a genital sore, ``we found that this reasoning is erroneous,'' they said. ``The rates of subclinical shedding among men approximated those among women'' in the study.
New tests coming onto the market will allow doctors to routinely test for a ``silent'' herpes infection, the researchers said. ``Thus, it is just becoming possible to identify the large reservoir of persons with infrequent, short episodes'' of genital herpes.
People with silent infections may not need to take drugs, said Wald and her team. ``However, they do require education and counseling regarding their risk of transmitting the infection to others,'' they said.


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