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Type 1 (HSV-1) is most familiar as the cause of cold sores on the lips. The more serious Type 2 (HSV-2) typically causes genital lesions. Yet the sores of the two strains cannot easily be distinguished from each other, nor do they stick to their own turfs. The astounding and belated news is that ordinary cold sores can be transferred to the genitals by finger or mouth and become a venereal disease. Indeed, oral sex may be a potent force in spreading both strains. One survey shows that one-third of young women under 24 who have herpes on their genitals are actually suffering from HSV-1.
Once herpes has penetrated the skin, it multiplies rapidly. The first symptoms may be a tingling or itching sensation. Blisters may appear within two to 15 days after infection. In genital herpes, the first episode lasts on the average three weeks, as opposed to around five days for subsequent attacks, and blisters may be accompanied by fevers and pounding headaches (see following story).
Why the dramatic rise now in the incidence of herpes? Sexual freedom is obviously implicated. "With herpes, every new case is added to the pool," says Dr. Yehudi Felman, a New York City VD specialist. "The increase is exponential after a while." Not only are more people indulging in sex, they are also more active—starting younger, marrying later, divorcing more often. The wider acceptance of oral sex has also played a role. Richard Hamilton, a San Francisco family physician and author of The Herpes Book, thinks science has wrought the herpes epidemic: penicillin allowed greater sexual contact with little risk, and the Pill and other contraceptives largely replaced condoms, which prevent direct contact with sores.
Herpes is hardly the worst disease in the world, or even the worst venereal disease. Untreated, syphilis and gonorrhea do far more damage. But few modern ailments have altered so much basic behavior so quickly. Perhaps the reason is its sudden upsurge and incurability. As many family doctors put it: "It won't kill you, but you won't kill it either." "Herpes is a puzzle, an enigma," says Dr. John Grossman, a Washington, D.C., gynecologist. "The medical community doesn't do very well with viruses anyway, and with this one, our bodies aren't able to give us any assistance in killing it." All by itself, says New York Group Therapist Dominick Riccio, herpes has changed the uneasy balance between sex for pleasure and sex for commitment. "People are beginning to realize that romance is what relationships are all about," Riccio says. "They're disillusioned with free sex and terrified of getting herpes and having it forever."
Many swingers have dropped out because of herpes. And a trip to a prostitute is a high-stakes gamble. For a book on herpes, Philadelphia Writer Frank Freudberg interviewed 20 prostitutes in several cities and found they all had the disease. "Of course it wouldn't be good for business to mention it," said one popular pro in Atlantic City. "I bet me and my sister must have given it to a thousand guys --laugh. But this sure isn't a convent down here, honey."