Letters to the Editor
gomezfj
Published Letters: 25 Editor's Choice: 3
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Get a grip.
[Read the article: I have herpes. Do I have to tell all my partners?]
[Read more letters about this article: Here]There is a lot of misinformation and incomplete information in the letters submitted.
Even by saying that herpes is not a stigma, you are making it into a stigma. Let me drop a Little Medical Knowledge into the conversation:
Herpes genitalis is the second most common STD in the US. Near 25% of men and a somewhat lower percentage of women have clinical symptoms of infection.
The true prevalence of infection is likely to be much higher among sexually active humans there are unknown numbers of asymptomatic carriers, which shed the virus intermittently. The virus can be detected by PCR if you catch them during this episodes of asymptomatic shedding. Perhaps the true prevalence of infection approachesthat of HSV-1: 80 to 90%
While Herpes can be severely painful and have systemic complications, the overwhelming majority of the individuals with infection have one or a few episodes that become less and less severe and frequent, even without treatment. Herpes can become a more intractable problem in immunosuppressed patients from AIDS or transplant therapy.
Despite the very high numbers of females with Genital Herpes, child complications from neonatal herpes are quite rare.
There are a lot of the horror stories circulating about Genital Herpes, which are probably true, but the fact that they are told repeatedly and become urban legends is because they are exceptional. The overwhelming majority of HSV-2 infections are asymptomatic, mild or moderate.
On the other hand, the prejudice and ignorance around the issue turned HSV-2 into the Leprosy of the 20th century,
The wrath of God for Sins of the flesh and all that non-sense.
So my answer to the original question is: Yes, if I had Herpes I would tell my partners. If they leave me for that reason, much better. The last thing I need is an ignorant, prejudiced asshole by my side. . .
FJ Gomez MD
Infectious Diseases Specialist.
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To Anonymous:
[Read the article: I have herpes. Do I have to tell all my partners?]
[Read more letters about this article: Here]Can the doctor clarify...
First of all, I do not want to hijack this place as an Online medical consultation. There are other venues for this including www.netwellness.org. Where I do answer questions like this from a professional point of view. In here, I wanted to express my opinion, a POLITICAL and SOCIALLY charged opinion.
...--can we consider ourselves relatively "safe" from shedding? Especially if we take valtrex or famvir and never have sex when even a hint of a tingle is there?
I would say that the chances of transmission are small, but not zero under the circumstances you describe.
Can he clarify if there is really such a thing as asymptomatic shedding, or is this overstated and unproven?
Asymptomatic shedding is a very much proven fact, and is probably the most common instance in which HSV-2 Transmission takes place. In longitudinal studies, 2/3 of the people that acquired HSV-2 infection did so from an asymptomatic partner.
Moreover, in studies in which HSV-2 infection is detected by sero-conversion (appearance of HSV-2 specific antibodies, which CAN distinguish HSV-2 from HSV-1 infection) only 37% of the individuals remember any kind of genital lesions or symptoms , suggesting that the majority of infections were subclinical, asymptomatic.
-I've heard from several doctors that it's next to impossible to transmit this malady if there is not a visible open sore.
That view is not supported by these studies:
Risk factors for the sexual transmission of genital herpes.
Mertz GJ; Benedetti J; Ashley R; Selke SA; Corey L
Ann Intern Med 1992 Feb 1;116(3):197-202.
Risk of acquisition of genital herpes simplex virus type 2 in sex partners of persons with genital herpes: a prospective couple study.
Bryson Y; Dillon M; Bernstein DI; Radolf J; Zakowski P; Garratty E
J Infect Dis 1993 Apr;167(4):942-6.
The chances of transmission may be higher if there is intercourse in the presence of active lesions, but there is definite risk of transmission in their absence.
And if it truly is possible, then why do many of us long-term carriers seem to NOT transmit it?
Multiple possible explanations: The frequency and the amount of shedding decreases as time goes by. There could be some level of transmission but it tends to be sub clinical. HSV-2 has genetic variability and some strains may be more virulent, more transmissible and more symptom generating than others.
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The Shia Factor
[Read the article: If only Newt Gingrich were president]
[Read more letters about this article: Here]Adding to what others have stated:
Those who salivate with the prospect of bombing Iran,
most consider that while the government and the elite of most oil rich countries in the region are solidly in US pocket (Saddam slipped off in 1990, but never mind) The populace is fiercely opposed to the US policies and angry to the brink. . .
A push in the wrong direction and all those Saudi princes won't be able to behead enough people to maintain control of the angry mob uprising.
Iran may not need to bomb the Saudi and Kuwaiti refineries: Some local volunteers may be more than glad to lend a helping hand
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Umberto Eco
[Read the article: The right-wing brain in action]
[Read more letters about this article: Here]This is a rather disquieting assay on the subject of Fascism, and its obvious relationship with the Current reality.
http://www.pegc.us/archive/Articles/eco_ur-fascism.pdf
I hope posting this web link does not infringe on some "digital intellectual property" rule.
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@ Anonymous
[Read the article: Guarding boys with Gardasil?]
[Read more letters about this article: Here]I am not sure what your sources are.
The vaccine IS effective in the population it has been targeted,
Early teen age girls, to prevent infection with high risk HPV serotypes.
The effectiveness against Cervical cancer is not as strong, because such a study does require following hundred of thousands of subjects over 20 or so years, but anyone with some insight in the molecular biology of HPV knows that the potential benefit of the vaccine is very real.
Now, some people stick their guns and maintain that nobody has convincingly shown that smoking cigarettes causes lung cancer. . . which is technically true, but a flagrant idiocy when you come to think about it