It is one of the most widespread yet frequently misunderstood infections on the planet, according to global guidelines released by the World Health Organisation (WHO) in May 2025. Per WHO, billions of people around the world are carrying the herpes simplex virus (HSV) — often without even realising it. Also read | Do you kiss babies? UK physician explains how babies can get infected with lifelong viruses due to this mistake
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The WHO data outlines a stark reality: 3.8 billion people under the age of 50 (64 percent of the global population) are living with HSV-1, the primary driver of oral herpes. Meanwhile, an estimated 520 million people aged 15 to 49 (13 percent) worldwide are infected with HSV-2, the principal cause of genital herpes.
Despite its vast global footprint, herpes remains shrouded in social stigma, anxiety, and misconception. Here is a comprehensive breakdown of what the WHO guidelines reveal about symptoms, transmission, risks, and treatment options.
⦿ HSV-1 (oral and genital): Primarily acquired during childhood through oral contact (such as kissing or sharing utensils), HSV-1 traditionally causes cold sores in or around the mouth. However, it can also cause genital herpes through oral-genital contact. Of the 3.8 billion HSV-1 cases, approximately 10 percent (376 million people aged 15–49) are genital infections.
⦿ HSV-2 (genital): Transmitted almost exclusively through sexual contact, HSV-2 is the primary cause of genital herpes. HSV-2 infects women almost twice as often as men, as male-to-female sexual transmission is significantly more efficient. While overall prevalence rises with age, the highest rate of new infections occurs among adolescents and young adults.
⦿ Key difference in recurrences: HSV-2 is far more likely than genital HSV-1 to cause recurring symptomatic flare-ups over a person’s lifetime.
One of the main reasons herpes spreads so easily is that the vast majority of infections are asymptomatic or unrecognised. People who show no visible sores can still shed the virus and pass it to others. When symptoms do appear, they typically begin with a warning sign: tingling, itching, or burning in the affected area before sores manifest.
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⦿ Physical injury or surgery
⦿ Emotional stress
While herpes is primarily an uncomfortable condition, it carries significant health consequences under specific circumstances:
⦿ Three-fold HIV risk: HSV-2 infection increases the risk of acquiring HIV approximately threefold. Furthermore, individuals co-infected with both HIV and HSV-2 are more likely to transmit HIV to sexual partners. Because of this link, the WHO recommends that anyone displaying symptoms of genital herpes be offered HIV testing.
⦿ Neonatal herpes: if a mother contracts herpes (particularly a first-time infection in late pregnancy), the virus can be passed to the infant during delivery. While rare — occurring in roughly 10 out of every 100,000 births globally — neonatal herpes is a grave medical emergency that can result in lasting neurological disability or death.
⦿ Severe disease in vulnerable groups: in immunocompromised individuals (such as those with advanced HIV), HSV can cause severe, frequent recurrences, and in rare cases, lead to life-threatening complications like encephalitis or meningoencephalitis (brain infections) or keratitis (eye infection).
There is currently no cure or vaccine for herpes, but effective medical interventions exist to control symptoms and reduce transmission risks.
⦿ Antiviral therapies: standard prescription antivirals include acyclovir, famciclovir, and valacyclovir.
⦿ Episodic treatment: starting antiviral therapy within 48 hours of symptom onset significantly shortens the duration and severity of an outbreak.
⦿ Suppressive therapy: taking a daily lower dose of antiviral medication reduces the frequency of outbreaks and substantially lowers the risk of passing the virus to partners. Daily suppressive therapy is often recommended for individuals with severe/frequent outbreaks or those in discordant relationships.
To ease discomfort during flare-ups, simple at-home adjustments can provide significant relief. For oral herpes, staying hydrated with cold drinks or sucking on popsicles can soothe painful mouth sores, while those prone to sun-triggered flare-ups should consistently wear sunscreen and limit direct exposure to ultraviolet light.
For genital herpes, sitting in a warm bath for 20 minutes without soap helps clean and calm irritated tissues, and wearing loose-fitting clothing prevents unnecessary friction on sensitive areas. Over-the-counter oral pain relievers such as paracetamol (acetaminophen), naproxen, or ibuprofen can manage underlying body aches, while topical numbing medications containing lidocaine or benzocaine can be applied directly to soothe painful localized sores.
Preventing the transmission of HSV requires communication and consistent protective measures.
⦿ Abstain during outbreaks: Avoid oral or sexual contact whenever active blisters, sores, or prodromal symptoms (tingling/itching) are present.
⦿ Barrier protection: Consistent and correct condom use provides the best protection for sexually active individuals, though condoms only protect areas they cover.
⦿ Male circumcision: Voluntary medical male circumcision offers lifelong partial protection against HSV-2, HIV, and HPV.
⦿ Avoid sharing saliva: For oral herpes, refrain from sharing drinks, lip balms, or utensils that come into contact with saliva.
Team Analysis
Herpes simplex virus is a treatable, lifelong viral infection that primarily spreads through skin-to-skin contact. Once inside the body, the virus resides inside nerve cells, alternating between dormant (inactive) and active phases.
The virus is categorised into two distinct types:
⦿ First outbreak: Initial infections are usually the most severe. Alongside painful blisters or open ulcers, patients may experience systemic flu-like symptoms, including fever, body aches, swollen lymph nodes near the infection site, and sore throat (for oral herpes) or headache.
⦿ Recurrent episodes: Subsequent outbreaks tend to be shorter, less severe, and localised. In 2020 alone, an estimated 205 million people aged 15–49 (5.3 percent of that age bracket) experienced at least one symptomatic genital herpes episode — 92 percent of which were caused by HSV-2. Also read | Can herpes virus impair the body’s immune system? Study finds hidden agent that triggers it
Because the virus stays dormant in nerve tissues, common physical and emotional stressors can reactivate it:
⦿ Fever or general illness
⦿ Sunlight / UV exposure (especially for oral cold sores)
⦿ Menstruation
Match Outlook
⦿ Pregnancy care: Expectant mothers with a history of genital herpes should notify their healthcare provider early to establish a prevention plan for late pregnancy and delivery.
The bottom line from the WHO is clear: HSV is a widespread global human condition. With open communication, proper medical guidance, and proactive care, those infected can manage the virus effectively and lead healthy, fulfilling lives.
Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.
