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Only one in five people who has genital herpes knows it, and that is fuelling an epidemic, according to a new study.

This means public-health officials must start paying as much attention to the infected who do not have obvious symptoms as to those with visible sores, a leading infectious disease specialist writes in today's edition of the New England Journal of Medicine.

"At present, the medical and public health communities largely ignore persons who have asymptomatic HSV-2 infection because little information is available as to what is the benefit in identifying such person," Dr. Anna Wald, director of the University of Washington Virology Research Clinic, said.

There is no cure for herpes simplex virus 2, but it is not fatal. It can be suppressed with medication, but the virus remains in the body and the disease can flare up.

"In fact, most HSV-2 infections are acquired from a person with no history of genital herpes infection. In order to prevent the spread of HSV-2 to babies and to sexual partners, we will have to identify and control the infection in people who do not currently realize they have the disease," Dr. Wald said.

She said there is a stubborn myth that people without active herpes blisters are not infectious, but that is not true.

Researchers found that 83 per cent of people who were infected with genital herpes but did not know it, in fact had the virus present in their genital secretions.

Herpes simplex virus 2 lurks in nerves at the base of the spine and, when it travels along the nerves to the skin, it can cause painful tingling and burning, sometimes resulting in blisters and ulcers in the genital area. (Herpes simplex virus 1 is commonly known as the cold sore.)

Genital herpes is dangerous principally because herpes sores facilitate the transmission of HIV, the virus that causes AIDS. It can also have serious consequences for pregnant women, because the baby can become infected.

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