Study: Fewer cold sores in kids associated with more genital herpes infections.

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Screen Shot 2013-10-21 at 2.10.11 PMA study in the Oct. 17 online edition of the Journal of Infectious Diseases reveals some surprising news about a change in the nature of genital herpes in young people today.

According to Dr. David Kimberlin, chair of infectious diseases at the University of Alabama at Birmingham, "HSV-1 now is the predominant herpes strain causing genital infection."

There are two forms of herpes simplex HSV-1, which is normally associated with cold sores, and HSV-2 which has been the most common cause of genital herpes. The two viruses are very similar, and both can infect the oral-facial and genital areas. Yet, the study revealed that now, the majority of genital herpes infections in younger people 60 percent actually come from oral herpes, HSV-1.

The authors attribute this to: 1) a decreased childhood exposure to cold sores determined by comparing the presence of HSV-1 antibodies in younger people to people of the same age one or two decades ago.; and 2) a change in sexual practices during that time (e.g., more oral sex among teens).

ACSH s Dr. Josh Bloom comments, Although this is quite surprising, it is not necessarily bad news. When the primary infection of genital area is by the oral type herpes, the infection is less severe than when genital herpes (HSV-2) is the infectious agent. And, although herpes stays with you for life, the subsequent occurrence of outbreaks is much lower when oral herpes attacks the genital area. And the same holds true for the opposite scenario. Apparently, the viruses are just not as happy when they infect the wrong site.

Dr. Kimberlin elaborates, [T]he new findings suggest that almost one in 10 adolescents who a decade ago would have already acquired HSV-1 and built up some immunity may now encounter HSV-1 when they first become sexually active. That could leave them more susceptible to genital herpes than young people were in the past.

What is the reason behind the rapid decline in the incidence of cold sores in children? This is not clear, but , Dr. Marcelo Laufer, a pediatric infectious disease specialist at Miami Children's Hospital suggested that since the virus is usually passed through saliva, in recent years better hygiene may have kept the virus from spreading to young children.

Dr. Bloom isn t convinced. Has oral hygiene really changed that much over the past 10 years, such that a highly infectious virus suddenly disappears from your saliva? Sounds like a stretch. I m guessing that there must be something else going on.