One of eight North Americans (30 million) has genital herpes, even though only one in five knows that he or she has it. Herpes is classified into type I that affects primarily the mouth ("canker sores"), and type II that affects primarily the genitals, although both types can go both places. According to a study in the American Journal of Epidemiology almost one percent of North Americans acquire new cases of recurrent genital herpes each year. That's 1,640,000 new cases of recurrent genital herpes, in 730,000 men and 910,000 women.

To get herpes, you need the virus and broken skin. Since rubbing breaks skin, sexual contact with infected partners is a frequent cause of herpes. Typically, a person develops grouped painful or itchy blisters that look like poison ivy and disappear after one to six weeks. For some, genital herpes never recur, but almost all people who have a painful first episode will have recurrent blisters in exactly the same place.

A person who has herpes can be contagious, even when there are no visible blisters. The only way to diagnose herpes is to have a culture done on a wet blister. There are no dependable blood tests to tell if you have herpes because more than 92 percent of all Americans have had herpes and therefore have positive blood tests.

Herpes is the most common cause of swelling and pain around the rectum or vagina; anyone with these symptoms should get a culture for herpes, even if they are not sexually active.

Almost all North Americans have had herpes, but only seven percent get blisters recurrently. If you have had only one bout of herpes, you do not need treatment. If you have fewer than four recurrent genital herpes attacks per year, your doctor will probably prescribe 21 500mg tablets of Famvir or Valicyclovir that you keep on hand all the time and take them at the first tingling or itching that precede an outbreak. If you have more than 4 attacks a year, your doctor will probably prescribe valicyclovir or Famivir. By the third year on that regimen, as many as 82 percent have no outbreaks at all. Taking acyclovir every day can help to prevent a person from being contagious. Valicyclovir and Famvir are both approved by the FDA for long-term use.

People with recurrent herpes can be contagious any time, but they are less likely to be contagious when they do not have blisters. Virtually everyone in North America has had herpes, but only seven percent get it recurrently. If a person with recurrent herpes is on Valtrex every day, he or she will not shed as much and not be as contagious. Personally, I would not ruin a relationship because of herpes because you are not likely to find anyone who has not had herpes.