The burden of infection with HSV-1 and HSV-2 in England and Wales: implications for the changing epidemiology of genital herpes

Objective: To measure the burden of infection with herpes simplex type 1 (H SV-1) and herpes simplex type 2 (HSV-2) in the general population of Englan d and Wales and to assess temporal changes in the incidence of HSV-1 infect ion in childhood. Methods: 4930 residual blood samples taken from people aged 0-69 years and submitted to 15 public health laboratories in England and Wales between Jan uary 1994 and June 1995, and 500 samples taken from people aged 10-14 years between November 1986 and December 1987, were screened for IgG antibody to HSV-1 and HSV-2 using type specific ELISA assays. Results: The prevalence of antibody to HSV-1 in 10-14 year olds declined fr om 34% in samples collected in 1986-7 to 24% in samples collected in 1994-5 (p<0.001). HSV-1 antibody prevalence in adults increased with age and was higher in females than males, reaching 54% in females aged 25-30 years in 1 994-5. In samples collected in 1994-5 from people aged 16-69 years HSV-2 an tibody was detected in sera from 3.3% of men and 5.1% of women. Conclusions: The incidence of HSV-1 infection in childhood is falling in En gland and Wales. The prevalence of HSV-2 infection in the general populatio n is low, with the rate of infection significantly lower than that describe d for the general population in the United States and developing countries. The falling rate of HSV-1 infection in childhood may be one factor contrib uting to the increasing incidence of genital HSV-1 infection.