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Epidemiologic Notes and Reports Genital Herpes Infection - - United States, 1966-1979

CDC has analyzed data on genital herpes infection collected by the National Disease and Therapeutic Index (NDTI)*. This analysis supports the widely held contention that an epidemic of genital herpes infection occurred in the United States from 1966 to 1979--the most recent year for which data are available.

The estimated number and rate of consultations with physicians for genital herpes infection both increased markedly from 1966 to 1979 (Figure 1). The number of consultations for genital herpes infection increased from 29,560 in 1966 to 260,890 in 1979. The rate at which patients consulted fee-for-service office-based physicians for genital herpes infection increased almost 9-fold from 3.4/100,000 consultations in 1966 to 29.2/100,000 in 1979.

In contrast, the NDTI survey showed a less than 2-fold increase in the rate of consultations for oral herpes infection (comprised of conditions cited as herpes labialis and herpes stomatitis) and for ocular herpes infection (Figure 2). Three other codes used in the NDTI survey are herpes febrilis, herpes simplex, and herpes "not otherwise stated." The trend in the rates of these physician contacts is depicted in Figure 3.

The only other national data set available for estimating the number of consultations with U.S. private physicians for herpes infection is the National Ambulatory Medical Care Survey (NAMCS), a study conducted by the National Center for Health Statistics. NAMCS first used a separate code for genital herpes in 1979. The NAMCS-estimated number of consultations for all types of herpes infection increased from 838,000 in 1973 (earliest data available) to 937,000 in 1979 (latest data available), an 11.8% increase. For that same period (1973-1979), the NDTI data showed an increase in all types of herpes infection of 9.9%. Reported by Venereal Disease Control Div, Center for Prevention Svcs, CDC.

Editorial Note

Editorial Note: Social, demographic, and behavioral changes within the U.S. population during the 1970s have placed an increased proportion of that population at risk for sexually transmitted diseases such as genital herpes infection (1-4). The observed increase in rate and number of consultations for genital herpes infection supports the observations of gynecologists who have noted an increase in patient visits for genital herpes infection (5-7).

The increased incidence of genital herpes infection is particularly noteworthy for several reasons (4): clinical manifestations of the infection tend to recur, and no specific treatment is available to prevent recurrence; there is an association between genital herpes infection and the development of cervical cancer; and infections of newborns acquired during passage through the birth canal are often life threatening.

The total number of consultations for this infection in the United States cannot be estimated on the basis of NDTI data. Patients with genital herpes infection may seek care in public health care facilities and from other private ambulatory-care providers--hospital emergency rooms, prepaid practices, outpatient departments of community hospitals--which are not included in the survey. Therefore, the total number of health care consultations for genital herpes infection in the United States is unknown. However, the upward trend of cases diagnosed in private-physician practices supports the contention of an ongoing epidemic of genital herpes infection.

References

  1. Zelnik M, Kantner JF. Sexual and contraceptive experience of young unmarried women in the United States, 1976 and 1971. Fam Plann Perspect 1977;9:55-6, 58-63, 67-71.

  2. Zelnik M, Kantner JF. Sexual activity, contraceptive use and pregnancy among metropolitan-area teenagers:1971-1979. Fam Plann Perspect 1980;12:230-1, 233-7.

  3. Aral S, Kingon RJ, Johnson RE, Zaid AA, Fichtner RR, Reynolds GH. Trends in two STD'd 1967-1978: a comparison of syphilis and gonorrhea morbidity. Presented at 108th annual meeting of American Public Health Association, October 20, 1980, Detroit, Michigan.

  4. NIAID Study Group. Sexually transmitted diseases. 1980 status report. Washington, D.C.: U.S. Department of Health and Human Services, 1981. (Public Health Service. National Institutes of Health) (NIH Publication No. 81-2213).

  5. Gardner HL, Kaufman RH. Herpes genitalis: clinical features. Clin Obstet Gynecol 1972;15:896-911.

  6. Brown ZA, Kern ER, Spruance SL, Overall JC, Jr. Clinical and virologic course of herpes simplex genitalis. West J Med 1979;130:414-21.

  7. Amstey MS. Genital herpesvirus infection. Clin Obstet Gynecol 1975;18:89-100. *The NDTI survey is a national, stratified, random sample of data from patient consultations with physicians in fee-for-service office-based practice in the United States (excluding Hawaii and Alaska). Included in the sample are all consultations between patients and sample physicians in an office, hospital, or nursing home, or in the form of a house call or telephone conversation. The survey procedure does not include a confirmation of the physician's diagnosis.

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