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
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.
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.
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.
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).
Brown ZA, Kern ER, Spruance SL, Overall JC, Jr. Clinical and
virologic course of herpes simplex genitalis. West J Med
1979;130:414-21.
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.
Disclaimer
All MMWR HTML documents published before January 1993 are electronic conversions from ASCII text into HTML. This conversion may have resulted in character translation or format errors in the HTML version. Users should not rely on this HTML document, but are referred to the original MMWR paper copy for the official text, figures, and tables. An original paper copy of this issue can be obtained from the Superintendent of Documents, U.S. Government Printing Office (GPO), Washington, DC 20402-9371; telephone: (202) 512-1800. Contact GPO for current prices.
**Questions or messages regarding errors in formatting should be addressed to mmwrq@cdc.gov.
