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The seroepidemiology of herpes simplex virus type 1 and 2 in Europe
  1. R G Pebody1,
  2. N Andrews1,
  3. D Brown2,
  4. R Gopal2,
  5. H de Melker3,
  6. G François4,
  7. N Gatcheva5,
  8. W Hellenbrand6,
  9. S Jokinen7,
  10. I Klavs8,
  11. M Kojouharova5,
  12. T Kortbeek3,
  13. B Kriz9,
  14. K Prosenc8,
  15. K Roubalova9,
  16. P Teocharov5,
  17. W Thierfelder6,
  18. M Valle7,
  19. P Van Damme4,
  20. R Vranckx10
  1. 1Immunisation Department, Communicable Disease Surveillance Centre, London, UK
  2. 2Enteric and Respiratory Viruses Laboratory, Central Public Health Laboratories, London, UK
  3. 3Centre for Infectious Disease Epidemiology, RIVM, Bilthoven, Netherlands
  4. 4Centre for the Evaluation of Vaccination, Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium
  5. 5National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria
  6. 6Department of Infectious Disease Epidemiology, Robert Koch Institut, Berlin, Germany
  7. 7National Public Health Institute, Helsinki, Finland
  8. 8Department of Infectious Disease, Institute of Public Health, Ljubljana, Slovenia
  9. 9Centre of Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
  10. 10Scientific Institute of Public Health, Brussels, Belgium
  1. Correspondence to:
 Dr R G Pebody
 CDSC Health Protection Agency, 61, Colindale Avenue, London NW9 5DF, UK;


Objectives: To describe the seroepidemiology of herpes simplex virus (HSV) types 1 and 2 in the general populations of eight European countries to better understand recent reported changes in disease epidemiology.

Methods: Belgium, Bulgaria, Czech Republic, England and Wales, Finland, Germany, Netherlands, and Slovenia conducted national cross sectional serological surveys for HSV-1 and HSV-2 between 1989 and 2000. Survey sizes ranged from 3000 to 7166 sera. External quality control was ensured through reference panel testing.

Results: Large intercountry and intracountry differences in HSV-1 and HSV-2 seroprevalence were observed. Age standardised HSV-1 seroprevalence ranged from 52% in Finland, to 57% in the Netherlands, 67% in Belgium, 81% in Czech Republic, and 84% in Bulgaria. Age standardised (>12 years) HSV-2 seroprevalence ranged from 24% in Bulgaria, to 14% in Germany, 13% in Finland, 11% in Belgium, 9% in Netherlands, 6% in Czech Republic, and 4% in England and Wales. In all countries, probability of seropositivity for both infections increased with age. A large proportion of teenagers and young adults remain HSV-1 susceptible particularly in northern Europe. Women were significantly more likely to be HSV-2 seropositive in six of seven (p<0.05) countries and HSV-1 seropositive in four of seven (p<0.05) countries, particularly in northern Europe. No significant evidence of a protective role of HSV-1 for HSV-2 infection was found adjusting for age and sex (p<0.05).

Conclusions: There is large variation in the seroepidemiology of HSV-1 and HSV-2 across Europe. The observation that a significant proportion of adolescents are now HSV-1 susceptible may have implications for transmission and clinical presentation of HSV-1 and HSV-2.

  • seroepidemiology
  • herpes simplex virus
  • Europe
  • CDSC, Communicable Disease Surveillance Centre
  • ELISA, enzyme linked immunosorbent assays
  • HSV, herpes simplex virus

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