The large reservoir of persons with asymptomatic HSV-1 and HSV-2 infections indicates that control of HSV disease through suppressive antiviral chemotherapy and/or educational programs will be limited. Control of HSV infection will require prevention of infection, a goal most likely achievable by vaccination. Effective HSV vaccines are not currently available in the United States. Many heterologous vaccines such as smallpox, bacillus Calmette-Guerin, influenza, and polio vaccines have been used as therapies for genital HSV infection. All have been ineffective. In particular, smallpox vaccine is ineffective in reducing the recurrence rate of herpes. Deaths from disseminated vaccinia infection have occurred, and this potentially dangerous form of therapy should be actively discouraged.
Currently no proven effective means of prophylaxis of HSV has been established. Barrier forms of contraception, especially condoms, may decrease transmission of disease especially during periods of asymptomatic viral excretion. Transmission of disease when lesions were present despite the use of a condom may still occur, and patients should be instructed to avoid sexual activity when genital lesions are present.