DEAR DR. ROACH: If a person has been exposed (verified by blood test) to herpes 1 and 2, can that person be a blood donor? Could a person catch herpes by sitting on a toilet seat that has been used by an infected person? Are scientists working on a cure for herpes? — Anon.

ANSWER: There remains a stigma against people with genital herpes, which is almost always caused by herpes simplex virus type 2. However, most people with genital herpes will not have major disruptions to their lives provided they take some precautions.

First off, a person with herpes simplex virus type 1 (about half of the population between ages 18-49, higher in older people) or HSV-2 (about 12 percent of the same population) certainly can donate blood. Second, being exposed doesn’t guarantee infection. Third, blood testing is not perfect. Fourth, getting any kind of sexually transmitted infection from a toilet seat is very unlikely. Herpes viruses have a very difficult time getting through intact skin, which is why most exposures come through mucus membranes, especially of the genitals and mouth.
There is a type of herpes (usually HSV-1, occasionally HSV-2) in wrestlers, called herpes gladiatorum or “mat herpes,” and it can be transmitted from person to person through skin-to-skin contact, especially if the skin is raw or chafed.

Once a person has herpes of either variety, there is no cure. The virus stays in the nerve cells. There is extensive work being done both on preventing transmission and curing existing infections, but herpes viruses are very good at escaping the immune system. This makes herpes difficult to treat.

DEAR DR. ROACH: I have recently started transitioning to a plant-based diet for preventative health reasons. While discussing the benefits of nuts and seeds with a dietitian, they had a disclaimer that flax seed can interfere with medications and to eat them two hours before or one hour after taking medications. I would not sit down and eat a handful of flax seeds, but now I am afraid to use them in the meals I prepare at all. Can you help me make a good decision in using them? — J.E.

ANSWER: For people eating reasonable amounts (like a handful or two) of flax seeds as part of a meal, it is unlikely that they would interfere with medications enough to cause any significant problem, for most medications.

There are two situations that might merit concern: In powerful anti-clotting agents, such as clopidogrel, flax seeds might prompt increased activity. Secondly, flax seeds may lower blood sugar a small amount. In combination with insulin or oral diabetes drugs, the blood sugar could possibly dip lower than expected. I doubt either of these interactions is likely to cause harm, but it is reasonable to discuss with your doctor if you are on one of the classes of medications mentioned.

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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.

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