Genital Herpes Transmission ~ Risk ~ Latency ~ Shedding
Transmission
Herpes (types 1 and 2) can be transmitted through skin to skin contact, kissing, sexual intercourse, and
oral sex. The mucous membranes (mouth, nose, ears, throat, genitals, and anus) are most susceptible to
infection with HSV. The cervix and urethra are also high target areas. Also susceptible are any areas that
may be subject to abrasion, and warm, moist areas such as the upper thighs, underarms, hairline, lower
back, perineum, scrotum, and buttocks - any areas when sweating is common.
Herpes is most easily passed through inoculation from active lesions. The virus may also spread during
times when there are no symptoms, and from sites that are seemingly inactive. Most incidences of genital
Herpes occur during sexual intercourse. There is, however, a significant percentage of genital herpes
infections resulting from oral to genital sexual contact. Most of these oral to genital transmissions will be
of the type 1 variety, although type 2 incidence is not uncommon. Many times the partner who carries the
virus is not even aware of an outbreak. In most cases, however, close examination may reveal a history of
some of the symptoms listed previously.
Inoculation and autoinoculation (self-infection) of genital Herpes occurs primarily through vigorous
intercourse, masturbation, anal sex, and oral sex with an infected member. Herpes can be passed via the
use of sexual stimulators such as vibrators.
Inoculation and autoinoculation can occur by transferring the virus from one part of the body to another,
usually via touching a sore with a hand and then touching another susceptible area, such as the mouth or
eyes. This complication is more common during a first episode because of higher amounts of virus present
during that time. Herpes is also more likely to spread to compromised epithelial tissue - skin that has
suffered cuts, abrasions, scrapes, etc.
Risk of Transmission
In studies of transmission of genital Herpes in couples, the annual risk of transmission averaged 5 to 10%
per year for those abstaining from sex during outbreaks. The risk of acquisition was much higher (16.9%)
for women, but somewhat lower for those who already had HSV-1. There is some evidence that people
who have HSV-1 are more resistant to the HSV-2. This should not be interpreted as immunity but rather
as a higher resistance factor. The transmission rate was also lower for those who used condoms. The
greater risk of acquisition for women may be due partly to anatomy, and partly because, generally, men
tend to have more frequent outbreaks, while women tend to have more severe outbreaks. More frequent
outbreaks means more times there is virus on the surface of the skin, and hence a greater the risk of
transmission.
The best way to avoid transmission is to abstain from sexual activity during prodrome and outbreaks,
and to use condoms the rest of the time. While consistent use of condoms affords some measure of
protection, the nature of HSV is such that condoms may not cover the site of active virus, and therefore
condoms are not a guarantee against transmission of the virus. For example, if the virus is active on the
scrotum (which isn't covered by a condom), and the scrotum comes in contact with the partner's genitals,
the virus could be transmitted.
The risk of transmission for HSV-1 from the oral to the genital area is much higher than the risk of
transmission of HSV-2 from the genital to the oral area. In addition, the recurrence and shedding rate for
genital HSV-1 is much less than for HSV-2 - this is why getting a culture to determine the viral type can
come in handy. And although HSV-2 can be transmitted to the mouth, because HSV-2 "prefers" the
genitals, the recurrence rate of oral HSV-2 is statistically very low - about once every ten years.
Latency
Once infected, the Herpes virus stays in the body. After outbreak, the virus goes into "latency." While
latent, HSV lives in a kind of state of suspended animation, in the nerve centers in the spine: genital HSV
in the sacral nerve roots (ganglia) at the base of the spine, and oral-facial HSV in the trigeminal nerve roots
at the base of the neck. When reactivated, HSV begins to replicate, and travels the nerve pathways to the
surface of the skin.
Transmission
Herpes (types 1 and 2) can be transmitted through skin to skin contact, kissing, sexual intercourse, and
oral sex. The mucous membranes (mouth, nose, ears, throat, genitals, and anus) are most susceptible to
infection with HSV. The cervix and urethra are also high target areas. Also susceptible are any areas that
may be subject to abrasion, and warm, moist areas such as the upper thighs, underarms, hairline, lower
back, perineum, scrotum, and buttocks - any areas when sweating is common.
Herpes is most easily passed through inoculation from active lesions. The virus may also spread during
times when there are no symptoms, and from sites that are seemingly inactive. Most incidences of genital
Herpes occur during sexual intercourse. There is, however, a significant percentage of genital herpes
infections resulting from oral to genital sexual contact. Most of these oral to genital transmissions will be
of the type 1 variety, although type 2 incidence is not uncommon. Many times the partner who carries the
virus is not even aware of an outbreak. In most cases, however, close examination may reveal a history of
some of the symptoms listed previously.
Inoculation and autoinoculation (self-infection) of genital Herpes occurs primarily through vigorous
intercourse, masturbation, anal sex, and oral sex with an infected member. Herpes can be passed via the
use of sexual stimulators such as vibrators.
Inoculation and autoinoculation can occur by transferring the virus from one part of the body to another,
usually via touching a sore with a hand and then touching another susceptible area, such as the mouth or
eyes. This complication is more common during a first episode because of higher amounts of virus present
during that time. Herpes is also more likely to spread to compromised epithelial tissue - skin that has
suffered cuts, abrasions, scrapes, etc.
Risk of Transmission
In studies of transmission of genital Herpes in couples, the annual risk of transmission averaged 5 to 10%
per year for those abstaining from sex during outbreaks. The risk of acquisition was much higher (16.9%)
for women, but somewhat lower for those who already had HSV-1. There is some evidence that people
who have HSV-1 are more resistant to the HSV-2. This should not be interpreted as immunity but rather
as a higher resistance factor. The transmission rate was also lower for those who used condoms. The
greater risk of acquisition for women may be due partly to anatomy, and partly because, generally, men
tend to have more frequent outbreaks, while women tend to have more severe outbreaks. More frequent
outbreaks means more times there is virus on the surface of the skin, and hence a greater the risk of
transmission.
The best way to avoid transmission is to abstain from sexual activity during prodrome and outbreaks,
and to use condoms the rest of the time. While consistent use of condoms affords some measure of
protection, the nature of HSV is such that condoms may not cover the site of active virus, and therefore
condoms are not a guarantee against transmission of the virus. For example, if the virus is active on the
scrotum (which isn't covered by a condom), and the scrotum comes in contact with the partner's genitals,
the virus could be transmitted.
The risk of transmission for HSV-1 from the oral to the genital area is much higher than the risk of
transmission of HSV-2 from the genital to the oral area. In addition, the recurrence and shedding rate for
genital HSV-1 is much less than for HSV-2 - this is why getting a culture to determine the viral type can
come in handy. And although HSV-2 can be transmitted to the mouth, because HSV-2 "prefers" the
genitals, the recurrence rate of oral HSV-2 is statistically very low - about once every ten years.
Latency
Once infected, the Herpes virus stays in the body. After outbreak, the virus goes into "latency." While
latent, HSV lives in a kind of state of suspended animation, in the nerve centers in the spine: genital HSV
in the sacral nerve roots (ganglia) at the base of the spine, and oral-facial HSV in the trigeminal nerve roots
at the base of the neck. When reactivated, HSV begins to replicate, and travels the nerve pathways to the
surface of the skin.
| Paths of virus latency, reactivation, & asymptomatic shedding. |
Viral Shedding
Once infected with any type of Herpesvirus, the person remains capable of transmitting virus for the rest
of their life even when showing no symptoms due to a process called viral shedding. Shedding means
that the virus is active on the skin, and risk of transmission is high. HSV sheds at prodrome, during
outbreaks, during healing periods after outbreaks, but also at random times where there may be no
noticeable symptoms at all. This is called "subclinical shedding" or "asymptomatic shedding."
Asymptomatic Shedding
Asymptomatic Shedding is the release of the virus on the skin when there are no symptoms. These
asymptomatic shedding episodes occur (according to studies) typically 3 to 10 days in the year, so
although the risk is minimal it does exist, because one can't necessarily tell when those days are. During
an episode of asymptomatic shedding, virus often sheds from several different sites in the area
concurrently. And there is new research suggesting that shedding occurs more frequently than
previously thought. In a recently published study, researchers found that half of the episodes of
subclinical shedding of HSV occurred within seven days of a symptomatic recurrence. Unfortunately,
asymptomatic shedding is not detectable by any procedure or test available outside a research study. It
should be noted that for the first 6 months to a year after a primary episode, shedding may occur much
more frequently. The incidence of asymptomatic shedding is greatest during the first year or two after
infection.
Shedding can occur randomly and sporadically and seems to some degree influenced by sites of infection
and viral type, severity and frequency of outbreaks, though studies remain unclear. Thus, the more
outbreaks one has, the more severe one's outbreaks are, the higher the incidence of shedding. HSV-2
seems to shed more often than HSV-1, particularly in genital infections. Medical experts believe
asymptomatic shedding is responsible for most cases of transmission. Suppressive acyclovir therapy has
been shown in some studies to reduce the rate of shedding by up to 95%.
Once infected with any type of Herpesvirus, the person remains capable of transmitting virus for the rest
of their life even when showing no symptoms due to a process called viral shedding. Shedding means
that the virus is active on the skin, and risk of transmission is high. HSV sheds at prodrome, during
outbreaks, during healing periods after outbreaks, but also at random times where there may be no
noticeable symptoms at all. This is called "subclinical shedding" or "asymptomatic shedding."
Asymptomatic Shedding
Asymptomatic Shedding is the release of the virus on the skin when there are no symptoms. These
asymptomatic shedding episodes occur (according to studies) typically 3 to 10 days in the year, so
although the risk is minimal it does exist, because one can't necessarily tell when those days are. During
an episode of asymptomatic shedding, virus often sheds from several different sites in the area
concurrently. And there is new research suggesting that shedding occurs more frequently than
previously thought. In a recently published study, researchers found that half of the episodes of
subclinical shedding of HSV occurred within seven days of a symptomatic recurrence. Unfortunately,
asymptomatic shedding is not detectable by any procedure or test available outside a research study. It
should be noted that for the first 6 months to a year after a primary episode, shedding may occur much
more frequently. The incidence of asymptomatic shedding is greatest during the first year or two after
infection.
Shedding can occur randomly and sporadically and seems to some degree influenced by sites of infection
and viral type, severity and frequency of outbreaks, though studies remain unclear. Thus, the more
outbreaks one has, the more severe one's outbreaks are, the higher the incidence of shedding. HSV-2
seems to shed more often than HSV-1, particularly in genital infections. Medical experts believe
asymptomatic shedding is responsible for most cases of transmission. Suppressive acyclovir therapy has
been shown in some studies to reduce the rate of shedding by up to 95%.
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |
HerpeSite ~ Herpes Online Personal Empowerment & Support
| Questions or Comments? Email: support (at) herpesite .org This Reference Copyright © 1996 ... 2008 HerpeSite(tm) Disclaimer Privacy Statement Herpes Online Personal Empowerment & Support www.herpesite.org |
 | |  | |  | |  | |  |
 | |  | |  | |  | |  | |  | |  | |  |
 | |  | |  | |  |
| There's a lot more here at HerpeSite! Click the topics below to Continue: |