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Herpes Transmission
May 31, 2002

I know that herpes can be passed when no sores are visible but I don't understand the dynamics of the process. If one wears a condom and no sores are present is there still a danger of transmission. In other words can asymtomatic shedding occur from the skin around the genitals of an infected individual to the skin around the genitals of the uninfected individual or is membrane contact necessary?

Response from Mr. Kull

The theory of asymptomatic shedding goes like this:

When a person has a genital HSV (herpes simplex virus) infection, he might initially experience an outbreak of lesions at the point of infection. Then the virus travels up nerve pathways to the base of the spine where it remains "dormant". Certain events (that are not fully known, but possibly stress, immune suppression, sun exposure) can "activate" the virus, causing it to travel down the nerve pathways to the surface of the skin of the genital region. There, the virus might again cause a lesion (during the period before, during, and shortly after an outbreak, viral shedding does occur). In the case of asymptomatic shedding, the virus is near the skin's surface, and therefore is transmittable (shedding), but does not cause symptoms (asymptomatic).

Research suggests that asymptomatic shedding occurs an average of 3 to 10 days a year. Shedding is more likely to occur during the first six months following initial infection, and a person who has a more severe course of illness (more outbreaks) may shed more than the average. In these cases, ongoing suppressive therapy can help.

Herpes does not require mucous membrane contact for transmission. Herpes virus can infect the mucosal tissue or the skin around the mouth and genital regions.

RMK



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