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spreading STD's without symptoms
Oct 29, 2002

Can Herpes Type 1 be spread to a second person without a sore in or around the mouth region? How can a person who is a "Carrier" be tested?

Response from Mr. Kull

It is unlikely that herpes simplex virus would be transmitted without symptoms being present, but it is possible. This is called "asymptomatic shedding". When a person has, for instance, a genital herpes infection, he might initially experience an outbreak of lesions at the point of infection. Then the virus travels along 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). A similar dynamic can also occur for herpes infections in the oral region.

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.

It is really not useful to test for HSV-1 infection (the type that typically causes oral lesions). Approximately 90% of Americans are infected with HSV-1 and have no significant symptoms. Therefore, testing for infection has no real relevance; avoid contact with active lesions around the mouth or genitals.

RMK



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