hsv 1 transmission

[sammy4321]

Doc, I had my first outbreak with oral herpes almost 16 years ago and have not had any since until just recently. I did not have it diagnosed at the time of primary infection and have have had impetigo four times since which led me to believe that I was wrong in my original assessment. Recently my tests came back positive for cold sores. The problem is, I am now married and have been for 10 years with two children 5 and 7. My wife doesn't understand and is terrified (righfully so, as am i) of transmitting to her and my children. I've done countless research on the web regarding asymptomatic shedding and understand there are risks of transmission. My wife hasn't been tested but she has never had any symptoms.

My questions are:

1. Does asymptomatic viral shedding decrease over time? If so how much?

2. What would the risk be in terms of transmitting to my wife without any lesions forming or present?

3. Do I avoid saliva contact with my kids, ie. sharing drinks, candy?

4. And, do you think that if I begin a solid health program, how likely will reccurrances happen?

5. Anything you can add to help us overcome our fears and if you think that stronger meds will eventually come?

Thanks

[Terri Warren, RN, Adult Nurse Practitioner]

Asymptomatic shedding decreases somewhat over time, but never goes away completely.  The risk of shedding virus without symptoms and transmitting to your wife is not known statistically, but we know it happens, both through giving her oral sex and kissing her.  I would not worry about sharing saliva with your kids or drinks or candy.  Recurrences could happen in spite of your most healthy activities - its just happens.  You could take daily therapy to reduce the risk of infecting your wife.  However, before you do that, I think she should be tested.  She may well be infected and not know it.  If she is, then you have no worries about passing this back and forth.  

So you've been married for 10 years, why is this becoming an issue now?

And also, about 56% of the US population has HSV 1, in people ages 14 to 50, not the higher number described above.  (Xu is the author if you want to see the paper).  

Terri

[Bbohhy]

Well considering that 70% of children have it by the time they start school (i think) and 90% of all people have it by the time of their death, I don't think you really should spend too much time worry about it.

[sammy4321]

I5 years ago, I was really sick from what i thought was food poisoning. I broke out in blisters on my lower lip, uneducated and in denial, I thought it was related. 15 years later with absolutley no symptoms in between with the exception of impetigo in the same place a few times, I broke out with a cold sore. We never discussed it as it was a non-issue. My wife doesn't understand and I can tell is questioning my fidelity. Thanks for the response, I wish it were more reassuring news. Is there a reliable home kit to detect hsv?

[Terri Warren, RN, Adult Nurse Practitioner]

I'm guessing (just guessing of course) that your impetigo was an outbreak of herpes.  They are frequently mixed up by clinicians.  Maybe not, I wasn't there.  People can go 25 years between outbreaks of either genital or oral herpes, there is no reason to question your fidelity because you have a recurrent cold sore, that just isn't reasonable.    There is no way to detect the presence of the herpes virus without an outbreak, at least not easily available to the public.  I would very strongly encourage you to get your wife tested to see what is actually going on here.  This is such a common problem, I hope you will get some perspective on this through further reading.

Terri