Herpes Transmission

[samatashnia1988]

Hello doctor,

I just have a few questions with regards to herpes transmission, just to clear up some confusion.  

1) Can herpes be transmitted to me during intercourse if I am using a condom, assuming the condom doesnt rip? (in other words, can the virus get through latex?)

2) In terms of oral herpes, can I contract the virus from someone if they do not have any visible symptoms, i.e. cold sores, etc? And if so, how likely is it to contract the virus if there are no visible symptoms present?

3) my last question is, are there any symptoms I should look out for both orally and genitally to help better protect myself?

Thank you very much for your time.
Sam Atashnia

[Edward W Hook, MD]

No, HSV infections can occur on non-mucous membrane skin.  Any direct contact can lead to infection.

No, asymptomatic shedding of the virus can occur at any time and, in fact, is thought to account for most HSV transmission as persons who have lesions tend to avoid contacts. EWH

[samatashnia1988]

Thank you very much for the information Doctor, it has been very helpful.

Sorry for the late reply, I just returned from vacation and was unable to access the internet.  

I only have two more question with regards to my first question.  You said that condoms are not 100% because areas with lesions may not always be covered by condoms.

My question is, doesn't hsv transmission require a mucous membrane in order to pass through? So if my partner for example had a lesion on her inner thigh, would that be able to transmit without genital contact?

My final question is with regards to oral herpes.  Does asymptomatic shedding occur only before or after the appearence of visible symtoms? Or can a person have a full outbreak without having any visible symtoms at all?

Thank you very much for your time,
Sam Atashnia

[Edward W Hook, MD]

Welcome to our Forum.  I'll be glad to try to address your questions.  

1) Can herpes be transmitted to me during intercourse if I am using a condom, assuming the condom doesn’t rip? (in other words, can the virus get through latex?)
The herpes virus will not pass through the latex used in condoms so, unless the condom breaks, condoms do reduce the risk of HSV transmission. It is also important to point out however that the reduction in risk for infection due to condoms is not 100% since a person might have HSV lesions not covered by a condom. In general, about 90% of HSV lesions occur in areas where condoms should cover then and therefore prevent infection but the protection is not absolute.  

2) In terms of oral herpes, can I contract the virus from someone if they do not have any visible symptoms, i.e. cold sores, etc? And if so, how likely is it to contract the virus if there are no visible symptoms present?
Yes, for both oral and genital HSV there is a phenomenon called "asymptomatic viral shedding" in which the virus is present on normal appearing skin.  Asymptomatic shedding accounts for a portion of the transmission of infection.  For genital herpes we estimate that in the absence of lesions the risk of acquiring HSV form a partner who is otherwise asymptomatic to be less than 1 in 1,000.

3) my last question is, are there any symptoms I should look out for both orally and genitally to help better protect myself?
The classical symptoms of HSV are easy to spot- they are uncomfortable small blisters which quickly become ulcerated.  Not all HSV lesions hurt severely so this misleads some persons with infection, causing them to miss it

Hope these comments are helpful. EWH