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Infectious Diseases

Only oral

05/18/2000

Question:

I need to know it genital herpes 1 can be transmitted by oral contact only? I have been married for 10 years and have never contacted it until now. Is this at all possible or could i have picked it up elsewhere? My husband and i are both faithful. He has never had any symtoms two weeks after my outbreak he got a mouth sore.HELP????

Answer:

I will start my answer with a short clarification of terms. The human Herpes Simplex Virus (HSV) produces a variety of infections in people. From the common "cold sore", medically termed herpes labialis, to genital herpes, herpes genitalis, to herpetic lesions anywhere in the skin or mucosal membranes: Perianal herpes, herpes around finger nails called herpetic withlow. It can also affect internal organs: Herpes encephalitis, herpes meningitis, even herpes hepatitis.

Herpes can be distinguished in the lab as type 1, which most commonly, but not always is involved in herpes labialis (cold sores), and type 2 which is most commonly but not always associated with genital herpes.

While type 2 herpes is transmitted most often through sexual contact, and type 1 mostly through mucosal membranes contact ( kissing, close contact with lesions), it is not infrequent to find "cross-over".

Another important feature of HSV is its life long infection, often asymptomatic. More than thirty percent of the adult population in the US harbor Herpes virus type 2 in the genital tract and have never had any symptoms. However, they are able to transmit the infection through sexual contact despite the fact they do not have active lesions. The number of adults carrying Herpes type 1 is even higher. During episodes of physical stress the virus, which lies dormant in the nerve roots, becomes reactivated and produces clinical lesions.

To address directly your question: Genital Herpes can be produced by type 1 Herpes virus but is more commonly produced by type 2 virus. The most common form of transmission of genital herpes is sexual contact but other forms of close contact can and have transmitted the virus. The presence of genital lesions at this point in time may be the manifestation of a dormant infection acquired a long time ago, by either your husband or you. The lesions that your husband developed two weeks after you had clinical manifestations may have been acquired from you by close contact (unlikely), or be reactivation of an old infection "cold sore" type. Usually, when an adult is infected with herpes labialis for the first time, the infection is more severe, with extensive involvement of the mouth mucosa.

Herpes virus infection is quite common, and questions like yours are frequently asked to Infectious Diseases practitioners. A clear understanding of the natural history of the infection and its modes of transmission, as well as debunking the stigma of this infection can relieve a lot of anxiety. Please refer to HerpesWeb and other web resources, or consult your family practitioner for other questions.

Related Resources:

HerpesWeb

For more information:

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Response by:

Francisco   Gomez, MD Francisco Gomez, MD
Assistant Professor
College of Medicine
University of Cincinnati