Genital Herpes Vs Oral Herpes: Ways of transmission.

Patient

Q: I suspect that this sounds extremely paranoid, but I recently received oral sex from a woman who has genital herpes. Is there some way I could become infected as a result of this contact? It seemed a perfectly illogical concern at the time, but in retrospect I have become worried. All of the research I have done indicates that one can transmit oral herpes to the genitals by PERFORMING oral sex, and that one can transmit genital herpes by RECEIVING oral sex, but nowhere have I seen any reference to the permutation that concerns me: transmitting genital herpes by performing oral sex, kissing, and other sexual activity that does not directly involve the infected site. I would very much appreciate a response. Thanks so much!

Doctor

A:   There are two types of Herpes Virus: herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2). Both are closely related. HSV-1 is traditionally associated with orofacial (mouth and face) disease, while HSV-2 is traditionally associated with genital disease. HSV (BOTH TYPES) is transmitted by close personal contact, and infection occurs via inoculation of the virus into susceptible mucosal surfaces (eg, oropharynx, cervix, conjunctiva) or through small cracks in the skin.
Reactivation is more common in HSV-2(genital) infection than in HSV-1 infection. Nevertheless, in individuals with no symptoms viral shedding in saliva or genital secretions may occur in 1%-2% of infected persons and may be as high as 6% in the first few months after acquisition of the infection.
Some preventive measures include: avoiding contact with individuals who (often with no symptoms) are excreting the virus in saliva or genital secretions. Daily antiviral therapy can be given to reduce episodes of asymptomatic genital shedding and to further reduce the risk of transmission. Avoid touching saliva, skin, or mucous membranes that have sores.
In your siruation, trnasmission of the virus would only be possible if your mucous membranes came into contact with her genital secretions.

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