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Simutanious Outbreaks / Length of Contagion
I posted this question a few weeks ago in the free section but no one was able to help. I am hoping an expert can provide me with some clarification.
I have had recurrent HSV outbreaks orally since childhood (I assume type 1 because of the period of initial infection). I am now in my mid 20's and outbreaks reoccur roughly every 1-2 years when I am ill or getting ill and they are quick and mild - unnoticeable to most others unless pointed out.
Three weeks ago my most recent outbreak began in a very typical fashion save for the location (upper lip corner instead of bottom). The lesion healed within a week and the skin looked completely normal shortly after. Here's the twist, when the 1st was almost healed a second appeared close to my usual location (bottom & centre) but away from the outside of the lip (where the top and bottom lips connect, almost inside). Is this uncommon during extended illness (3+ weeks) - A new lesion forming in a different location before the other has completely healed ?
Additionally, how long is someone infectious following healing (no visible sign of the sore). Most information I can find implies that once the lesion has healed the risk is over save for periods of viral shedding. However, I recently read on the Canadian Public Health website that the virus can be secreted in saliva for 7 weeks after an outbreak (http://www.phac-aspc.gc.ca/msds-ftss/msds80e-eng.php). Does that mean any oral activity is at an increased risk for almost 2 months after every reoccurrence? I can't I find similar time frames anywhere else.
Thank you in advance,
I have had recurrent HSV outbreaks orally since childhood (I assume type 1 because of the period of initial infection). I am now in my mid 20's and outbreaks reoccur roughly every 1-2 years when I am ill or getting ill and they are quick and mild - unnoticeable to most others unless pointed out.
Three weeks ago my most recent outbreak began in a very typical fashion save for the location (upper lip corner instead of bottom). The lesion healed within a week and the skin looked completely normal shortly after. Here's the twist, when the 1st was almost healed a second appeared close to my usual location (bottom & centre) but away from the outside of the lip (where the top and bottom lips connect, almost inside). Is this uncommon during extended illness (3+ weeks) - A new lesion forming in a different location before the other has completely healed ?
Additionally, how long is someone infectious following healing (no visible sign of the sore). Most information I can find implies that once the lesion has healed the risk is over save for periods of viral shedding. However, I recently read on the Canadian Public Health website that the virus can be secreted in saliva for 7 weeks after an outbreak (http://www.phac-aspc.gc.ca/msds-ftss/msds80e-eng.php). Does that mean any oral activity is at an increased risk for almost 2 months after every reoccurrence? I can't I find similar time frames anywhere else.
Thank you in advance,
MEDICAL PROFESSIONAL
This is a bit off topic for this forum, since oral herpes isn't an STD, and Dr. Hook and I don't follow the scientific literature on oral herpes as closely as for genital. I'll do the best I can, but you might consider seeing what Dr. Rockoff has to say on the MedHelp dermatology forum.
As a rule of thumb, recurrent HSV outbreaks always are in more or less the same location. Exceptions are uncommon with genital herpes, but they occur; I assume the it's the same for oral herpes, but I don't know for sure. Oral herpes outbreaks are more directly triggered by other infections than genital herpes -- hence the names "cold sore", "fever blister". In the context of another illness such as you describe, more frequent outbreaks and/or atypical locations might be more common than otherewise. But again, I have little direct experience with this. If the new/early outbreak is otherwise entirely typical compared with your past episodes, most likely it's herpes -- but if there is any doubt, you might need to see a health care provider (preferably a dermatologist) to be certain.
HSV certainly can be found in saliva of people with oral herpes at times when overt outbreaks aren't present. As the technology for detecting HSV improves, with PCR tests increasingly able to detect extremely minute amounts of virus, asymptomatic viral shedding has been found to be more common than previously believed. Still, the amount of virus 7 weeks after an outbreak (or at any other time when there are not symptoms) probably is minute and likely not enough for easy transmission. The standard advice for many years is that people with oral herpes should avoid kissing or oral sex from the first sign of an outbreak (e.g. the first tingle or skin bump) until healing is complete. To my knowledge, the newer knowledge about asymptomatic viral shedding doesn't change that advice.
I hope this helps. Best wishes-- HHH, MD
As a rule of thumb, recurrent HSV outbreaks always are in more or less the same location. Exceptions are uncommon with genital herpes, but they occur; I assume the it's the same for oral herpes, but I don't know for sure. Oral herpes outbreaks are more directly triggered by other infections than genital herpes -- hence the names "cold sore", "fever blister". In the context of another illness such as you describe, more frequent outbreaks and/or atypical locations might be more common than otherewise. But again, I have little direct experience with this. If the new/early outbreak is otherwise entirely typical compared with your past episodes, most likely it's herpes -- but if there is any doubt, you might need to see a health care provider (preferably a dermatologist) to be certain.
HSV certainly can be found in saliva of people with oral herpes at times when overt outbreaks aren't present. As the technology for detecting HSV improves, with PCR tests increasingly able to detect extremely minute amounts of virus, asymptomatic viral shedding has been found to be more common than previously believed. Still, the amount of virus 7 weeks after an outbreak (or at any other time when there are not symptoms) probably is minute and likely not enough for easy transmission. The standard advice for many years is that people with oral herpes should avoid kissing or oral sex from the first sign of an outbreak (e.g. the first tingle or skin bump) until healing is complete. To my knowledge, the newer knowledge about asymptomatic viral shedding doesn't change that advice.
I hope this helps. Best wishes-- HHH, MD
Dr. Handsfield,
Thank you, I believe that this is all the reassurance I need but will consider consulting Dr. Rockoff if any unease persists on my part.
Thank you for your time and effort
Thank you, I believe that this is all the reassurance I need but will consider consulting Dr. Rockoff if any unease persists on my part.
Thank you for your time and effort
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
