Dear Alice,

Could you please explain to your readers, exactly what you mean when you talk about the "asymptomatic shedding" or "viral shedding" when describing one of the herpes virus phases? How can someone recognize this phase in order to avoid transmission? I'm hoping you can illustrate this to me and your readers.

The asymptomatic

Dear The asymptomatic,

Herpes is one of the most prevalent sexually transmitted infections. So your question is a good one and many will find an answer helpful. Let’s tackle your second question first: How can someone recognize asymptomatic viral shedding of the herpes virus in order to avoid transmission?

Here’s the scoop: Unless a person is experiencing a herpes outbreak (often associated with blisters or painful sores), it’s very difficult to determine whether s/he is shedding the virus at any given time. The process of asymptomatic shedding is invisible to the naked eye. Asymptomatic = no visible symptoms. The good news is that herpes medications are now available which greatly reduce (but do not eliminate) asymptomatic viral shedding and herpes outbreaks, substantially lowering the risk of herpes transmission. In addition, avoiding sexual contact during outbreaks, and using condoms or other barrier methods between outbreaks, can further reduce the risk of transmission.

Here’s more about viral shedding: The herpes virus makes its home in the nerve cells of an infected person. The virus will, at times, travel along the nerves up to the surface of the skin. This process is called "viral shedding.” Sometimes shedding is accompanied by other symptoms such as blisters. Other times, shedding occurs without any noticeable symptoms — this is referred to as "asymptomatic shedding." During either type of viral shedding, the herpes virus can be passed on to others by direct skin-to-skin contact — especially from anal, oral, or vaginal sex. The frequency of outbreaks and asymptomatic viral shedding varies greatly from person to person. But regardless of how often it happens, all people carrying the herpes virus experience periods of shedding at one time or another.   

A person is most contagious when herpes blisters are present. This is a clear indication that viral shedding is taking place and precautions should be taken to prevent spreading the virus. This would include temporarily avoiding intimate or sexual contact with others. Interestingly, because people are more likely to engage in sexual activity when they are not experiencing symptoms, it is more common for herpes transmission to occur when asymptomatic. Again, the use of herpes medications and using condoms during asymptomatic periods will reduce the risk of transmission.

To learn more about herpes, check out the Go Ask Alice! herpes archives.

Hope this sheds some light on viral shedding!


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