Herpes Simplex Virus Type 1 Shedding in Tears and Nasal and Oral Mucosa of Healthy Adults.
Herpes simplex virus type 1 (HSV-1) is prevalent worldwide and causes mucocutaneous infections of the oral area. We aimed to define the frequency and anatomic distribution of HSV-1 reactivation in the facial area in persons with a history of oral herpes.



Eight immunocompetent HSV-1 seropositive adults were evaluated for shedding of HSV-1 from 12 separate orofacial sites (8 from oral mucosa, 2 from nose, and 2 from conjunctiva) 5 days a week and from the oral cavity 7 days a week for approximately 5 consecutive weeks by a HSV DNA PCR assay. Symptoms and lesions were recorded by participants.



Herpes simplex virus type 1 was detected at least from 1 site on 77 (26.5%) of 291 days. The most frequent site of shedding was the oral mucosa, with widespread shedding throughout the oral cavity. Lesional shedding rate was 36.4% (4 of 11 days with lesions), and the asymptomatic rate was 27.1% (65 of 240 nonlesional days). In individual participants, the median rate of HSV shedding by HSV PCR was 19.7% of days (range, 11%-63%).



Reactivation of HSV-1 on the oral mucosa is common and usually asymptomatic. However, HSV-1 is rarely found in tears and nasal mucosa. Frequent oral shedding of HSV-1 may increase the risk for transmitting the virus to both oral and genital mucosa of sexual partners.
From the *Department of Medicine, University of Washington, Seattle, WA; †The Aboriginal and Torres Strait Islander Health Program, Kirby Institute, Sydney, Australia; ‡Department of Laboratory Medicine, §Department of Biostatistics, University of Washington; ¶Infectious Disease Division, Fred Hutchinson Cancer Research Center; and ∥Department of Epidemiology, University of Washington, Seattle, WA.
Meena
M
Ramchandani
Marlene
M
Kong
Elizabeth
E
Tronstein
Stacy
S
Selke
Anna
A
Mikhaylova
Amalia
A
Magaret
Meei-Li
ML
Huang
Christine
C
Johnston
Lawrence
L
Corey
Anna
A
Wald
D000328:Adult; D003228:Conjunctiva / Q000821:virology; D005260:Female; D006561:Herpes Simplex / Q000821:virology*; D018259:Herpesvirus 1, Human / Q000235:genetics / Q000276:immunology* / Q000502:physiology; D006801:Humans; D008297:Male; D009061:Mouth Mucosa / Q000821:virology; D009297:Nasal Mucosa / Q000821:virology; D012747:Sexual Partners; D013666:Tears / Q000821:virology; D017201:Virus Shedding; D055815:Young Adult