Viral shedding occurs most often with herpes simplex virus infections. The virus remains in cells in the body after the first infection in a latent or dormant form. At some point, this latency ends and the virus begins to multiply, thereby becoming transmittable. This shedding may or may not be accompanied by symptoms of a rash. HSV-2 is more likely to shed than HSV-1, especially in women. As a matter of fact, it is possible that over half of the people infected with HSV-2 shed the virus at some time without having any symptoms or rash. It is also estimated that one-third of all HSV-2 infections are caused when a non-infected person comes in contact with someone who is shedding virus without symptoms.
Ideal symptoms of blisters and ulcers do not occur in everyone who has herpes. If herpes symptoms do develop they usually do so within two to 20 days of first infection. The virus moves from the skin into the nerve endings to the nerve root or ganglion (located near the spinal cord). Here the virus remains dormant and then periodically migrates back out to the surface of the skin.
The herpes virus does not usually spread to other areas of the skin in people with herpes who are otherwise healthy. An exception to this finding is a phenomenon called a number of things, including asymptomatic viral shedding, sub-clinical shedding and, autoinoculation In strict usage, symptoms refer to any marker of disease – including not only visible lesions but the feelings such as burning or itching. Therefore a person who experiences itching, for example, would not be asymptomatic. Especially during the first few weeks of an initial infection before the body has built up immunity to the virus a person can spread the virus by touching the area of infection then immediately touching another area of the body this is uncommon and can generally be avoided by thoroughly washing hands.
For the first six months to a year after the initial episode, shedding may occur more frequently. The incidence of asymptomatic shedding is greatest during the first couple of years after infection.
Shedding occurs randomly and seems to some be influenced by sites of infection and viral type, severity and frequency of outbreaks. Thus, the more outbreaks one has, the more severe one’s outbreaks are, the higher the incidence of shedding. HSV-2 seems to shed more often than HSV-1, particularly in genital infections. Medical experts believe asymptomatic shedding is responsible for most cases of transmission.