[Question #2018] HPV indirect transmission to child

47 months ago
I recently had a positive high risk HPV test on my pap smear, no abnormalities, and the MD said it could be a reactivation of a prior infection.   So I started thinking and suddenly became very paranoid after reading so much online and the ways of transmission.   I had a positive hpv test with some atypical cells approximately 10 years ago also.  At that time my son was about 11 months old  and slept in the same room with me and my husband.  I remember one time he crawled over the bed to us while we were having sex surprisingly and I freaked out.  I know I immediately picked him up and moved him back to his crib in the room.  He was fully covered so I am not worried about genital infection, but I keep wondering could he have touched fluids on the sheets, or on me or on my hands or husbands hands, and then put his hands in his mouth  and caught high risk hpv orally?  or if I or my husband touched his pacifier and then he put the pacifier in his mouth  I doubt even that happened, but I have beating myself up thinking about it and if I could have accidentally transmitted this to my son orally.  I know there is no way to even test for it, I just need some reassurance this wasn't likely to have happened.  I keep reading info on hand to genital hand to mouth transmission, and with all the information on oral cancer and hpv its scaring me to death.  Thank you
Edward W. Hook M.D.
Edward W. Hook M.D.
47 months ago
Welcome to the Forum.  On our Forum we do our best to provide science-based answers to our clients' question.  As I'm sure you can imagine, the scenario you describe is not something that has been studied.  Further, our knowledge and understanding of HPV is still growing and so there remains much to be learned.  With that, let me try to alieve your concerns.  Long before HPV was recognized or tests developed, the infection was still common and rather than having advantages that we have now (tests, a highly effective vaccine, better understanding), our only mechanisms for preventing what we want to prevent (HPV-related cancers which occur among only a tiny (less than 1%) fraction of infected persons), was the PAP smear. Despite this HPV-related cancers and pre-cancers were still rare.  As the prevalence of HPV infections has been studied it has become clear that most genital HPV infections are transmitted through direct sexual contact and that passive transmission such as hand-to genital transmission is a rare exception to this generalization.   We simply do not see a meaningful amount of HPV in people who have not had sex, no matter what site we look at. 

While I understand and endorse your concern for your son's health, I would urge you not to worry that you have transmitted infection to him passively through the events you describe.  No one has ever suggested that this is an important route of HPV transmission.  I would not worry about this.  I would also suggest that, particularly on this topic, you stay off the internet.  It is full of mis-information.

I hope my assurances are helpful to you.  EWH
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47 months ago
Thank you for your quick response.  It is helpful, and I feel better, but still have a small amount of despair thinking transmission could have occurred.  Would amount of viral particles on the hand or object  and lack of friction also decrease the risk of such passive transmission?    Say if my son had touched my hand and just a small amount of vaginal fluid got onto his, or just a brush with infected fluids occurred, would there be less chance of infection with smaller viral amounts? Or could even contact with "fomites" cause for infection?  And is the mouth a less favorable place for transmission to occur with high risk types ?       Also if this was an initial source of infection for me would viral shedding even be of concern from me?  
Edward W. Hook M.D.
Edward W. Hook M.D.
47 months ago
There is general acknowledgement that passive transmission MAY occur on rare occasions but is just that, quite rare.  Further, as you suggest, friction would be expected to increase the miniscule risk for transmission.  I really do not think you should be at all worried.  EWH
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