[Question #3749] HPV Transmission

Kay
34 months ago
Hi Experts, 

A close family member, who I will refer to as X, is coming to stay with us (my husband, myself, and my 2yo toddler) for a few weeks. X got an abnormal pap smear and tested positive for HPV, and her Ob/Gyn has sent off a sample to be biopsied. My understanding is that the HPV strains that cause cervical cell changes are the strains with the potential to develop into cancer (?). My concern is that there is any possibility of HPV transmission to us - most importantly, to my toddler. Are any of the following scenarios possible modes of transmission?

1. X does not wash hands after using the toilet and due to bad hygiene gets HPV on her hand. X immediately after touches toddler's hands/fingers. Toddler shoves hands in his mouth (into throat: he has new habit of eating his entire hand deep in mouth) or puts fingers deep in his nose. (I understand that genital and oral HPV differ, but don't know if X also has oral HPV or not. Assume that she does; or could the same genital strain affect her orally as well?)

2. Same scenario as above, except that X changes toddler's diaper and comes into contact with his genitals. 

3. General kissing, roughhousing, food/utensil exchange involving swapping saliva (feeding food from mouth), laundry 

I've read some of your answers, and I'd guess that based on those, the above modes of transmission would not be a cause of concern; however, I've read articles stating that non-sexual HPV transmission is (theoretically?) possible. Happy to link you in follow-up questions but running out of characters. 

THANK YOU 

Edward W. Hook M.D.
Edward W. Hook M.D.
34 months ago
Welcome to the Forum.  I'll try to help.  Nearly all genital HPV transmission is sexual (remember, there are over 100 different HPV types, not all infect the genital tract- the types of HPV that cause warts on the hands and feet are transmitted through direct contact as well but do not infect the genital tract), involving DIRECT contact between an infected site and the site that becomes infected. There is no evidence that the sort of indirect contact that you describe leads to acquisition of HPV.  I would not worry about acquisition of HPV from the sort of activities of daily living that you describe.   Many studies show that HPV infections begin to be acquired only following the onset of sexual activity in unvaccinated persons, occurring following sexual debut at a rate of about 15% per year.  Before the onset of sexual activity however, genital HPV infections rarely occur despite the fact that over 50% of sexually active adults have the infection.  This fact alone is strong evidence that non-sexual transmission is not a problem.

With respect to your specific questions:
1. X does not wash hands after using the toilet and due to bad hygiene gets HPV on her hand. X immediately after touches toddler's hands/fingers. Toddler shoves hands in his mouth (into throat: he has new habit of eating his entire hand deep in mouth) or puts fingers deep in his nose. (I understand that genital and oral HPV differ, but don't know if X also has oral HPV or not. Assume that she does; or could the same genital strain affect her orally as well?)

There is no evidence that HPV is passed from person to person in the hands or through ingestion.  Oral HPV infections can occur with oral-genital contact (oral sex) but not through transfer on someone's hands.

2. Same scenario as above, except that X changes toddler's diaper and comes into contact with his genitals. 
There is no reason for concern regarding transfer of HPV while a diaper is being changed.

3. General kissing, roughhousing, food/utensil exchange involving swapping saliva (feeding food from mouth), laundry.
Kissing, rough and tumble play, sharing food utensils are not involved with HPV transmission.

I would not worry about your toddler acquiring HPV from your visitor during her visit.  I hope that my comments are reassuring.  EWH
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