[Question #7211] hpv and toilet seat

7 months ago
Hello,

I have some questions about HPV. Ive been diagnosed with high risk HPV. I have three qustions about this
1. Do I have to be careful with toilet seats, to prevent spreading my HPV? I looked into research about this, but I could not really find anything conclusive (some say it is possible, others say it is not). 
2. I have a question about a specific case. I was sitting at a toilet with my labia really close to the seat. I changed my position on the toilet seat a bit, so I "wiped" my skin of my legs a bit over the toilet seat. Sometimes I have a bit vaginal fluid on my skin of my legs, so it could be that this was on the toilet seat afterwards. I did "clean" the toilet seat afterwards with a piece of dry toilet paper (maybe also with a wet toilet paper, but I cannot remember this) Could I have transmitted this to the person using the toilet after me? Even if there is a really small change, I would like to know. Because I know that HPV can also be around the vagina instead of only inside? 
3. Is HPV dangerous for pregnant woman? Could it cause pre term birth or miscarriage or anything like that? 

Thank you very much in advance! 
7 months ago
One extra remark: On the website with reliable information about medical subjects in my country, it sais that you can get genital warts from sharing towels. Does that imply that this is also the case for toilet seats? 
Edward W. Hook M.D.
Edward W. Hook M.D.
7 months ago

Welcome to our Forum.  Thanks for your questions.  Before I address your specific questions, please let me emphasize some facts about HPV.  We know that over 80% of sexually active persons, even persons with a singe sexual partner, will have HPV at some time.  As a result is extraordinarily hard to determine who has given a person HPV.  In addition, carefully done studies have clearly demonstrated that nearly all HPV infections are transmitted by DIRECT sexual contact.  Studies looking for HPV DNA in the environment will often find it but that does NOT mean that the virus is likely to be transmitted through environmental or casual contact.  On the other hand, in science one can never say never and it is possible that a very, very small proportion of HPV infections are acquired through non-sexual, environmental contact.  They however are the exceptions and most experts do not suggest special precautions or concerns about acquiring the infection through non-sexual contacts or exposures.  None of the references you have found provide meaningful evidence to the contrary.  With this background, let's address your specific questions:

1. Do I have to be careful with toilet seats, to prevent spreading my HPV? I looked into research about this, but I could not really find anything conclusive (some say it is possible, others say it is not). 

It is possible, in the same way it is possible that you will be struck by lightening today.  On the other hand, it is not more likely and there is no reason to take special precautions in using toilet seats.

2. I have a question about a specific case. I was sitting at a toilet with my labia really close to the seat. I changed my position on the toilet seat a bit, so I "wiped" my skin of my legs a bit over the toilet seat. Sometimes I have a bit vaginal fluid on my skin of my legs, so it could be that this was on the toilet seat afterwards. I did "clean" the toilet seat afterwards with a piece of dry toilet paper (maybe also with a wet toilet paper, but I cannot remember this) Could I have transmitted this to the person using the toilet after me? Even if there is a really small change, I would like to know. Because I know that HPV can also be around the vagina instead of only inside? 

You are correct that HPV can be on the outside of the genitals as well as inside but the situation you describe does NOT raise any concerns about possible transmission.

3. Is HPV dangerous for pregnant woman? Could it cause pre term birth or miscarriage or anything like that?

No, HPV does not cause miscarriages and is typically not dangerous for pregnant women or their children.  No special precautions are needed.

Reading your questions suggests that you are quite concerned about your HPV.  Please don't be. As I mentioned above, these infections are extraordinarily common are very, very rarely cause problems for infected persons as long as they follow recommendations for regular check-ups and testing.  Further, going forward, the best approach to preventing future HPV infections is to get the HPV vaccine. it is safe and highly effective.

I hope that this information is helpful.  EWH
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7 months ago
Thank you very much for your fast reply. 
I was a indeed quite worried, that is because I shared a toilet with a 63 year old woman and people above 60 will not be tested for hpv anymore. 
I know that there is a very small change for environmental spreading, so that is also the for the situation  that I described? (like the same chance as being struck by lightening?) 
And can HPV also be in vaginal fluid, and on legs/buttocks (that touches the toiletseat)? And would my wiping with the toilet paper afterwards have helped? 
And how could I interpret the research then (that I quoted), that states that HPV is found in (a quite large percentage of) boys and in girl virgins? Could that also be the DNA part? 

Thank you very much! 
Edward W. Hook M.D.
Edward W. Hook M.D.
7 months ago
I response:

No, I would not be concerned about the specific situation you described, nor should you be concerned about the possibility of vaginal fluid containing HPV on your leg or the toilet seat.  Most contact with HPV other than through sex does not lead to infection.  In fact even most single sexual contacts withHPV do not lead to infection.  Part of the reason environmental contact so very, very rarely leads to infection is that transmission is facilitated by the repeated friction which is part of sex and does not occur with the sorts of environmental exposures that you describe.

As for the descriptions you have found on the Internet regarding a high frequency of HPV amongst virgins, I would again point out that this virus is very very common and that detection of the virus does not always mean that infection has occurred. Please don’t be misled by things that are said on the Internet. All too much of what is found there is taken out of context, misstated, misinterpreted, or just plain wrong. 

I hope this information again is helpful to you. Please don’t worry.  EWH
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7 months ago

Thank you very much for your reply. I just have some more follow up questions (I realize this will be my last ones!)

In the case I described, what would you think the chance is in percentages that the woman after me going to the toilet catched my HPV? (very small chance is a bit difficult to interpret for me).

Somewhere else on the forum I have read that 1 percent of the HPV cases are unexplained. Does that mean that 1 percent is caused by environmental transmission?

If someone has high risk HPV and it is never checked or treated, what are the chances that somebody will have cancer in the end?

Even if the person will never be checked for HPV or cervix cancer again, would you still not advise me to warn her because of this situation?

On the reliable information website of my country it is mentioned that the chance to get HPV by a single sexual contact, if this person is infected is 70%. So that is not right? Because it is on the website that is specialized in STD’s, so I was a bit confused when you mentioned it is not common after a single sexual contact.

I realize I worry too much (especially about other people), so it would help to have some numbers.

And I want to thank you for this opportunity to ask questions! 

Edward W. Hook M.D.
Edward W. Hook M.D.
7 months ago

I'm sorry that my earlier replies have not been sufficient to allow you to move forward.  On the Forum we do our best to use available scientific data to address our clients's question.  some of your follow-up questions are beyond the realm where there are data to answer.  I'll do my best in these final answers.


Getting HPV off a toilet seat is undescribed and unproven.  the risk that your infection would be transmitted in this way if far , far less than 1%.

More often than not, the so-called unexplained occurrence of HPV is the result of exposure to a sexual partner not thought to be "risky".  Far less than 1% of HPV infections are due to environmental exposure. 

Less than 1% of undetected, untreated "high risk" (this is a poor descriptor since even "high risk HPV rarely progresses to cancer) go on to cause cancer.  Obviously routine check ups allow pre-cancerous lesions to be detected and treated.

Correct, warnings of the sort you suggest are not only unnecessary but are a potential source of unwarranted concern and even stigmatization.

I have no idea where the estimate of 70% came from. I am not aware of any high quality scientific studies which provide data on this topic.  My own guess is that less and perhaps far less than half of unprotected sexual exposures result in transmission of infection.. 

This will complete this thread.  I think you are worrying far more than is needed.  EWH

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