Risk of transmission is highest when the virus is active. But first outbreaks or primary lesions are the most infectious because they include more virus particles on the skin, and the lesions persist for a longer period. HSV also can be transmitted when the infected person is asymptomatic. About 1 percent of the time, most people asymptomatically shed traces of the virus, sometimes from lesions that are too small to be noticed. Autoinoculation and transmission by skin contact can have serious complications.
Dental professionals are at particular risk of developing a complication known as herpetic whitlow.
It is the same disease as oral or genital herpes with the same symptoms, but it is very visible and often very painful. The constant use of protective gloves and other universal precautions, including sterilization and disinfection techniques, can prevent herpetic transmission in the dental office. Ocular herpes, an infection of the eye, is most often caused by autoinoculation. Fortunately, ocular herpes resolves itself without treatment about half the time and does not recur. Still, the infection can lead to serious damage and even blindness.