Desperately needed edit, Dan: Change "But while you're right to be concerned about immune system, AHCDWHT, I promise you get herpes from your roommate so long as two are doing normal roommate things — sharing a living space, kitchen utensils, furniture, utility bills, etc. " to " But while you're right to be concerned about immune system, AHCDWHT, I promise you WILL NOTget herpes from your roommate so long as two are doing normal roommate things — sharing a living space, kitchen utensils, furniture, utility bills, etc. "

That is, if you are trying to allay her fears and keep her from freaking out . . .

You should have asked the PP doctor about sharing a pipe or makeup. That seems riskier.

I would think she would not want to share lipstick or lip balm with a herpes-infected person.

“Technically, a person could get the virus from lipstick, but it's not a common way that people acquire the infection,” said Dr. Amesh Adalja, an infectious-disease specialist and a senior associate at the Johns Hopkins Center for Health Security in Baltimore. “Technically, if one contagious person used the lipstick and transmitted virus particles to the makeup, and then, almost immediately after, another person used the lipstick, the second person could become infected,” Adalja said. The length of time the virus survived on the lipstick would depend on environmental conditions, such as humidity and moistures levels, but it could be there for a "couple of hours," Adalja added.

But if LW is really concerned about this, and is under treatment by physicians, she should probably ask them whether her concerns are warranted.

Yeah, I wouldn't share makeup. But that's always been a particular squick for me.

Geez, sorry to hear of your health troubles, AHCDWHT. You're so young to be dealing with all of that. I hope you have family to help you through it. ***Hugs***

It's unclear whether you mean sharing water glasses, like, having a common set of glasses in the cabinet and washing them between uses, or sharing glasses like "you've got to try a sip of this margarita."

In fairness, I don't think a person with a compromised immune system would normally share a just-used glass, or grab a bite off someone's plate with the same fork, or borrow a roommate's lipstick. But the letter writer listed sharing makeup and toothpaste and a pipe (frankly, why would you ever share that if it HADN'T just been in someone's mouth?) as normal roommate things, so she's already got a lower bar for swapping germs with roommates than I do.

If you are reading this column you have herpes

@7 - Um - no. I've been tested (yes, recently, and yes, for everything - I requested it specifically), and I don't have it. Nothing against those that do, I was just curious since I've never had a cold sore or anything.

I started getting bad cold sores as a toddler. My parents thought I may have gotten it from my dad, because he was the only person I was around who had them. He got very large, painful sores, so he had been nervous about transmitting to us kids. He always taught us not to share drinking cups or utensils, and to kiss grownups on the cheek, not the mouth. But I still forgot and sometimes drank after him, and I have no doubt that if I saw a tube of chapstick sitting around the house I would have used it.

My sister has a compromised immune system and is still very nervous about drinking after me She doesn't have a dishwasher to sterilize things, so she usually gives me a paper cup when I visit. I don't feel judged though, because I know cold sores can be especially painful and huge if you have a weak immune system.

Oral herpes is very contagious, and can be spread via contaminated utensils and definitely toothbrushes. In fact, if you have an active herpes outbreak on your lip (I.e., not crusted over) we make you reschedule your appointment so we don't spread it to other parts of your face (yes, I'm in dentistry).

DO NOT share a pipe, either

With all the health concerns this LW has, she should speak to a doctor about this. And yes, with those immune issues, she probably shouldn't share utensils or glasses with anyone (and by share, I mean drink from the same glass or use the same fork at the same time- "taste this"- sharing dishes that are washed between users is fine.) It's really easy to use your own makeup and toothpaste. You probably shouldn't share those with your roommate anyway regardless of herpes because a common cold could affect you so much.

I've had herpes type 2 for 30+ years, and have never transmitted it to any of my partners, ex-wife married 14 years, current girlfriend 8 years, and everyone in between. Of course, your experience may vary, but it's not measles, you can't get it through casual contact. Take reasonable precautions (don't lick open sores even if that's your kink – man, have I been reading this column too long), and yes, @10 don't share utensils or transfer anything mouth to mouth. Common sense stuff. Take a little care, especially during active outbreaks, but don't freak out.

Common medical wisdom is certainly that passing a pipe can transmit oral HSV. People like to be reassuring about "you won't get it by..." (and it's much less likely than you already got it by skin contact) but HSV does persist pretty well in saliva on surfaces.

Here's an epidemiological study: https://www.ncbi.nlm.nih.gov/pmc/article…

Given the writer's immune situation, i wouldn't share a pipe.

@13, may I ask what you've done to so effectively prevent spreading the virus? Barrier method? Antiviral therapy? Black magic? My understanding is that, while HSV-2 is not a Big Deal, it's nonetheless quite contagious.

What's your roommate's attitude towards having HSV? If she feels freaked out or grossed out then she's more likely to respond badly to your concerns. But just the fact that she told you (have to admit I wouldn't discuss my HSV with my roommates) suggests she's reasonably cool with it?

If that's the case, and you just say what you've said here, I think it'll be fine. You know it's not inherently a big deal or nasty or slutty, you just have immune system issues.

@12 makes an excellent point about if you're trying to avoid other far more contagious viruses too...

"vegetables being used as shared insertion toys prior to going into a crock pot."

And this is why I love you, Dan!

Seconding Salty @15, as I recently learned the standard STI tests (at least in my country) don't include testing for herpes because a majority of people have the virus so it's a waste of resources, so who knows how long I had it without realising what it was. I was meticulous about condoms, so I was safe from STIs, right? :-/

There is actually increasing evidence that HSV-1 is linked to a rare esophageal disorder called achalasia (and that is indeed a big deal). https://www.ncbi.nlm.nih.gov/m/pubmed/18…

"In addition, HSV-1 DNA was demonstrated in the vast majority of patients, but also in controls."

Hm. Is there a stronger linkage than that?

Sorry Dan and Planned Parenthood, but this is horrible advice. Usually I am a fan, but this advice could actually be dangerous to someone with a compromised immune system. I hope LW reads this comment. I have an auto immune disorder, so I am also very immune suppressed. This is serious, and both you and your roommate need to take your health very seriously. You can in fact contract herpes from makeup and also from toothpaste. Imagine, your roomie brushes her teeth a bit too hard one day and gets blood or extra mucus on her toothbrush. Next time she touches that brush to the toothpaste tube, there is a snall chance of cross contamination- something small enough to not effect most people but you are immune compromised. If you contract herpes, it can weaken your immune system further, allowing for other more dangerous infections to take over. But herpes aside, do not share makeup, utensils, glasses, nasal sprays, eye wash, or basically anything that could transmit any type of germs to you from anyone. Buy cheap disposable face masks online and wesr them on public transportation or confined public spaces, like movie theaters. Carry disinfectant wipes with you everywhere you go and use them whenever you touch money, door handles, etc. Learn to open doors without using your hands, or use your shirt fabric to create a barrier. Do not touch buttons on elevators or subways with your finger tips, use a knuckle, and then disinfect. Do not allow people to double dip around you, and spray every handle and switch in your house every few days with disinfectant. This means doors, cabinets, water pitchers, sink handles, shower knobs, lights, etc. Every time you and your roommate comes home or you have a guest, first thing before you touch anything, disinfect your hands, the take off your coat. Afterwards, wash your hands, and ask roomie to do the same. Spray all guests, just tell them it is not personal, of they care about you they will understand. If your roomie gets sick, try your best to quarrantine yourself from her, and do not help or take care of anyone else who is sick. What is a seven day cold to most people could at the very least last months for you, and at the worst could lead to an infection so severe it could kill you. If you are vigilant with everything and everyone you will hopefully lessen your chances of illness. This is how I do things, and since I started, I have been much less sick. People with cancer and auto immune diseases die everyday from infections like pneumonia. I am not trying to scare you, I just want you to know how to take care of yourself. It sounds over the top, but there are many articles by medical professionals out there that outline how to protect yourself. Read them, and in this case, do not listen to the irresponsible advice you got here. I usually love this column, but today was a big miss.

Dan’s advice, and the title “Herpes Hysteria”, would be good if this were a writer with a normal immune system. But this LW is immunocompromised and HSV-1 can lead to encephalitis, for crying out loud. No sharing pipes or makeup!

@15Salty ~ "may I ask what you've done to so effectively prevent spreading the virus?...
Nothing other than "don't have sex the second I suspect an outbreak is coming". I'm probably lucky that I have a pretty mild case, there are only a few lesions on my groin, not my penis (so condoms don't cover them) and they go away after a week and a half or so. I understand that I may be shedding the virus before any symptoms appear, but so far (knock on wood) that hasn't been a problem due to (?) good luck / fortunate timing I guess. Also, as the years have gone by, my outbreaks have become very infrequent - I haven't had one for months. Type 2 herpes is almost always a genital condition, so makeup/toothbrush etc care doesn't really apply. An astoundingly high (maybe 80%) number of people already have type 1, so if you don't have it, you're probably either young or very lucky.

Of course, we are talking about someone with a compromised immune system, who should be taking all these precautions (not sharing personal items, etc) anyway, not just because of herpes, but all the other stuff out there as well.

@24 "so if you don't have it, you're probably either young or very lucky" -- or could be the test for HSV-1 doesn't work as well as for HSV-2. 67% sensitivity for HSV-1, so about 1/3 of the time it says you don't have antibodies (history of exposure) when actually, you do: https://www.ncbi.nlm.nih.gov/pmc/article…

(specificity is good though, so, few false positives; positives in the medical sense = you have it)

https://en.wikipedia.org/wiki/Sensitivit…

While there are no documented cases of HSV being spread through utensils and cups, many other viruses can be spread through saliva, including EBV, another herpes virus that in rare cases can cause lymphoma. And like HSV1, EBV infects a majority of humans, most by the time they reach adulthood. This is just one example, with more practical reasons to abstain being cold and flu. The one item I've read is theoretically able to transfer HSV is lip balm, but it seems to me there are lots of reasons why someone in the letter writer's circumstances would abstain from sharing lip balm. Additionally, most people with HSV1 and/or HSV2 are unaware they are infected, so if letter writer has particular anxiety about contracting HSV, she might want to get tested (if she hasn't already) to see if she is still vulnerable to contracting it or already has it. Most people have never been tested and just assume they are uninfected.

If he has been tested and is free of Herpes perhaps she should ask her doctor about getting Gardasil.

@18 DiDanFan: Agreed! and @Dan: "....vegetables being used as insertion toys prior to going into a crock pot" sounds so yummy!

Sharing a toothbrush is now considered "normal roommate behavior?" Kids these days.......

Letter writer here! Did not realize this got posted until today, so sorry for late reply. Thank you so much Dan, I've been a longtime reader and listener since 2008.

Also to clarify, we do not share toothbrushes! Haha. We use the same toothpaste tube. I leave my makeup in the bathroom and often notice my bag is open, so sometimes it's not all "willingly sharing" Sometimes it just happens accidentally. I do not use any of her lipstick/Chapstick that contact her mouth. At least on a regular basis. I do admit to trying one when she offered about a year ago, but not after she just used it. Mostly we shared stuff like eyeshadow and body wash. The biggest thing was splitting a hookah while out at the hookah bar with her, but I have stopped smoking because of my health issues.

I do not often share these types of things with everyone or just anyone. I made an exception for this roommate because we have known eachother since elementary school and she has a habit of becoming a bit overly sensitive and offended upon refusing. I don't want to refuse trying her drink or something similar and make her think I believe she is disgusting. She will often offer things like this and I usually just accept out of courtesy and not wanting to seem rude. I love this friend but she is a very defensive person. I want to preserve her feelings whenever possible but I don't want to risk my health to do it, if it is dangerous.

She has never had sores or an outbreak on her mouth that she can recall and did not know she even had it until being tested. However, she feels absolutely contaminated/disgusting and is not taking the diagnosis well. This is the reason she revealed her HSV status to me, we are close and she needed support.

I wasn't super worried about HSV2, Mostly HSV1 from the oral sharing and was wondering if it was worth stopping whenever possible, even if I could risk offending her. I was more paranoid at the time of writing this than I am now, as it was all so fresh.

Lastly, I should include that I have been tested for these, since I frequent the doctors office. I do not have either strain of HSV or the EVB mono virus either. Thanks for all your advice!

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