Transmission of Genital HPV Through the Hands:

A 1999 article reports:

Objective: To determine whether patients with genital warts carry human papillomavirus (HPV) DNA on their fingers.

Methods: 14 men and eight women with genital warts had cytobrush samples taken from genital lesions, finger tips, and tips of finger nails. Samples were examined for the presence of HPV DNA by the polymerase chain reaction.

Results: HPV DNA was detected in all female genital samples and in 13/14 male genital samples.

HPV DNA was detected in the finger brush samples of three women and nine men. The same HPV type was identified in genital and hand samples in one woman and five men.

Conclusion: This study has identified hand carriage of genital HPV types in patients with genital warts. Although sexual intercourse is considered the usual mode of transmitting genital HPV infection, our findings raise the possibility of transmission by finger-genital contact.

(Sex Transm Inf 1999;75:317–319)

I don't know whether the study has since been confirmed or undermined, though some casual searches suggested this possibility is being taken seriously, but the magnitude of the risk is unknown. If you know more than I do about this, please post something on the subject in the comments.

Likewise, while my casual assumption is that if hand-genital transmission is possible, hand-hand transmission followed by hand-genital transmission by the recipient (i.e., a woman shakes an HPV carrier's hand, and then transfers the HPV to her hand when touching her own genitals), I'm not sure whether that's right. Of course, even if it's not, this means that an HPV-positive parent could transmit the virus to an infant or a toddler when wiping, washing, or examining the child. (Mother-to-newborn transmission of HPV is also possible, though my vague sense from a few snippets I've seen is that it's not seen as a major likely source of serious disease.) In any case, given the recent debates about HPV immunization, I'd be happy to hear more about this from those who know.

The world seems to be an even ickier place than I had thought.

Fub:
IANAVirologist, but HPV transmission via hands doesn't seem so surprising when one considers that common 'flu, rhinoviruses, and some hepatitis viruses are known to spread via hand or finger carriage.
2.11.2007 12:03pm
David M. Nieporent (www):
[Response to deleted post deleted. -EV]
2.11.2007 2:17pm
Brian Schmidt (mail) (www):
There's a huge difference between theoretical and actual. Take HIV transmission through oral sex - theoretically possible, but with almost-no proven transmissions, depending on whether you believe people's testimonies about their behavior.

IOW, given the wide prevalence of HPV, we'd have much better evidence of hand-genital transmission than is the case. At most, it's a freak event, like oral sex transmission of HIV.

And hand-to-hand-to-genital transmission would ask for two freak events in a row.
2.11.2007 4:13pm
corwin (mail):
fub,et al
Rhino viruses are transmitted by an aerosolized medium >they are very fragile(die easily) if dried.Likewise Hep A -which I asume you're speaking about-can be transmitted via a fecal oral mode,but again,once it dries it's dead.
Re' HPV.As someone who has had the dubious pleasure of removing hundreds or (sob) thousands of warts in my career,let me give some SEMI expert thoughts.
First,I always tell the patient."just because there are no visible warts,doesn't mean the virus is gone.it isn't and it's still transmissible."But remember ,the genital area is moist and warm.So,can it be transmited via a handshake.I find this extremely unlikely.I'l ask one of the virologists tomorrow,but it doesn't sound reasonable to me.
2.11.2007 6:02pm
Dr. T (mail) (www):
The presence of HPV DNA on the fingertips of persons with HPV genital lesions is unsurprising. What we need to know is whether those same fingertips carried live, transmissible, virus particles. That 1999 study deliberately was designed to give "scary" results without adding any useful public health information. My review of recent HPV epidemiology literature shows no evidence of casual contact spread.
2.11.2007 8:21pm
Lev:

The world seems to be an even ickier place than I had thought.


According to evolution, viruses and bacteria have had a 4 billion year head start on us. And as sophisticated as our chemical and biological defense systems are, the enemy has still had a 4 billion year head start coupled with the ability, in modern parlance of war, to operate inside our decision/response cycle.
2.11.2007 10:13pm
Elliot123 (mail):
This could put some folks in a difficult position. Many have argued that even the slightest chance of contracting a venereal disase is sufficient grounds to abstain from sexual relations. This is a favorite among the people who advoate an abstinence only approach to sex education.

However, if HPV can be transmitted through non-sexual encounters, does that not justify a vaccination? If action is predicated on avoidance of low probability outcomes, would that theory apply as much to getting a vaccination as to avoiding sexual intercourse?

So, I suggest the abstinence only programs add instruction on the danger of contracting HPV from non-sexual encounters, and recommend vaccination to avoid infection. (I suppose they could also recommend abstinence from people.)
2.11.2007 11:12pm
Bob Woolley:
"The world seems to be an even ickier place than I had thought."

I am reminded of the theme song from the TV show "Monk":

It's a jungle out there
Poison in the very air we breathe
Do you know what's in the water that you drink?
Well I do, and it's amazing
People think I'm crazy, 'cause I worry all the time
If you paid attention, you'd be worried too
You better pay attention
Or this world we love so much might just kill you
I could be wrong now, but I don't think so
It's a jungle out there
2.12.2007 12:36am
mr. meade (mail):
Here's a question I have yet to see addressed: should young men/boys get the vaccine? I have three sons, all uncircumcised, who could very well benefit from not having HPV. I don't know if getting vaccinated will help any future partners of theirs, but I'm pretty sure it could help them. Right?

Anyone?
2.12.2007 7:07am
David Schwartz (mail):
Umm, no, viruses and bacteria didn't have an evolutionary head start on us. Every single living thing on this planet has evolved for just as long as every other living thing.
2.12.2007 10:24am
TJIT (mail):
David Schwartz,

Actually since bacteria and other single cell life forms were in existence long before mammals were they have a head start on us:-)
2.12.2007 11:07am
Tony Dismukes:

Actually since bacteria and other single cell life forms were in existence long before mammals were they have a head start on us


However, mammals and other multicellular organisms didn't arise out of nothing. We're all descended from those same bacteria. (In fact, at the cellular level we still use some of the same biochemical tricks invented by those bacterial ancestors.)

Another way to look at it - if you could trace your entire family tree back to its root, and do the same thing for an e coli bacterium -the two family trees would go back the same number of years and end up at the same root.
2.12.2007 11:53am
Eugene Volokh (www):
Mr. Meade: To my knowledge, the HPV vaccine hasn't been tested on men and boys. I don't know if there are any attempts to test it. Note though that HPV itself (as opposed to warts, which not all HPV infections manifest as) can't be tested for in men, and, as I understand it, HPV-caused cancers are much rarer in men than in women; that might be a reason why testing HPV vaccines in men might be much harder than in women.
2.12.2007 2:19pm
julep2323 (www):
From the American Cancer Website:

"Transmission by genital contact without intercourse is not common, but infection has been reported in women who did not have a history of intercourse. Oral-genital and hand-genital transmission of some genital HPV types is possible and has been reported. Transmission from mother to newborn during delivery is rare. When it occurs it can lead to development of warts in the infant’s throat called respiratory papillomatosis."


A study in Epidemiology and Infection (Fairley et al., 1995 Aug;115(1):169-76)provides some of the evidence that hand-genital transmission is possible.

Remember that HPV is a virus, like herpes, and is transmitted through viral shedding, not through contact with pus or blood or an actual lesion.

This is NOT cause to freak out, though. By age 50, at least 80% of women will have acquired genital HPV. Just remember to get your Pap smears!
2.12.2007 7:25pm
Mary Katherine Day-Petrano (mail):
I would want to know about the thimersol or other mercury in the vaccine. Which is worse, HPV or autism?
2.12.2007 11:15pm
Eugene Volokh (www):
A quick google search for "hpv vaccine mercury" reveals the CDC's assertion that "There is no thimerosal or mercury in the HPV vaccine."
2.13.2007 8:51pm