Saliva‑Transmitted Infections: Pathogens & Prevention

Saliva can transmit a range of viral, bacterial, and fungal pathogens.

Major Saliva‑Borne Infections

Risk Modifiers

• Oral lesions/bleeding gums increase viral load in saliva.
• Immune status of recipient.
• Volume/frequency of exposure.

Prevention

• Oral hygiene (reduces bacterial/viral load).
• Avoid sharing utensils, cups, toothbrushes with infected individuals.
• Vaccination: Hepatitis B, HPV (oral), meningococcal.
• Antiviral suppression (HSV, HIV) reduces shedding.

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Pathogen	Disease	Transmission Route
Epstein‑Barr virus (EBV)	Infectious mononucleosis	Kissing, shared utensils/cups
Cytomegalovirus (CMV)	Mononucleosis‑like; congenital if primary in pregnancy	Saliva, urine, sexual
Herpes simplex virus‑1 (HSV‑1)	Oral herpes (cold sores)	Direct contact with lesions/saliva
Human herpesvirus‑6/7	Roseola (infants)	Saliva
Hepatitis B (rare)	Hepatitis B	Saliva if high viral load; blood more efficient
HIV	HIV/AIDS	Saliva alone not efficient; requires blood/mucosal breach
Streptococcus pyogenes	Strep throat, scarlet fever	Respiratory droplets, saliva
Neisseria meningitidis	Meningococcal meningitis	Respiratory/saliva droplets
Candida albicans	Oral thrush	Saliva (vertical, kissing)