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herpes whitlow potential and antibody bloodwork without outbreak
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herpes whitlow potential and antibody bloodwork without outbreak

Hello. Thank you for all of your work and public service. I have a couple of questions I apologiize if they've been answered before.

I work in healthcare ad recently was touching a patients lower back/sacrum without barrier protection. After contact she told me she was experiencing what felt like herpes prodrome in the area I had touched. In subsequent follow ups, no outbreak occured innpatient. My concern is contracting herpetic whitlow. A week after contact I started experiencing numbness and an odd sensation on my fingertip. I immediately started famciclovir the next day (8 days post potential exposure) My finger still feels numb/ slightly cold/ very mildly swollen with red spots and hyperaensitivity at the tip (havent been touching anything with that finger) which is 1.5 weeks. I got a fever a few days ago which was 1 week after I felt potential symptoms and 2 weeks post potential exposure. My stomach is also sensitive and my glands on the same side were swollen the same time my finger started feeling off. I did bloodwork which will be a baseline of "what do I have currently" having never had lesions and havin tested negative for both 1/2 several years back. Im in a holding zone (of paranoia). Everyone thinks contracting it was unlikely. Im a little terrified and dont know why else my finger would feel weird. It seems long for a prodromal but perhaps the famciclovir kept things at bay. I took 500 mg 2x day for a week.
My questions: Do you think contractions was possible (anything possible!) I didnt have cuts on my hands.

and

If I test my blood in 4 months and it is negative: will that mean I do not have herpes ? Does the body need an outbreak to develop antibodies. If the fever was unrelated: can I trust a negative test 4 months out.
So far Im using barriers with everything now.
If I do get a positive test but no lesions I wont know if its my finger or elsewhere!
Thank you for your expertise!
-hypo
55646_tn?1263664409
First let me assess your risk.  IF she was having prodrome and IF you touched it and IF your skin was intact on your finger, the chances of contracting the virus is exceedingly low.  an intact finger is hard to infect.  

It is important that you get a baseline type specific antibody test for HSV 1 and 2.  Very important, and do it now.  Let your employeer know about your concerns, and what you are doing about it if you haven't already.  Stop taking the antiviral therapy, it can impact your test results.  Retest in four months and compare the two results.  DO NOT take any herpes medicines unless you have a positive swab test from the finger skin.  Be certain your are documenting all of this very carefully with your workplace.

Again, I doubt that you would have contracted HSV under these circumstances, but play it safe.

Terri
5 Comments
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Avatar_f_tn
thank you terri,
i took my baseline 1 week and 2 days post potential exposure. but 2 days AFTER starting famciclovir. ive since stopped famciclovir.
should i redo a baseline? i will retest in 4 mos as well. my main concern is my finger still feels mildly swollen and mildly numb. It started 1 week after touching patient and has lasted two weeks. Ive told my employer but not formally documented my personal actions. Would an initial outbreak surface after stopping meds?
Thank you again

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55646_tn?1263664409
It might, hard to say.

I doubt that two days of Famvir would interfere with the initial test, or even subsequent ones, honestly.  It is suppression early on that can interfere with seroconversion.  

My professional advice, as an employer, would be to document your actions and concerns, just to be on the safe side.  

Have you gotten back the results of your antibody test?

Terri
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Avatar_f_tn
Hi Terri,
Thanks. I just got my baseline (taken 11 days post potential exposure and 2 days on famciclovir) Both HSV 1/2 are negative. So this is a good baseline for retesting in 3 more months. ( its been 3.5 weeks since potential exposure now).

You mention early supression affects seroconversion. Ive since stopped the famciclovir. Should I wait extra time for follow up bloodwork?
Does my usage affect seroconversion permanently?

My finger still feels numb and tingly! ( and cold. is cold a symptom)

Thanks for your expertise.
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55646_tn?1263664409
No, the medicine does not affect it permanently.  It is daily suppression that impacts the blood test, not a week or two of therapy.

Cold is not a symptom

Terri
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55646_tn?1263664409
Terri Warren, RN, Adult Nurse Pr...Blank
Westover Heights Clinic
Portland, OR
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