HSV1 and transmission to Wife

Question Regarding this:

I encountered a situation with my wife and was wondering what the chances were of passing the virus (Herpes).

I have had cold sores for most of my life and as a by product of that I am very conscious of them. I wash my hands, don't kiss, and I don't allow anyone to eat/drink after me and so forth. One night the wife and I were fooling around and I manually stimulated her. We've both come to terms with the sores. So I decided to give a "hand job." As best I can recall I didn't pick or rub, or even touch my cold sore at any point prior to the sex. My fear came, and from the sounds of it paranoia, in that an errant drop of spital with Herpes got on my hand and I passed it on. Is it likely that I exposed her? Or does she have a better chance of getting hit by an asteroid?

I also understand that typically it takes 2-10 days for an HSV1 infection to show up after infection. Would this apply in the case I described above? Or would a different lenght of time apply? I am just curious in case I did give her an exposure how long would I, her, we need to wait to look for outward signs of an infection short of a having a blood test.

And just out of curiosity how long can HSV1 survive outside, say on the hands or another like surface (I realize that nothing is for certain and that humidity, heat, UV light exposure, and type of surface all factor in).

Sorry for so many questions, the only one thats critical to me is about the exposure to my wife. Thanks so much!

[H. Hunter Handsfield, M.D.]

I'm glad you got in with your question; perseverence pays off.  Posting should be easier soon; starting in a few days, Med Help will charge $10.00 for new questions on the STD Forum, which is intended to reduce the number of attempts and thus the competition to get a new question onto the forum.

The first thing to do is have your wife see a health care provider and have a blood test for HSV-1 antibodies, such as HerpeSelect.  Because so many people are infected, with or without symptoms, there is at least a 50% chance she already is infected.  (Indeed, she could have already been infected by you, if not before.)  If her HSV-1 test is positive, she is immune to catching the virus again.  In that case, you need take no precautions whatsoever--kissing, cunnilingus, whatever turns you (and her) on.  (To be super safe, it's still not a bad idea to avoid such contact when you have an overt outbreak, but you certainly can forget about all risk in between your cold sores.)

Even if your wife is susceptible (negative HSV-1 test), most people with long-standing recurrent oral HSV-1 infections probably do not have frequent asymptomatic shedding of the virus between outbreaks.  So if you avoid oral sex and kissing when you have outbreaks, you will go a long way to protecting her from infection.  But another consideration is to ask why make a big deal of it.  So she gets HSV-1 from you--so what?  Most infections are asymptomatic, so she might never know it.  Genital HSV-1 typically doesn't cause frequent recurrent outbreaks; and if she does get symptoms, or recurrences, effective treatment is available to speed healing or prevent outbreaks.  What is not to say you shouldn't take precautions; but at the same time, if you discuss it openly with your wife, together you may decide this isn't a big deal.  Which, in my opinion, it isn't.

To answer your remaining questions:  You don't need to worry about indirect (your mouth to hand to her genitals); transmission won't occur.  Even though HSV can survive on surfaces for hours or even days, the amounts typically are too small for transmission.

Best wishes--  HHH, MD