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Herpes- possibilities thereof
I wanted to get your assessment of my potential to have contacted herpes. My gut instinct is that my exposure was pretty low based on some of your previous responses to questions, but i figured i would ask.
About me:
HSV 1 and 2= NEGATIVE (was tested recently by herpeselect)
About partner:
HSV2 positive.
She has been HSV2 positive for 26 years. She has not had an outbreak for 5 years and before she had her last outbreak it was 4 years before that. So one outbreak is the last 9 years. However, she is NOT on suppresive therapy.
The situation:
No vaginal intercourse or anal intercourse.
She performed oral on me, i did not perform on her.
There was some very slight genetal rubbing, but for a secord or two.
I did digitally stimulate her with my fingers.
My concerns:
obviously since there was no intercourse, I would assume my changes of contracting HSV2 are greatly reduced. Do i need to worry about Whitlow? I checked my hands for cuts, ect afterword and there was nothing. I even used alcohol to see if there were cuts i couldn't see. Nothing.
Should i be even concerned at all about the genital rubbing? It was quite short, (10 seconds or so) and i quickly changed positions to minimize exposure.
However, out of curiousity, the fact that she has had the virus so many years, does that diminish the amount of asymptomatic shedding she will have? My assumption is yes it does, but I'm interested to know by how much? Realistically, how much asymptomatic shedding will she have at this point after this many years with the virus? Is this one of those situations that because of the length of time, that my exposure likely would not lead to an infection?
Thanks Doctor for your responses.
About me:
HSV 1 and 2= NEGATIVE (was tested recently by herpeselect)
About partner:
HSV2 positive.
She has been HSV2 positive for 26 years. She has not had an outbreak for 5 years and before she had her last outbreak it was 4 years before that. So one outbreak is the last 9 years. However, she is NOT on suppresive therapy.
The situation:
No vaginal intercourse or anal intercourse.
She performed oral on me, i did not perform on her.
There was some very slight genetal rubbing, but for a secord or two.
I did digitally stimulate her with my fingers.
My concerns:
obviously since there was no intercourse, I would assume my changes of contracting HSV2 are greatly reduced. Do i need to worry about Whitlow? I checked my hands for cuts, ect afterword and there was nothing. I even used alcohol to see if there were cuts i couldn't see. Nothing.
Should i be even concerned at all about the genital rubbing? It was quite short, (10 seconds or so) and i quickly changed positions to minimize exposure.
However, out of curiousity, the fact that she has had the virus so many years, does that diminish the amount of asymptomatic shedding she will have? My assumption is yes it does, but I'm interested to know by how much? Realistically, how much asymptomatic shedding will she have at this point after this many years with the virus? Is this one of those situations that because of the length of time, that my exposure likely would not lead to an infection?
Thanks Doctor for your responses.
Ok, you were right. Turns out that my bump is actually a callus and has not changed at all over the last 4 days. Same bump, no redness, no tenderness, no pain. The Doctor must have thought i was delusional.
I know that anxiety is causing me much stress right now as even dry skin by my fingernail is freaking me out.
I'm curious why you state that "hand genital" does not transmit the virus? Also, does the 3 weeks wait time to see if something happens still apply to non-genetical infection? I am now going past the week time, and two more weeks of this will be quite stressful.
I know that anxiety is causing me much stress right now as even dry skin by my fingernail is freaking me out.
I'm curious why you state that "hand genital" does not transmit the virus? Also, does the 3 weeks wait time to see if something happens still apply to non-genetical infection? I am now going past the week time, and two more weeks of this will be quite stressful.
MEDICAL PROFESSIONAL
I agree the timing and location are worthy of attention, and conceivably these could be early signs of a herpes whitlow. However, lack of pain, tenderness, and redness argue against it. My guess is that you're just noticing a callus that actually isn't new. Anxiety can do wonders for our ability to become aware of previous symptoms or skin anomalies that had not been noticed.
Nothing more can be said from this distance. If you are convinced the lesion is new, you should see a health care provider for examination and possible testing of the lesion for HSV. We're in the middle of a 3-day weekend, so you probably would have to find an urgent care clinic. You probably can safely wait until Tuesday and see your personal physician or other non-emergency provider, unless the lesion enlarges or becomes red and/or tender; in that case, don't wait. In the meantime, do nothing to the lesion: no poking, squeezing, or prodding; no neosporin or any other creams, and don't take any leftover antibiotics you may have around or any other medication.
As for yesterday's question, the chance of oral to genital HSV-1 transmission is just as low as for genital HSV-2, probably lower. And for sure asymptomatic shedding is less frequent over time (and less frequent overall) for HSV-1 than HSV-2. In my experience, most cases of genital HSV-1 infections follow oral-genital exposure to partners with overt outbreaks of oral herpes, not from asymptomatic shedding.
Let me know the findings if and when your finger has been examined by a health professional. I'll have no further comments or advice until then.
Nothing more can be said from this distance. If you are convinced the lesion is new, you should see a health care provider for examination and possible testing of the lesion for HSV. We're in the middle of a 3-day weekend, so you probably would have to find an urgent care clinic. You probably can safely wait until Tuesday and see your personal physician or other non-emergency provider, unless the lesion enlarges or becomes red and/or tender; in that case, don't wait. In the meantime, do nothing to the lesion: no poking, squeezing, or prodding; no neosporin or any other creams, and don't take any leftover antibiotics you may have around or any other medication.
As for yesterday's question, the chance of oral to genital HSV-1 transmission is just as low as for genital HSV-2, probably lower. And for sure asymptomatic shedding is less frequent over time (and less frequent overall) for HSV-1 than HSV-2. In my experience, most cases of genital HSV-1 infections follow oral-genital exposure to partners with overt outbreaks of oral herpes, not from asymptomatic shedding.
Let me know the findings if and when your finger has been examined by a health professional. I'll have no further comments or advice until then.
UPDATE-
ok, so it has been about 3 days since the encounter and now i have a rather large bump on the finger that i used to stimulate and enter her. It just appeared over night. it isn't at the junction with the nail, but rather about 5-10cm below the fingertip on the left side of the finger. It is about a 2cm bump, looks kinda white underneath and seems kinda hard to the touch. It doesn't itch, or hurt, but it is DEFINITELY visible.
This can't be just a coincidence. It looks like one of those hard spots you get on your finger when you write too much, but i haven't used any pens in days.. what do you think of it?
ok, so it has been about 3 days since the encounter and now i have a rather large bump on the finger that i used to stimulate and enter her. It just appeared over night. it isn't at the junction with the nail, but rather about 5-10cm below the fingertip on the left side of the finger. It is about a 2cm bump, looks kinda white underneath and seems kinda hard to the touch. It doesn't itch, or hurt, but it is DEFINITELY visible.
This can't be just a coincidence. It looks like one of those hard spots you get on your finger when you write too much, but i haven't used any pens in days.. what do you think of it?
Last question:
I assume your assessment also applies to potential HSV1 infection from oral? As i previously stated, she does not appear to have a history of HSV1 outbreaks, but obviously that doesn't mean that she doesn't have it. Assuming she has HSV1 from an early childhood infection, does the same correlation that related to the length of time that she has had HSV2 also apply to HSV1 infection? ie- if she has had HSV1 that long, the probability that she is shedding HSV1 also declines over that long period of time thereby minimizing my chances of contracting that also?
Sorry for all the questions, but your responses are extremely helpful and reassuring.
I assume your assessment also applies to potential HSV1 infection from oral? As i previously stated, she does not appear to have a history of HSV1 outbreaks, but obviously that doesn't mean that she doesn't have it. Assuming she has HSV1 from an early childhood infection, does the same correlation that related to the length of time that she has had HSV2 also apply to HSV1 infection? ie- if she has had HSV1 that long, the probability that she is shedding HSV1 also declines over that long period of time thereby minimizing my chances of contracting that also?
Sorry for all the questions, but your responses are extremely helpful and reassuring.
MEDICAL PROFESSIONAL
Whitlow occurs by direct infection at the site exposed. Most whitlows start at the skin-nail junction, where protective tissues may be thin, and an area subject to preexisting lesions from minor trauma, e.g. a minor nick from nail trimming, a hangnail, etc.
It isn't certain that asymptomatic shedding in fact declines over time; there have been few if any studies of asymptomatic shedding in people infected 20 years or more. Probably shedding never stops entirely. However, symptomatic outbreaks clearly decline over the years, as for your partner, and it is rare to see new genital herpes in people with partners in their 40s and 50s. So it is logical to suppose that asymptomatic shedding also occurs less frequently and/or with lower viral loads.
Thanks for the thanks about the forum.
It isn't certain that asymptomatic shedding in fact declines over time; there have been few if any studies of asymptomatic shedding in people infected 20 years or more. Probably shedding never stops entirely. However, symptomatic outbreaks clearly decline over the years, as for your partner, and it is rare to see new genital herpes in people with partners in their 40s and 50s. So it is logical to suppose that asymptomatic shedding also occurs less frequently and/or with lower viral loads.
Thanks for the thanks about the forum.
Thank you doctor. I suspected that you would likely re-affirm my assumptions.
To answer a couple of your questions.
1) Yes, my testing happened before this event. Unless I see some evidence within the first 2 weeks after my exposure, i will assume i didn't contract anything.
2) Her HSV2 infection is genital, not oral. She doesn't have a history of HSV1 outbreaks, so my assumption is that the likelihood of contracting HSV1 from oral is also pretty slim.
I have a couple questions just for my own understanding and learning:
a) for whitlow, when it does occur, how does the virus enter the body? It is my understanding that thicker skin, like that found on the fingers and other epidermis cells create a barrier. Does the virus enter the body when there are cuts on the skin? so people with cut cuticles, hang nails and the like are more likely to acquire?
b) I'm curious why asymptomatic shedding slows after so many years? My guess is that the body is better able to keep the virus in check so it can't travel from the nerve ends to the sight of infection? Does asymptomatic shedding eventually almost competely stop over time?
Thanks, I very much appreciate your candid responses and this sight is such a great resource.
To answer a couple of your questions.
1) Yes, my testing happened before this event. Unless I see some evidence within the first 2 weeks after my exposure, i will assume i didn't contract anything.
2) Her HSV2 infection is genital, not oral. She doesn't have a history of HSV1 outbreaks, so my assumption is that the likelihood of contracting HSV1 from oral is also pretty slim.
I have a couple questions just for my own understanding and learning:
a) for whitlow, when it does occur, how does the virus enter the body? It is my understanding that thicker skin, like that found on the fingers and other epidermis cells create a barrier. Does the virus enter the body when there are cuts on the skin? so people with cut cuticles, hang nails and the like are more likely to acquire?
b) I'm curious why asymptomatic shedding slows after so many years? My guess is that the body is better able to keep the virus in check so it can't travel from the nerve ends to the sight of infection? Does asymptomatic shedding eventually almost competely stop over time?
Thanks, I very much appreciate your candid responses and this sight is such a great resource.
MEDICAL PROFESSIONAL
Welcome. There are several issues embedded in your quesions. Individually, they convey no risk you were infected; collectively, it is virtually impossible.
First, your closing assumption is correct: after 26 years your partner may be minimally infectious, especially with no outbreaks for 5 years. Most likely asymptomatic shedding is similarly infrequent. Second, among monogamous couples in which one person has HSV-2 and not on treatment, who have unprotected sex an average of 2-3 times per week, transmission occurs in only 1 in 20 couples each year. That translates to a risk under 1 for every 1,000 episodes of sex. Even with unprotected sex, your risk would have been far lower than this estimate. Third, you didn't even have sex with her. Hand-genital doesn't transmit the virus and brief genital rubbing without intercourse carries little or no risk. Fourth, she could not have given you here genital HSV-2 infection by oral sex; it is rare that people with HSV-2 have oral infection.
I gather your HSV blood test was before the exposure described. If 3 months or more after the exposure, it adds to the evidence you weren't infected.
In summary, you describe a no-risk situation with respect to catching HSV-2. Assuming you do not develop typical symptoms of genital herpes (blisters/sores, etc) within 3 weeks of the sexual exposure -- which almost certainly will not happen -- you can disregard this event. You don't need testing.
I hope this helps. Best wishes-- HHH, MD
First, your closing assumption is correct: after 26 years your partner may be minimally infectious, especially with no outbreaks for 5 years. Most likely asymptomatic shedding is similarly infrequent. Second, among monogamous couples in which one person has HSV-2 and not on treatment, who have unprotected sex an average of 2-3 times per week, transmission occurs in only 1 in 20 couples each year. That translates to a risk under 1 for every 1,000 episodes of sex. Even with unprotected sex, your risk would have been far lower than this estimate. Third, you didn't even have sex with her. Hand-genital doesn't transmit the virus and brief genital rubbing without intercourse carries little or no risk. Fourth, she could not have given you here genital HSV-2 infection by oral sex; it is rare that people with HSV-2 have oral infection.
I gather your HSV blood test was before the exposure described. If 3 months or more after the exposure, it adds to the evidence you weren't infected.
In summary, you describe a no-risk situation with respect to catching HSV-2. Assuming you do not develop typical symptoms of genital herpes (blisters/sores, etc) within 3 weeks of the sexual exposure -- which almost certainly will not happen -- you can disregard this event. You don't need testing.
I hope this helps. Best wishes-- HHH, MD
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
