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Syphilis/Herpes anxiety
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Syphilis/Herpes anxiety

Dear Dr. EWH/HHH, although i had a low risk I cannot stop constantly worrying and suffering. Please! answer my detailed questions as these details might be able to rest me assured. I had two encounters last week with the same massage lady. She gave me handjobs. I briefly inspected her hands and found no really evident lesion. Afterwards I worried if a "lesion std" could have been transmitted that way. I particularly worry about syphilis and herpes. I REALLY hope with your information I can relax and move on with my life. My questions:
1) What amount of fluid from a syphilitic sore would be needed for transmission? Would it be a at least a visible drop like in HIV-transmission or would microscopic traces be sufficient?
2) Could I even miss a syphilitic sore on her hands that could lead to transmission?
3) Same as 2) for herpes (whitlow)?
4) Do I need testing?
5) Do I need to inform my wife?
6) Should I just forget this episode and move on?
Please help me out of that. I cannot function properly now and am afraid to lose my wife and kids.

Thank you!
A remorseful Fenimore
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Welcome to the forum.

By definition, anxiety is not rational, and it rarely goes away simply by knowing the facts.  I'll answer your questions briefly, but if you are typical, the replies will not resolve your irrational fear of syphilis and herpes in this situation.  But here you go.

First, syphilis and herpes are never transmitted by hand-jobs.  Nobody ever caught these or any other STD in a massage parlor unless they had unprotected vaginal, anal, or oral sex while there.  You're not going to be the first exception.  Second, syphilis is very rare in persons like your massage worker.  Only about 20,000 new cases occur each year in the entire US (with even lower rates in most other industrialized countries) and two thirds of those occur in gay men, the rest in a few especially high risk populations -- not including most sex workers.  In 70% of US counties, there is no syphilis at all.  To the specific qeustions:

1) Unknown; probably very scan amounts would be sufficient.  But this doesn't change the facts above -- no syphilis risk.
2) Syphilis lesions on dry skin typically are not infectious.  Even if your partner had it, you were not at risk.
3) Hand-genital herpes transmission doesn't occur.  The chance your partner had an infectious whitlow at the time of your exposure is microscopic.
4) You do not need testing for anything.
5) You do not need to worry about transmitting anything to your wife.  From an STD risk standpoint, you do not need to inform her of this event.  However, you're the only one who can decide whether it would be a good idea to tell her from a relationship perspective or to help get you beyond your fears.
6) Yes, for sure you should "ust forget this episode and move on".

I hope these replies help settle your irrational fears -- and they are definitely irrational.  But as implied above, most likely your anxieties will continue.  If so, professional counseling should be the next step.  I suggest it from compassion, not criticism.

Regards--  HHH, MD
2 Comments
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Dear Dr. Handsfield, thank you so much for this amazingly fast response. Your answers are profound and do help a lot. I feel even stupid now for having asked them but do well understand that my fears are completely irrational.

A very thankful Fenimore
(no reply expected)
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H. Hunter Handsfield, M.D.Blank
University of Washington
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