time of first outbreak

Hi, if a girl who's never had any symptoms of Herpes before has a major genital outbreak on Monday/Tuesday after having a new male and female partner on Friday, (oral given and received with male, oral received from female, fingered by both) is it safe to assume that the infection came from those new partners?

[H. Hunter Handsfield, M.D.]

Usually that is a safe assumption.  Of all people with first outbreaks of genital herpes, about 40% in fact have been infected a long time and only now are recognizing it.  However, the more severe the first outbreak, the more likely it is recently acquired.  Multiple lesions that are distributed on both sides of the genital area midline, the occurrence of swollen lymph glands in the groin, and systemic symptoms (fever, muscle aches, headache) also usually are signs of brand new infection.  The timing of onset in your case (3-4 days) is very typical.

Good luck--   HHH, MD