Oral risk syphillis/herpes

[verynervous111]

Dr...I am freaking out. I recently received an unprotected bj from a sw. I live in NJ. I did not notice any sores on her mouth. I am freaking out about the possibility of an std, especially syphillis and herpes from this encounter. I has been about 4 days with no symptoms of any sort. I know it is too early to be tested for either of the two. How likely is the transmission from such an act with this high risk partner.  (she must preform bbbj often I am guessing). I am in a LTR and terribly regret this decision and am scared I will pass something to my gf. Please help.

[Edward W Hook, MD]

Herpes lesions typically appear in a week or less.  As for syphilis, this can take up to three weeks but remember, there will be only 10,000 cases of syphilis in the US this year in a population of 300,000,000.   Mathematically your odds are one in 30,000.  Add to that that transmission occurs through lesion contact and is rare from oral sex and you have almost nothing to worry about.  EWH

[verynervous111]

Dear Dr....it's been about 11 days with no std symptoms. If anything was going to show up, would it have done so by now? How long is it before Herpes and Syphillis normally show?

Thank you.

[Edward W Hook, MD]

1. Protected sex with your GF is OK
2.  Oral STDs rarely occur and are not efficiently transmitted
3.  SV almost never occurs in the mouth but HSV-1 occurs in the mouth and can casue genital herpes
4.  3 weeks is fine for syphilis
EWH

[verynervous111]

Sorry one last thing....is 3 weeks a definitive time to test for Syphilis? Would I have to test again if it was negative?

[verynervous111]

Thank you Dr. I will get tested as soon as I can. Do you think it is safe to have PROTECTED sex with my gf at this point? Also, are STD's rarely transmitted orally because they are rare orally? or is it because the vector of transmission is not very sufficient? And in the case of herpes I am confused as the weather HSV 2 is transmitted orally from mouth to genital. I don't see it talked about much here, only HSV1.

[Edward W Hook, MD]

Your risk is very low.  No visible sores, I would guess your chances of getting syphilis are less than 1 in 100,000.  I'd have a harder time manufacturing a figure for herpes but also very low risk.  STDs are just not effectively transmitted through oral sex.

As for the levofloxacin, it would be only partially effective and might obscure things.  Your risk is so low that I would urge you to go on and get tested for gonorrhea, chlamydia (which a promise you will not be there) and nongonococcal urethritis (NGU).  then wait till about three weeks and get the syphilis test.  When all of those results come back negative as I'm sure they will, forget the entire episode and move on.  Do not take antibiotics please.  EWH

[verynervous111]

also...would 1 500mg tab of Levofloxacin be enough to ward off gonorrhea/clamidia if i was infected so recently?