Syphilis fear

[Fazzo]

Dear Dr.,

your work is fantastic, thank you so much for what you do!

20 days ago I made the mistake to receive an erotic massage. It was in Munich/Germany. The naked worker masturbated me to ejaculation and I fingered her vagina. I did not touch my penis nor did she touch her vagina, so there was no cross transfer of fluids. From what I have read online there is only a risk for herpes, hpv, syphilis. Without ANY symptoms after nearly 3 weeks I ruled out herpes and do not bother about HPV as it is inevitable anyway. But my fear concentrates on syphilis! We have a 4 week old baby and my wife is over the moon and I feel so depressed. My questions:

1) Can you estimate my propability of acquiring syphilis from this event taking into account that there are no symptoms after nearly 3 weeks?

2) Can I have sex with my wife?

3) Do you recommend testing?

4) If you recommend testing, when would a test be reliable?

I hope you can calm me down, I have been looking so much forward to christmas with the baby. Any idea out of your enormous experience how I can break this cycle of worrying?

Thanks so much and merry christmas,
Fazzo

[Edward W Hook, MD]

Your fears do not make bilogical sense. there is no risk for chlamydia or other STD from the exposure you describe.  This will end this thread. further questions will be deleted without comment.  EWH

[Fazzo]

Please Dr. Hook answer my last question, I promise there will be no more follow up.

[Fazzo]

Last follow-up, promise! I managed to convince myself that Syphilis is not a concern for me. Now I started to think that perhaps she had vaginal fluids on her hands and if that could have been massaged into my urethra. I do not have any symptoms but thought that perhaps chlamydia could be a concern. Is that possible or is my guilty mind just playing tricks on me now?

Thank you,
Fazzo

[Edward W Hook, MD]

Your reasoning does make sense but I would estimate the reliablity of a test taken at 24 days post exposure to be higher, in the neighborhood of 80% or more.  You should not be worrying about this.  EWH

[Fazzo]

Dear Dr. Hook, as I could not shake my worries I decided to have a syphilis test today. It was a rapid test provided by the central public health service in Munich. It was 24 days today after the encounter. I know that this was a bit early to test, but how would you comment on the reliability of this test? My thought was that I could reduce a tiny propability much further even with say a 50% test reliability. Like probability of infected partner and hand transmission of 1:100,000 and then a test with 50% reliability makes the probability I am infeted 1:200,000 (=550 years and same exposure every day and still perhaps not infected). That brings it closer to be killed by a meteorite tonight... Does my reasoning make sense? I need to end this worrying now!! as I have to function again for my job and family. Thank you doctor and happy new year!
Fazzo

[Edward W Hook, MD]

Welcome to the Forum.  I'll try to help.  Your risk of syphilis is very, very low.  Syphilis is a relatively rare infection in Germany so the chance that your partner had syphilis, and particularly syphilis on her hand are almost indescribably low.  Further, if you had been exposed to and acquired syphilis. you would have likely developed a sore ("chancre") on your penis by now.   Although they rarely occur at later times, this is also very uncommon. Thus putting the rarity of syphilis and the low risk nature of your exposure together with the absence of symptoms, you really need not worry.

let me repeat myself related to your specific questions:

1.  See below- close to, if not zero probability that you have syphilis from the encounter you describe.
2.  Yes, I see no reason not to have sex with your wife.
3.  I do not see a need unless it is for your peace of mind.  If you test I am confident it will be negative.
4.  See above.  For complete reliability the literature tells us that you would need to wait until 3 months post-exposure to be sure but as I said, this too in really not something you need worry about.

I hope this is helpful. EWH