[Question #200] Can I get herpes from contact in a hot tub

36 months ago
Hi, feeling a bit paranoid like everyone else. I was with a woman that said she has genital HSV-1. We were in the hot tub together and while in the hot tub she sat on my lap. My penis touched her vagina. There was no rubbing, penetration etc. It was brief and a touch. She did perform oral sex on me. When she later told me she has genital HSV-1 I was upset. To re-assure myself I am asking if I could get HSV from her from a brief and gental touching while in the hot tub?  I have not had any breakouts since that occasion (three weeks ago) but I have had jock itch. The bumps from the jock itch were on my scrotum and did not contain any fluid, did not break open etc. They responded to Tenactin anti-fungal cream.  I did show the "jock-itch" bumps to my physician who said they did not look like herpes.  Do I need to get a blood test in three months?
Thanks
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
36 months ago
Hi John,
Thanks for your question.  HSV 1 is becoming more common than ever before, likely for two reasons.  The first is that people are getting it that cold sores are actually caused by the herpes virus and so they are more careful about kissing their children when they have a cold sore so they won't get "herpes".  The result of that is that more and more teenager are entering their sexual maturity without any antibody to HSV 1 infection.  The other part of the equation is that oral sex, both giving and receiving, is much more common than it used to.  Some people believe that oral sex really isn't "sex".  Hmm, wonder where that idea came from?  It certainly is sex.  So you combine teenagers with no HSV 1 antibody and an increase in oral sex , you find that most new genital herpes in the college age population, for example, is HSV 1 - in fact 78% according to one study out of the University of Wisconsin.  It turns out that HSV 1 genital infection is really a whole different condition than HSV 2 genital infection.  It recurs infrequently (about 0.7 time per year, on average, and sheds significantly less than HSV 2 genital infection.  In fact, if a person does not have a recurrence within the first year of infection, there is an 88% chance they won't in the future. 

Now let's talk about your encounter.  It takes way more contact than you describe to acquire HSV 1 infection.  Way more.  In addition you have the water of the hot tube diluting whatever virus might be there (which is likely very little) and no penetration or direct aggressive rubbing, per your description.  I would say that you should have no concerns whatsoever.  Jock itch looks nothing like herpes so I think you can feel confident about the clinician's diagnosis.

Terri
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36 months ago
Hi thank you that really helps. It's the cdc site and other sites that use the phrase "herpes symptoms can be so mild that they can be confused with yeast infection, jock itch etc" that makes things unclear or creates irrational thinking. My follow up question is if a person never has a blister with a clear fluid that breaks open and heals over can it be said that the person doesn't have herpes?  
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
36 months ago
Yes, I think herpes and yeast can be confused more easily in women, but far less often in men because often jock itch in men comes between the scrotum and the leg and that is pretty classic in its presentation.  No, it cannot be said that if a person has no classic blisters that they don't have herpes.  It turns out that about 80% of those who test antibody positive for HSV 2 say they don't have genital herpes .  Most often that is because they don't recognize subtle symptoms and often that is because they already have HSV 1 infection and that antibody response keeps symptoms very much under control. 

Terri
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36 months ago
Thank you again. So you can get HSV without having the lesions etc so if I were to be in an exposed situation (not the one I described) I should take a blood test to ensure I don't have HSV and not just rely on the lack of an outbreak. Is that correct?  Also to reiterate a point made in another post for confirmation genital HSV doesn't cause the virus to be in a persons mouth so HSV stays where is breaks out so the oral sex in my original question was not a risk factor in getting HSV since she had it in her genitals.
Thank you for this service. My family doc is great but not able to provide the definitive statements that you did which resolved my concerns.

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
36 months ago
If you want to know if you have herpes or not, you cannot rely on whether you have symptoms or not, correct.  According to a national study looking at people who test positive for HSV 2 (in particular but it also likely applies to HSV 1), 80% of those infected report no symptoms consistent with herpes. So yes, if she has only genital HSV 1, then she can only transmit virus from the genital area, not the mouth.  But lots of people ask that same question.  The virus does not leave the sacral nerve group, that supplies the genital area, and move up and come out of the mouth.  I believe that is what you are asking? 
So happy to be of help to you John. If you have further questions, you can always renew, but I think for this particular incident, you are good to go
Best
Terri
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