[Question #3577] Chances of HSV 1&2 from single exposure - terrified

36 months ago

Hi Terri,


I understand that you are the person to ask on here about HSV, I am terrified about a possible transmission I had. I engaged in deep kissing and received oral sex (blow job) from a 38 year old heterosexual woman on 20/02. The oral sex lasted for 10-20 seconds tops - the oral sex was unprotected but there was no sex. She did not have any visible sores on her lips i don't think and she told me that she has "never had a cold sore" but I do not believe that - stats would suggest due to her age she is probably infected. 


Since the exposure I have had some discharge problems, which are hopefully clearing with Azithromycin after doxy didn't work. The discharge started around 2/3 weeks and is still present (in smaller amounts since medication) and DR HHH suggested that Herpes could be the cause? I have never had a coldsore or any blisters on my genitals previously so if I get either it will be because of this exposure but I have a few questions.


1) If she had no visible cold sore on her lips (I understand it could be inside her mouth of shedding) - what are the chances of contracting HSV1 to the mouth and genitals on one single exposure


2) It has been 50 days since the event and I have not yet had a cold sore on lip or cluster of puss filled sores on my genitals (that i know of) is this sufficiently long enough to assume I am not infected or could this happen at any point in the future for the initial outbreak?


3) I intend to test at 90 days for a full STI screen and includes HSV 1&2 - would this be accurate at this time if I chose an IgG test from the private clinic?


4) I think I have been getting more canker sores than normal at the minute but notice that the initial oral outbreak can be inside the mouth, would this be obvious and painful to eat or drink etc? My throat isn't overly sore but feels like i'm constantly swallowing things other than saliva which makes me nervous that there's something in my throat


5) chances of HSV2 from this?

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
36 months ago
1.  The chances of contracting HSV 1 through a single very short act of receiving oral sex are incredibly low
2.  While some people acquire HSV 1 without symptoms, I think as carefully as you looking, you would have noticed symptoms.
3.  The IgG test misses 30% of HSV 1 infections.  It would have been helpful to have gotten a baseline HSV 1 antibody test when this first happened because now, if it is positive, you cannot know if it was always there or is new.  If it's positive, I would guess it is old infection
4.  This does not sound like herpes.
5.  way way low!

Terri
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36 months ago
Hi Terri, 

Thank you for your answers, I have a few more questions if possible. 

1) I have 4/5 small white heads on my nose, they look like spots and are dotted about, could this potentially be HsV1? Or stress? They do not hurt

2) if she says she has never had a cold sore (I guess this would be in the recent past) and she didn’t have one that night, whatre the chances that she was shedding? Or what’s my risk so to speak 

3) the discharge and pain in my penis has been going on now for 4 weeks or so, would herpes inside the urethra or herpes in general cause this? It is not painful to urinate and the pain is often dotted throughout the day.  

4) I have a bit of a cold coming on, with a sore nose, chances that this could be related?

5) in the absence of an obvious outbreak at 7 weeks  (I have been checking thoroughly every day) whatre the chances I have HSV1/2?

6) If or when an outbreak comes, would it be in the typical symptoms of a cold sore inside the mouth/outside the mouth and also potentially on my thighs/penis/scrotum? And would it be painful?

7) if I have had no symptoms by 3 months and I get tested and come back negative can I put this behind me or could it crop up In the future?

8) if you could put a percentage chance on my exposure of getting HSV1 either genitally or orally what would it roughly be? (Tough question i know, but ballpark?) 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
36 months ago

1) I have 4/5 small white heads on my nose, they look like spots and are dotted about, could this potentially be HsV1? Or stress? They do not hurt

This sounds absolutely nothing like herpes to me.  Herpes would appear as water blisters and usually inside the nose if the nose is involved.

2) if she says she has never had a cold sore (I guess this would be in the recent past) and she didn’t have one that night, whatre the chances that she was shedding? Or what’s my risk so to speak

People with HSV 1 shed virus on about 1 out of 4 days

3) the discharge and pain in my penis has been going on now for 4 weeks or so, would herpes inside the urethra or herpes in general cause this? It is not painful to urinate and the pain is often dotted throughout the day.

No, herpes would not cause pain in your penis for 4 weeks - that is too long for herpes to be active inside the penis and if you did have herpes lesions in the urethra, it would hurt when you peed.

4) I have a bit of a cold coming on, with a sore nose, chances that this could be related?

Not related

5) in the absence of an obvious outbreak at 7 weeks  (I have been checking thoroughly every day) whatre the chances I have HSV1/2?

Extremely low, at least from this encounter. I have no idea if you might have been infected at some other point in your life.

6) If or when an outbreak comes, would it be in the typical symptoms of a cold sore inside the mouth/outside the mouth and also potentially on my thighs/penis/scrotum? And would it be painful?

If an outbreaks comes, it would likely be on the shaft of the penis or on your lip, but that would have happened by now most likely

7) if I have had no symptoms by 3 months and I get tested and come back negative can I put this behind me or could it crop up In the future?

Yes, you can put it behind you.  And if you test positive, I would be quite certain it was from some previous encounter.

8) if you could put a percentage chance on my exposure of getting HSV1 either genitally or orally what would it roughly be? (Tough question i know, but ballpark?)

I would say close to zero genitally and perhaps 3% with the kissing.  Wild guess

Terri

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36 months ago
Hi Terri,

1) If HSV1 was in the nose I take it that it would be very obvious/painful? I cannot see anything up there due to hair but if I put a finger up there I do not feel anything abnormal or painful?

2) As she didn't have a visible sore, theres a high chance she could have been shedding as you say, therefore chances of infection are quite high?

3) I have never had a cold sore in my life and do not believe I have been infected prior to this mistake, IF I was not infected previously and this was my first contact with the virus, would I have had definite and obvious painful sores on my lips or shaft of my penis by 55 days?

4) If you were in my position would you be content that at this stage a HSV1 infection has been avoided?

5) I take it from previous answers that the percentage chance of contracting HSV2 through oral is very low and I could not have not this from touching her and then touching myself?

6) I am aware that primary outbreaks can be missed, but is this common?

7) In the absence of sores both on my lips or penis shaft at 55 days post exposure would you suggest I am in the clear - or not yet? I know testing is the only way to be sure but in your opinion have you ever seen someone either with a primary infection so minor its unnoticed or a primary infection that has taken longer than 55 days to happen?

8) I have really quite a bad cold which I know can be a sign of HSV1 but this always accompanies sores when present?

9) Just so I know what i'm looking for, the hsv1 sores look like blisters and are painful? they last on average two weeks in total and are obvious?

10) If there was kissing prior to oral where would the infection show up? orally or on genitally? or both?

11) I take it that if there was HSV1 inside the urethra it would be extremely painful and unbearable? I have some red dots inside the head of my penis but they could be veins, they are red and pin prick sized, don't seem to be overly raised 

If I were a patient of yours would you be suggesting I forget HSV1/2 at this point?
 

35 months ago
Hi Terri, 

Do you have any update on my second set of follow up questions above? I apologise and realise you are very busy but I am very anxious. 

Thanks
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
35 months ago
1) If HSV1 was in the nose I take it that it would be very obvious/painful? I cannot see anything up there due to hair but if I put a finger up there I do not feel anything abnormal or painful?

You would normally have some sensation in the nose if there was a lesion there.

2) As she didn't have a visible sore, theres a high chance she could have been shedding as you say, therefore chances of infection are quite high?

Not high - just present

3) I have never had a cold sore in my life and do not believe I have been infected prior to this mistake, IF I was not infected previously and this was my first contact with the virus, would I have had definite and obvious painful sores on my lips or shaft of my penis by 55 days?

No necessarily, no

4) If you were in my position would you be content that at this stage a HSV1 infection has been avoided?

Probably

5) I take it from previous answers that the percentage chance of contracting HSV2 through oral is very low and I could not have not this from touching her and then touching myself?

Correct

6) I am aware that primary outbreaks can be missed, but is this common?

Yes, but not for people really observing every little thing

7) In the absence of sores both on my lips or penis shaft at 55 days post exposure would you suggest I am in the clear - or not yet? I know testing is the only way to be sure but in your opinion have you ever seen someone either with a primary infection so minor its unnoticed or a primary infection that has taken longer than 55 days to happen?

I have seen that, yes, an unnoticed infection.  I can't give you a promise but given your contact, I think infection is very unlikely

8) I have really quite a bad cold which I know can be a sign of HSV1 but this always accompanies sores when present?

Colds are not a sign of herpes

9) Just so I know what i'm looking for, the hsv1 sores look like blisters and are painful? they last on average two weeks in total and are obvious?

Yes, they look like blisters or open sores

10) If there was kissing prior to oral where would the infection show up? orally or on genitally? or both?

Both are possible

11) I take it that if there was HSV1 inside the urethra it would be extremely painful and unbearable? I have some red dots inside the head of my penis but they could be veins, they are red and pin prick sized, don't seem to be overly raised

Herpes in the urethra would make urinating painful - unbearable?  Maybe not.

Terri
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