1) I have read that the chance of contracting genital herpes is in the neighborhood of 1 in 1000 exposures provided the carrier is not experiencing an outbreak. How is this transmission rate affected if the person recently (within 1-6 weeks) contracted the virus? How much does it increase shedding etc. and therefore transmission risk? I ask this because a) I want to assess the likelihood I got it if my counterpart got it before antibodies showed up in an IGG test and b) I want to assess the risk that I could transmit it to my normal partner assuming I just got infected. If it makes a difference, my counterpart for the recent exposure tested negative for HSV1 and 2 and has not had any symptoms of an outbreak since the last time they had sex.

2) I have not had any sores or lesions present, but I have experienced odd tingling and pain in specific parts (mostly the left side of the of the tip) of my penis the last 10+ days and there have been some intermittent red spots that show up and disappear within a day or two. How often--if ever--does herpes present this way on an initial outbreak? I have read from some experts that if symptoms present on the penis it is usually on the shaft as well as the tip and rarely just the tip.

3). Reputable online sources often state up to 80% of people don't know they have genital herpes. I also understand that not knowing if one has herpes is not the same as not having symptoms (i.e., some people experience symptoms but do not make the connection with herpes). What is the true incidence of genuinely asymptomatic genital HSV2?

It is possible that someone could be infected recently and has not yet made antibody, that is correct.  A newly infected person sheds virus far more often than someone who has had herpes for a while.  We do not have data that is broken down to transmission rates based on duration of infection, we only have data on shedding rates in newly infected people vs. people infected for a longer time.

It is also my experience that rarely does herpes present only on the tip of the penis - very rare indeed, at least for me and what I've seen.  Also, with a new herpes infection, lesions would not disappear in a day or two so that doesn't fit. 

I think that probably only 20% of those infected with HSV 2 are truly asymptomatic - the rest are not recognized symptoms, sometimes very subtle, of herpes. 

Please let me know what else I can answer for you.

Terri

1) Should I be concerned that the intermittent sensations (tingling, pinpricks, throbbing) keep recurring in the same exact spot or two on the left side of the rim of the tip of my penis? Does that indicate that the virus went in there and is building up there? Seems awfully specific to be coincidental.

2) With regard to testing: is there any utility to getting tested (IGG HSV2) at 3 weeks and then again 4 weeks after the original exposure to track the values reflected in the results? I.e., attempt to see if the antibodies are trending up towards the equivocal or positive range? I have read conflicting information about the reliability of such tests after such a short time.

3) Can a doctor swab the area with all the weird sensations (again, it's pretty much the same spot or two every time) to test for HSV? Or do these tests only function properly when there are apparent lesions?

Again, I appreciate the time you take to help those of us in need of information. I have a suspicion that a lot of my issues are anxiety-driven, but at the same time I can't shake the feeling that something is amiss down there.

I welcome your follow-up comment, and I will likely reserve my last comment until several weeks to a month from now to serve as an epilogue for this whole ordeal. Many online threads of this nature cease without closure, leaving the nervous readers hanging, and I'd like for this exchange to be useful to others in a similar predicament.

The IgM test is useless in that IgM comes and goes and the test gives lots of false positives.

1.  These vague symptoms such as tingling cannot be interpreted as a herpes infection. 

2.  You could test at 3 weeks and if positive at an index value greater than 3.5 this would indicate an infection.  If negative at 3 weeks, that is only 50-50 accurate for detection of infection.  If you retest at 6 weeks, that is 70% reliable if negative.  The main reason to test now would be to rule out old infection.

3.  yes, a clinician can swab anything.  The very sensitive PCR can pick up virus even when no lesions are present.

Thanks for agreeing to update us with your results.

Terri