[Question #5456] Syphilis risk

74 months ago

Hi Doctor,

am from Milano, 49. Sorry for bad English, hope you understand. I have informed about the risk of my exposures by MedHelp and this forum and have a good background knowledge for my questions. Now I explain exposures and give some insight into my personal background. I am a married man and had some exposures out of my marriage with another man, 31 in Milano. The last exposure is 29 days ago as of today. I restricted my exposures to mutual masturbation and didn't let him touch my anus. So he only touched my body and penis and vice versa but there was a lot of touching back and forth with precum and cum on hands. With my research of your forums I realize that - if at all - I am only at risk for skin-to-skin, i.e. lesions diseases. I further exclude herpes as I haven't had any symptoms yet and don't worry about the inevitable HPV. So I have this one fear: syphilis. I am an operations research expert, so would really appreciate probability-based answers (numbers) as this approach generally helps me to deal with worries in life.

Questions:

1) How do you estimate my percentage of risk from a mutual-masturbation-only-exposure with another man for syphilis?

2) How do you estimate the percentage of risk generally that a given syphilis infection wouldn't produce any symptoms (i.e. the chancre) till 29 days after the exposure?

(Lets assume an infection and I am interested in the risk that this wouldn't show up till day 29. There is no chance that infection would have happened at a "hidden" site (mouth/anus), as we didn't do oral and also no anal contact. Basically just my penis and hands have been exposed.)

3) My overall (cumulative) syphilis risk?

4) I think about testing at day 40 post exposure. How reliable would a test be then?

(Background: At "day 41" a conference starts that I have to moderate and I want to allay fears before. Test would be quick test then.

Thank you!

Giuseppe

H. Hunter Handsfield, MD

74 months ago

Welcome to the forum. Thanks for your confidence in our services and your long term loyalty transferred over from MedHelp. Your English is fine -- there's nothing unclear in your questtions. Directly to them:

1) Syphilis is rarely if ever transmitted by hand-genital contact. Even in an actively infected person, infectious lesions are exceedingly rare on dry skin, including hands. In my 4+ decades in the STD business, have never seen or heard of a case of syphilis from hand-genital contact.

2) When the exposed area is obvious and visible (e.g. penis) a large majority of newly infected persons have an obvious sore, the chancre, within 10-20 days. Most asymptomatic cases occur because of hidden lesions, since chancres often are painless -- in the rectum, anal area, vaginal opening, inside the vagina or mouth, and so on.

3) You are at no meaningful risk of syphilis based on your usual exposures. That said, many anxious persons find lab test results more reassuring than even the most expert opinion.

4) The data on time to conclusive syphilis testing are not very precise. But 6 weeks is definitely conclusive, and 41 days is close enough. Or you could wait one more day.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD

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74 months ago

Thank you, Dr. Handsfield!

Those answers surely help a lot. Perhaps you can give me an estimate to answer number 2, please?

What is the chance that a syphilis infection wouldn't be noticed as a chancre till now 30 days after exposure? I wasn't exposed at a hidden site (rectum/mouth) and my penis and hands look perfectly fine.) Would this be like 1:100 or more 1:1000?

Thank you!

Giuseppe

H. Hunter Handsfield, MD

74 months ago

IF you got syphilis, I would guess there is an 80% chance you would see a typical chancre. Since there is little or no chance of syphilis being transmitted from hand-genital contact, you should not be worried. Let's guess there is once chance in a million you caught syphilis by this contact. With 80% recognition of a chancre, without it appearing within 30 days, your risk would be 1 chance in 5 million. In other words, still zero.

Do not overthink it. Nobody ever gets syphilis in this manner. Accept it, believe it, and move on without worry.

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74 months ago

Thank you Doc, that does surely help. I can let this worry go now I guess. What a relief! Great work, keep it up!

H. Hunter Handsfield, MD

74 months ago

Thanks for the thanks. That concludes this thread. Best wishes and stay safe.---