[Question #6897] Herpes

10 months ago
When I got genital herpes, it was from one of two partners I was with at the same time. The second partner had her initial outbreak 3 days after my initial outbreak (4-13 days after I contracted it), so I'm pretty sure we both got it from the first partner. The thing is, if I gave it to the second partner that would mean I was contagious for a few days/weeks but didn't shown symptoms yet. Can you be contagious before your initial outbreak if you only just got it a few days/weeks prior? How long does it take for the body to begin viral shedding? 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
9 months ago
Yes, you can be contagious before you show any signs of herpes if it was just acquired.  I don't think we have the exact data about when viral shedding starts, but we know it can happen before you have symptoms.  Does that answer your question?

Terri
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9 months ago

Yes that makes sense. I'm wondering, however, how if the CDC that says that some people can go beyond the normal incubation period (2-12 days) and show little or no symptoms, does that delay only apply to people who have mild symptoms? In my case, my initial outbreak (severe symptoms) was either four days or a few weeks after contracting it. Is it possible to unknowingly have it for weeks, months, or even years before having an initial outbreak that severe? 

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
9 months ago
The nature of the outbreak helps a bit to sort out whether it is new or a recurrence.  Primary outbreaks are most often bilateral (both sides of the genitals), lymph nodes are enlarged, there are often flu symptoms, like aching muscles, light sensitivity, difficulty urinating or defacating.  Without treatment, primary outbreaks can last 3 weeks.   But even with this, it isn't 100 % certain that this would be a primary outbreak.  It is possible to have this without knowing it for months or years.

Terri
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9 months ago
So does that mean it's possible for a recurring outbreak to be more severe (pain-wise and number of sores) than an initial outbreak? Isn't the initial outbreak meant to be the most severe? Or is it unlikely to have had an initial outbreak in the past that was so mild it went unnoticed but then to have an outbreak later that was so severe it had all the "initial outbreak" signs but wasn't actually the initial outbreak? For me, my "initial outbreak" only had sores on the right side of the penis. Does that mean it wasn't initial?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
9 months ago
No, that isn't what I mean.  A primary outbreak is almost always more severe than recurrences.  Could there be exceptions?  Yes.  These exceptions occur most often in pregnancy. 
It is possible to have a mild primary outbreak that goes unnoticed or is attributed to something else, and then have another outbreak (recurrence) that is more remarkable, yes.  The only way to really know if you are having a primary infection vs. a recurrence is to have a negative antibody test with one outbreak, followed weeks later with a positive antibody test.   I suspect you don't have that information available to you.  It's frustrating sometimes not to know if an infection is new or established, isn't it?

Terri
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