[Question #7160] Risk of auto inoculation

8 months ago

Female genital HSV 1 diagnosis 4 years ago, Valacyclovir every day 8 months after diagnosis

I am working with a therapist on this. These answers will help me combat irrational thoughts with facts.

1.  Risk of auto inoculation

            a. If I touch myself genitally with hands. What is the risk of herpetic whitlow?

            b. If I touch myself genitally with hands. What is the risk of herpetic whitlow given I have cuts on my hands from nail biting and over washing (due to HSV diagnosis and fear of auto inoculation to eye)?

            c. If I touch myself genitally with hands, what is risk of ocular HSV 1 from myself? My concern stems from wearing contacts. However, I would like to continue wearing them.

            d. What is risk of herpetic whitlow, oral, and ocular HSV 1 from my towel, that I use for my whole body, after I shower?

            e. What is risk of herpetic whitlow, oral, and ocular HSV 1 from my shower soap bar that I use on my face and body? It is free of many chemicals, may not have many antibacterial agents.

            f. What is risk of herpetic whitlow, oral, and ocular HSV 1 from jar of lotion that I use on my body and face?

            g. What is risk of me getting herpetic whitlow, oral, and ocular HSV 1 from penetration of fingers, penis, or object vaginally to mouth by myself or my partner?

            h. What is risk of herpetic whitlow, oral, and ocular HSV 1 from touching clothes that were in contact with my genitals?

            i. What is risk of getting HSV 1 orally, herpetic whitlow, or ocular from male partner if he got HSV 1 from me?

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
8 months ago

I'm happy to help with your questions

1.  Risk of auto inoculation

            a. If I touch myself genitally with hands. What is the risk of herpetic whitlow?

Just about zero

            b. If I touch myself genitally with hands. What is the risk of herpetic whitlow given I have cuts on my hands from nail biting and over washing (due to HSV diagnosis and fear of auto inoculation to eye)?

Just about zero as well.  Once you have HSV 1 in one location, it is extremely unlikely you would get it in a new location.  That includes hands and eyes and mouth

            c. If I touch myself genitally with hands, what is risk of ocular HSV 1 from myself? My concern stems from wearing contacts. However, I would like to continue wearing them.

See the answer to B

            d. What is risk of herpetic whitlow, oral, and ocular HSV 1 from my towel, that I use for my whole body, after I shower?

Just about zero

            e. What is risk of herpetic whitlow, oral, and ocular HSV 1 from my shower soap bar that I use on my face and body? It is free of many chemicals, may not have many antibacterial agents.

Just about ero

            f. What is risk of herpetic whitlow, oral, and ocular HSV 1 from jar of lotion that I use on my body and face?

Just about zero

            g. What is risk of me getting herpetic whitlow, oral, and ocular HSV 1 from penetration of fingers, penis, or object vaginally to mouth by myself or my partner?

Just about zero


            h. What is risk of herpetic whitlow, oral, and ocular HSV 1 from touching clothes that were in contact with my genitals?

Zero

            i. What is risk of getting HSV 1 orally, herpetic whitlow, or ocular from male partner if he got HSV 1 from me?

Just about zero as well


Let me ask - how were you diagnosed with HSV 1 genital infection?  I am assuming a positive swab test from a genital lesion

I have seen one case in 35 years of practice where someone states that they had cold sores and then developed genital HSV 1.  However, I am suspect of her history of cold sores.  It is also possible that she acquired HSV 1 orally at the same time she acquired it genitally.  Which is why I saw "Just about zero" rather than zero.  The risk of getting this in a new place for any reason or from any experience is just incredibly low.  And about half the population has HSV 1, most of it oral.  If ocular herpes was common, we would see way more of it, but we really don't.  Yes, we see it but not in half the population.


I can see that you are struggling with this a bit, I hope this is helpful


Terri

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8 months ago
Hi Terri,

First, thank you for taking the time to consider all of the scenarios I presented. I appreciate your candidness and understanding what these facts can do for me.

I was diagnosed through a genital lesion swab. 

Please let me know if this follow up question should actually be a new question.

I know it can be difficult to say 100% there is no lesion genitally especially for people with vaginas.

What is risk of male partner getting HSV 1 orally, genitally, herpetic whitlow, ocular from me from:

            a. vaginal penis penetration with condom and me taking daily antiviral?

            b. vaginal penis penetration without condom and with me taking antiviral?

            c. penetrating me fingers?

            d. From finger penetration, penis penetration, or oral sex when I have shaved my genitals?

            e. touching clothes that were in contact with my genitals?

            f. what is risk of further auto inoculation or spread from me to other parts of his body if partner does get HSV 1 from me? Is he more likely to get it multiple areas if he has never had it? If so, any recommendations such as not shaving to prevent this?

            g. is he more likely to get HSV 1 if he has an open cut?

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
8 months ago
I know it can be difficult to say 100% there is no lesion genitally especially for people with vaginas.

The first thing to know is if your partner is already HSV 1 positive, he is virtually risk free from acquiring your HSV 1 genital infection. 

What is risk of male partner getting HSV 1 orally, genitally, herpetic whitlow, ocular from me from:

            a. vaginal penis penetration with condom and me taking daily antiviral?

well under 0.5% per year. 

            b. vaginal penis penetration without condom and with me taking antiviral?

The same

            c. penetrating me fingers?

Zero

            d. From finger penetration, penis penetration, or oral sex when I have shaved my genitals?

The risk is very slightly higher when you shave, but it is already so very low, it may be meaningless


            e. touching clothes that were in contact with my genitals?

zero

            f. what is risk of further auto inoculation or spread from me to other parts of his body if partner does get HSV 1 from me? Is he more likely to get it multiple areas if he has never had it? If so, any recommendations such as not shaving to prevent this?

It does not change my answer from earlier - just about zero

            g. is he more likely to get HSV 1 if he has an open cut?

slightly more risk, yes


Terri

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7 months ago
Thank you Nurse Terri.

Is there a test you’d recommend for him to get done?

I was also wondering about the effectiveness of hand sanitizer to kill the HSV. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
7 months ago
Hand sanitizer should kill the virus, yes
Your partner could get an IgG test for HSV 1.  No IgM.  The best test is the herpes western blot but really expensive.  The IgG test misses 30% of HSV 1, but if positive, then it's conclusive if the positive index value is greater than 3. 
I'm going to close this thread now, but if you get his results or have more questions you want to discuss, you can always post again.

Terri
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