Two nights later I started getting a fever, chills, and fatigue symptoms along with some random muscle contractions in legs/butt. However I never got any sores (that I could find), and no painful urination. It's been >2 weeks now and still no sores. I also already have o/ghsv-1 for over 10yrs. No genital symptoms, only oral.

Further backstory is that I was in crowded bars with this girl that night, and the next night. Additionally I was in a minor car accident the night after our encounter which gave me whiplash and a concussion and had me in the ER for a check-up. So it's possible the flu-like symptoms are related to this other stuff. But given I can't get tested for at least 6 weeks to be accurate, I'd like to put my mind at ease - if possible :). Note my at-home COVID test was also negative.

So, my questions:

-What are the chances I could contract HSV2 and have a fever, but no sores?

-Could having ghsv1 have protected me from getting ghsv2 sores despite an infection?

It's a good thing that you didn't get sores - that would tell us a lot more about what's going on currently if you had and it would suggest a herpes infection.  the flu-like symptoms you experienced could be due to so many things, I really just don't know at all if this could be due to herpes.  We know that people who have oral and genital HSV 1 infections, who acquire HSV 2, usually have milder symptoms when they do so or none.  It isn't clear that your HSV 1 infection would offer any benefit in terms of not acquiring HSV 2, but the genital infection might.  

Are you at all able to contact this partner and ask about HSV status?  That would certainly be helpful if you could. 

I don't have any odds about you getting infected at two unprotected encounters and one that was protected.  We know that condoms reduce the chance of infection from female to male by about 65%. 

Terri

I can try to contact, and that is a good suggestion. Though I just haven't yet because I didn't want to raise alarm or accuse her of this without some justification.

As for testing, how soon could I get in and get an accurate test given that this occurred 9/2? This has definitely been weighing heavy on my mind and to know one way or other could help me either move on, or begin the acceptance phase here.

Thanks!

Terri

For context, over the past couple weeks I did manage to get in touch with the new partner and she says she does not have HSV2 and was tested after our encounter - all negative. However, well after the fact, I realized I should have asked if this was by blood testing and how long since her last partner. If I get another chance, I will ask this. Anyway, I also went to see one of your old partners, Sheryl Horowitz, as I live in Portland (she's great btw!). She gave me a confirmation that no sores were present and gave me a blood test just to easy my mind and check if I had a prior infection to this most recent partner - I will repeat at 12wk mark. My 4wk blood test was neg. 

Alright, to the questions:

1) Right now my main concerns over HSV-2 infection are my 3-4d fever/chills episode 2d after exposure, and now about 2-3wks of mild irritation at the tip of my urethra. It is pretty constant and I can seem to irritate it by touching the opening on my penis. No redness though, and Sheryl confirmed no Herpes-like lesions are present. Her take was this doesn't sound like a herpes symptom. However I have read on some online H-forums that other men have described similar symptoms persisting for months after becoming positive for HSV2. Does this symptom worry you in terms of HSV2? Perhaps a possible nerve-reaction I should be concerned about?

2) If this irritation could be HSV2 related, should I assume the virus is active in this region and be careful with sex - not that I plan on any more sex before my next test. But I'm moreso curious for long-term should this be HSV2.

3) Oral sex was also performed at this encounter, do you have any risk assessment for getting oHSV2 with an outstanding oHSV1 infection?

4) Also assuming I do find I'm pos for HSV2, since I had a previous gHSV-1 infection, how should I communicate shedding risk to new partners? Would you guess they are additive (ie 25% shedding for HSV2 + 5% for HSV1 for total of 30% viral shedding?)

5) Lastly, and again assuming the worst here with HSV2, I read that recent studies showed condoms prevent HSV2 transmission 90+% male to female. So if I assume unprotected, no antivirals risk is 10% per year, is it correct to assume with condoms this can be communicated to be ~1% per year and ~0.5% with antivirals? I want to ensure I'm not misleading anyone, but also provide positive news if I can!

Thanks a lot for the help Terri!

1) Right now my main concerns over HSV-2 infection are my 3-4d fever/chills episode 2d after exposure, and now about 2-3wks of mild irritation at the tip of my urethra. It is pretty constant and I can seem to irritate it by touching the opening on my penis. No redness though, and Sheryl confirmed no Herpes-like lesions are present. Her take was this doesn't sound like a herpes symptom. However I have read on some online H-forums that other men have described similar symptoms persisting for months after becoming positive for HSV2. Does this symptom worry you in terms of HSV2? Perhaps a possible nerve-reaction I should be concerned about?

It concerns me only mildly.  Many people have those symptoms and don't have herpes - in fact, most.  I do understand the chills were concerning, but mostly that is caused by other things if no herpes lesions are present. 

2) If this irritation could be HSV2 related, should I assume the virus is active in this region and be careful with sex - not that I plan on any more sex before my next test. But I'm moreso curious for long-term should this be HSV2.

If the symptoms are due to HSV 2, which we don't know at all that they are, but if you do have HSV 2, then yes, I would recommend avoiding sex when those symptoms are present as they could be prodrome.

3) Oral sex was also performed at this encounter, do you have any risk assessment for getting oHSV2 with an outstanding oHSV1 infection?

That is not something I would think you realistically need to worry about

4) Also assuming I do find I'm pos for HSV2, since I had a previous gHSV-1 infection, how should I communicate shedding risk to new partners? Would you guess they are additive (ie 25% shedding for HSV2 + 5% for HSV1 for total of 30% viral shedding?)

I wouldn't agree.  Once you have HSV 1 for at least two years, your shedding goes down dramatically.  And the shedding rate for HSV 2 also goes down over time and some people shed more than that and some less.  HSV 2 would clearly be the bigger worry

5) Lastly, and again assuming the worst here with HSV2, I read that recent studies showed condoms prevent HSV2 transmission 90+% male to female. So if I assume unprotected, no antivirals risk is 10% per year, is it correct to assume with condoms this can be communicated to be ~1% per year and ~0.5% with antivirals? I want to ensure I'm not misleading anyone, but also provide positive news if I can!

10% is the risk with nothing, condoms reduce transmission by 96%, antiviral meds another 48%. 

I hope you will continue to see our Sheryl for a western blot when the timing is appropriate

Terri