Hsv1 oral to genital transmission

[Sillybrain]

Hi,
Just a quick one about genital herpes transmission. I have had cold sores since I was a kid (bountiful outbreaks too) so I know I have hsv1 orally (have also had blood tests confirming this) What are the chances of getting hsv1 genitally from oral sex?
Had oral sex with my partner between 2.5 and 3 weeks ago and noticed he had a scabbed over cold sore (hidden in his beard) about a week after the oral sex. So I am guessing the oral sex happened either at the onset of the cold sore or just prior to.
I have not had any kind of physical symptoms of genital herpes, except for slightly raised (not sore) groin lymph nodes(which always seem to be slightly raised) (the ones under my arms are a bit tender too. I did have a sore throat, so I wonder if the glands are up from that), this lasted a day and occured over 2 weeks after the oral sex and an itchy bottom, where a previous hemmoroid has been and hangs around. The itch is similar to the hemmoroid itch. There are no lesions or any other symptoms like tingling, Itching, similar to that of a cold sore. Would I have seen lesions by now and the fact that I already have hsv1 orally, does that provide significant protection from getting hsv1 elsewhere on my body? Of course my brain has gone into silly overdrive over this as has my googling of this topic (there’s a lot of misinformation out there).
Thank you.

[Terri Warren]

The fact that you have had a history of cold sore provides virtual vaccination against you acquiring HSV 1 orally in a new location on your body. You can’t get what you already have. So put your worries to rest.

Terri

[Sillybrain]

Thank you so much Terri, the work you do to alleviate silly fears is amazing 🙂 Legend 🙂

I have read on other sites that there is a slim chance of contracting hsv1 Genitally even if you have had it orally for a very long time. How accurate is this information and should I really be paying attention to it?

I guess my concern is the possibility that he had an active sore when he performed the oral sex and I was unaware of this until a week later. I am usually very in tune with any twinges or itches etc down there after we engage in oral sex and I don’t recall anything untoward, however I wasn’t really looking. I’m afraid I may have missed any symptoms is all.

Such a silly thing to be worried about given I have been assured by a renowned specialist in this field. I am however feeling more confident that I’ve nothing to worry about.

Thanks again Terri 🙂

[Terri Warren]

In 33 years of practice, I have seen one person who was HSV 1 positive from a genital swab who reported – and that is the key word- a history of cold sores, and this was to another clinician in the practice, not me. I seriously doubt the reported history but let’s assume it was true – we have seen patients with known antibody testing and positive swabs and this is the ONLY one. From my perspective, that means the chances are so very tiny that it isn’t worth spending a lot of time worrying about it.

It is, of course, fine to ask!

Terri

[Sillybrain]

Thanks again Terri.

So I should really ignore the other information posted online about this situation. Most of this information is posted on un-reputable sites.

Could you just clarify what you mean about you have seen patients with known antibody testing and positive swabs?
I have had swabs done in the past on tears which have come back negative for genital hsv1 which adds further weight to my situation as does my extensive cold sore history as a child. My partner just seems to know when to get a cold sore to freak me out 😁
I can see it all and understand it so rationally, just some times hard to get the brain to follow suit.
Thanks Terri.

[Terri Warren]

I mean that someone who has a known history of cold sores (of which I am suspect), has a positive antibody test for HSV 1 and then presents with what they believe is a new genital HSV 1 infection that confirms as HSV 1 with a swab test.

Yes, I would ignore the other information that indicates it is possible to get HSV 1 in a new location after a long standing oral infection. Obviously I can’t say with 100% certainty that it never happens but if I was in your situation, I would not give this another thought at all. Not for a moment.

Terri

[Sillybrain]

Hi again,

Got some interesting news. I had noticed some itchy redness on my perenium and two splits on Sunday. I went and got them swabbed on Monday at a sexual health clinic in Australia. The results came back today, positive for hsv 1.

I guess I am a little bit shocked as the dr I saw on Monday said because I have suffered from oral cold sores since I was a child, I have immunity to getting hsv1 anywhere else on my body. Not quite sure how to take the news but I’ll get there. Guess I fall into that small group of contracting it genitally after having a well established oral infection.

[Terri Warren]

Well, that’s why I never say never. Let me ask – are you cold sores on the inside or outside of your mouth?

Terri

[Sillybrain]

Hello,
My cold sores have always presented on the outside of my mouth, on my lips or just above my top lip, never inside my mouth.
Do you think it is odd that these nicks presented so late (over 3 weeks after the oral sex) and were the only symptom?
What is the likelihood of the results being a false positive?
I’m just a bit shocked I think.
Any advice would be great.

[Sillybrain]

Sorry, I forgot to include in my last post.
These nicks are not at all sore, itchy or painful when I go to the toilet or in general. I have mucked around and touched them without any discomfort. Is this normal?
Also, my partner and I have had a fair bit of intercourse while they are present, again with no discomfort. Is he at risk of catching it genitally as well? Or what are the chances he already has it there given all that has gone on? The nurse that gave me my results said he more than likely has it already and we have bounced it between each other.

[Terri Warren]

I can understand that you are shocked – I’m a bit taken aback myself as this is only the second time I have seen or heard of this. I would say a false positive swab test is unlikely – possible, yes (I have definitely seen that) but not likely. And yes, I think the development of these is very late indeed. Herpes lesions don’t always hurt but when touched, my experience is that they are usually tender.

Given all of that, and the fact that your partner already has cold sores, I think it is extremely unlikely that he will now acquire it genitally (but we both now know that is not impossible). I would disagree that you are “bouncing it back and forth” – there is just no evidence for that at all.

How old were you when you started getting cold sores?

Terri

[Sillybrain]

Hello,
Not sure if I need to pay for another round of questions, please let me know if I do.

I found the clinic, especially the nurse to be rather dismissive and I did notice at the time, I don’t think the dr covered the Petrie dish with a cover, not that I recall seeing. He put it in a paper bag and took it to the lab for preliminary testing. He said they do preliminary tests to see if anything comes up in that time.I had to wait half an hour to see if anything came up in that time which he said nothing did and that it all looked ok. They said it would take a week for the results, I got them in 2 days, is that normal? And is preliminary testing like that normal or could that open up possibilities of contamination?
I went to another sexual health clinic a few days later for a reswab (waiting on the results), she covered the swab slides with a cover. She also said it didn’t look like herpes, rather dermatitis as my whole vagina was rather dry. Is there a possibility there was contamination with the first swab or that it may be flawed?

To be honest, previous thrush infections have been more painful, itchy and caused more discomfort. I could touch the nicks (which I did every day oops) with no pain, tenderness or discomfort. I could stretch the skin and be as rough as guts, and they didn’t hurt or twinge. Urinating, wiping, sex, nothing caused them to be painful, tender, itchy or sore.
Even when the swabs were taken and the Drs felts around there, I didn’t flinch.

They have gone in less than a week, no crusting, scabbing, just gone.

It’s just strange that I’ve not had a single typical or slightly typical symptom and that all advice points towards it not being herpes.

I have had cold sores since primary school (from 7 years old) nearly every school photo I have a cold sore and I found a picture of myself at the horse races, ten years ago, as a young adult, all prettied up, with a big old coldsore on my top lip. So I have had them for a very long time.

Thanks again Terri for your help.

[Sillybrain]

Hi,
I have purchased some more questions.
I forgot to add in my other post:
– when I noticed the mild itch, I was mucking around with the area with my fingers and nails when the nicks appeared. Could that plus the pulling on the skin have created the nicks? There was a hard small lump in the area too.
– I was mucking around with the area the morning of the test too, could that have an impact on the results?
Thanks.

[Terri Warren]

A petrie dish? They used a petrie dish for a herpes test? Where do you live? Not in the US? I also cannot imagine what preliminary herpes test they would have done. Maybe they were testing for something else? Lab testing might well have come back in 2 days accurately, yes. Do you know if it was a culture or a PCR test? I’m not sure about contamination in your situation. Did the doctor think it looked like herpes when they did the swab test? This is so odd really but I’m just not clear what happened here. You “mucking around” didn’t make a false positive swab test.

I am in Australia at an big STD meeting and I JUST heard someone in a lecture say having oral HSV 1 provides immunity against genital HSV 1. HMMMMMM.

Terri

[Sillybrain]

Hello,
Yep one of those little round plastic dishes was used. I recall seeing anything else, I remember watching him write my name with a grey lead on it. Lol, it’s funny the things you notice.
I’m in Australia. They were looking for something else too I think, haven’t gotten those results.
Did a PCR and he said that it looked like thrush, nothing like herpes at all. The second dr I went to said the same thing, doesn’t look like herpes but her swabs were applied to a slide.
Should I just wait until the second lot of results and take it from there?
I am as perplexed as you, Terri.

[Terri Warren]

I’m here in Australia with Anna Wald and we were talking about this situation today. We are both perplexed. I think maybe your doctor was checking for gonorrhea with the petri dish? But this is why we never say never. Things happen, there are outliers. And in reality, even though people don’t PRESENT with genital symptoms once they have oral ones, I guess we can’t say for certain if people might get it and and we just don’t know it because they never present with symptoms and no one swabs them. There is likely a lot of learn still about testing and perhaps infection.

Honestly, I’m not sure how to guide you but if you have HSV 1 genitally, then you do and you won’t shed often, far less than from your mouth.

Terri

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