Herpes: Is It Genital or Shingles? Key Insights

Q: Herpes: Is It Genital or Shingles? Key Insights

Hello： 1. <br>Can the incubation period be this long? --> It is possible. <br>2. <br>If I want to confirm whether it is herpes zoster or herpes simplex, where should I go for testing? --> You should go to a hospital for testing, but the results can only be used as a reference. <b

Uncertain whether the herpes was transmitted through sexual intercourse?

Hello, doctor.
In August 2020, I experienced itching and a burning sensation at the base of my penis, scrotum, and both sides of my buttocks.
Subsequently, I developed crusting at the base of my penis and scrotum, along with neuropathic pain.
I visited a dermatologist and was diagnosed with "herpes zoster." However, after researching on my own, I suspect it might be genital herpes (herpes simplex).
I recall that I had my first sexual encounter in July 2019 (and had no sexual activity until the onset of symptoms).
At that time, I only had oral sex without a condom and vaginal sex with a condom (heterosexual).
I'm uncertain whether the lesions in August 2020 were caused by this infection.
I would like to ask: 1.
Can the incubation period be this long? 2.
Where would you recommend I go for testing to confirm whether it is herpes zoster or herpes simplex? 3.
Is this contagious to family members? Should I avoid sharing utensils and clothing?

Niming, 20~29 year old female. Ask Date: 2021/06/20

Dr. Du Shixi reply Urology

Hello: 1.
Can the incubation period be this long? --> It is possible.
2.
If I want to confirm whether it is herpes zoster or herpes simplex, where should I go for testing? --> You should go to a hospital for testing, but the results can only be used as a reference.
3.
Can this be transmitted to family members? Should we avoid sharing utensils and clothing? --> There is a chance of direct transmission when there are blisters, but the risk of indirect transmission is low.
It is advisable to avoid sharing clothing as much as possible.
Wishing you good health.
You can refer to https://hlm.tzuchi.com.tw/mt/index.php/item/2019-03-16-06-47-24/611-item-herpes-simplex-virus.

Reply Date: 2021/06/20

More Info

Understanding herpes, particularly distinguishing between genital herpes (caused by herpes simplex virus type 1 or type 2) and shingles (caused by varicella-zoster virus), is crucial for effective management and prevention of transmission. Based on your symptoms and history, let’s address your questions in detail.

1. Incubation Period: The incubation period for herpes simplex virus (HSV) can vary. For genital herpes, symptoms typically appear within 2 to 12 days after exposure to the virus. However, in some cases, the virus can remain dormant in the body for years before symptoms manifest. This means that while it is uncommon, it is possible for you to experience symptoms long after your initial exposure, especially if the virus was latent and reactivated due to stress, illness, or a weakened immune system. In the case of shingles, the virus can reactivate years after the initial chickenpox infection, often presenting with localized pain and a rash.

2. Testing for Confirmation: To determine whether your symptoms were caused by shingles or genital herpes, it is advisable to consult a healthcare provider who specializes in infectious diseases or dermatology. They may recommend a viral culture or polymerase chain reaction (PCR) test from the lesions to identify the specific virus. Blood tests can also be performed to check for antibodies against HSV-1 and HSV-2, which can help determine if you have been infected with genital herpes in the past. If shingles is suspected, a similar approach can be taken, focusing on the varicella-zoster virus.

3. Transmission Risks: Both herpes simplex virus and varicella-zoster virus can be contagious, but the modes of transmission differ. Genital herpes can be transmitted through sexual contact, even when no visible sores are present, due to asymptomatic shedding of the virus. Shingles, on the other hand, can be transmitted to someone who has never had chickenpox or the vaccine, leading to chickenpox in that individual, but not shingles.
In terms of household precautions, it is generally safe to share utensils and clothing with family members, as the risk of transmission through these means is low. However, it is advisable to avoid close contact, especially during an active outbreak of genital herpes or shingles, until the lesions have healed completely. This includes refraining from sexual activity during outbreaks and being cautious about skin-to-skin contact.

In summary, while your symptoms could suggest either shingles or genital herpes, the definitive diagnosis requires appropriate testing. It is essential to consult a healthcare provider for a thorough evaluation and to discuss any concerns regarding transmission to family members. Understanding the nature of these viruses and their transmission can help you manage your health and prevent spreading the infection to others.

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