QUESTION
I was recently diagnosed with genital herpes after suffering through a severe first outbreak. My new partner has herpes and five to six days after he gave me oral sex, I developed herpes on my genitals. He and I have been getting conflicting information about the likelihood of him being the one who passed it on to me. Doctors and clinicians have told him that it's rare that he could have transmitted the virus via oral sex without having a current outbreak. He was also told it's possible that I have had the virus for a while and am just now having my first outbreak. It seems to me very likely that he is the transmitter. Can you offer any information on the likelihood of passing Herpes I from mouth to genitals without sores? And what is the likelihood of having an outbreak within two weeks of infection versus carrying the virus dormant for an extended period of time before an initial outbreak?

ANSWER
Herpes can be transmitted from partner to partner without any symptoms. Your outbreak seems related to your recent exposure, although it's very hard to ever say for certain when a virus may have been transmitted. About 50 to 80% of the adult population in the United States have oral herpes.

The only way to prove that your current outbreak is new is to have a culture test of the genital lesions turn out positive right now, and a blood test for the same type of herpes being negative right now. If a second blood test a few months later turns out positive it would confirm that this is a new infection since the blood upon new infection takes time to become positive. Please note that these blood tests are expensive and not readily available.

If it is Herpes type I, recurrences are less common than in type two, which also argues for new infection over re-activation. However, with herpes, as with any STD, a diagnosis shouldn't be about the blame game. What it should be about is good communication between you and your partner(s), education about the disease and the best way to stay healthy, and limiting transmission to others in the future.

To your health,
Dr. K