Screening for Genital Herpes

Screening for Genital Herpes

There are 2 types of test for Herpes:

  1. Blood test – for people without symptoms

  2. Swab test – for people with skin symptoms like rash, ulcer, blisters etc

If you wish to have a test for Herpes, please visit any one of our clinics. We use gold-standard testing methods and provide a discrete, comfortable and 100% confidential setting for our patients.

Genital Herpes is very common and is incurable. Herpes infection of the genitals can be caused by either Herpes Simplex Type 1 (HSV 1) or Herpes Simplex Type 2 (HSV 2).

Previously, Herpes was mostly diagnosed via physical examination of typical symptoms and confirmed by testing swab samples taken from the blisters. However, since up to 80% of people with Herpes do not show any symptoms, this method misses out the vast majority of people who carry the Herpes virus.

Previously, blood tests for Herpes were extremely inaccurate and almost impossible to interpret. Now however, newer blood tests have greatly increased in accuracy thus giving us the option to screen for asymptomatic Herpes infections.

However, before you run to your doctor’s and request for a blood test for Herpes, there are certain things you should know about.

How accurate are Herpes blood tests?’

About 96% sensitive and 97% specific. In other words, if the test says you do not have Herpes, it is wrong 4% of the time and if it says that you do, it is wrong 3% of the time.  This is when the Index Value comes into play. If the Index Value is more than 3.5, it is extremely likely that it is a true positive.

Of course, the gold standard for Herpes antibody identification is the Western Blot but that is not available in Singapore. Even then, the accuracy only reaches 99%.

Please remember that all the above only applies to people with no symptoms. If you do get symptoms, you should see a doctor for a swab test.

What are the symptoms of Genital Herpes?

Classic textbook symptoms are a cluster of painful blisters appearing in crops of 3 to 5 that break and form ulcers. Several crops would appear over a few days. Initial attacks can last up to 3 weeks. The blisters are always surrounded by red skin earning them the rather romantic name of ‘dewdrops on a rose petal’.

However, symptoms are not always classical. Herpes symptoms have been misdiagnosed as yeast infections, urinary tract infections, razor burn, insect bites, friction rubs, allergic reactions etc

When should I test for Herpes?

Antibodies to Herpes can usually be detected in 2 to 3 weeks from the time of infection. However, detectable antibodies can take up to 16 weeks to appear.

Can I swab normal looking skin to look for Herpes?

Yes you can. In fact, there was a study that used this method to determine the frequency of asymptomatic viral shedding of Herpes. But since it is estimated that the virus only sheds 20% to 25% of the time, you will need many swabs in order to get an accurate answer. This can be very costly.

How effective are condoms against Herpes?

Apparently not very useful at all. There was one study that said consistent and correct used of condoms provided 30% protection against Herpes.

How effective is suppressive treatment in preventing Herpes transmissions?

We do not really know. Studies have quoted anything from 48% to 71% reduction in risk of transmission. So we know that it does reduce the risk of transmission. And since these medicines have very few side effects if at all, and are rather low cost, doctors are advised to at least speak to their patients about the option.

So should I test for Herpes if I have no symptoms?

This is the golden question. Everyone can deal with a clear result. So if you test and the test shows you have no Herpes infection, all is well and good.

The question to ask yourself is can you deal with a positive result? Getting a positive Herpes test can be emotionally overwhelming. So you need to ask yourself what will you do if you are tested positive. If you are doing the test for a specific reason like you intend to take suppressive treatment to protect your spouse if you are positive etc then I think that is a very good reason to test. In other words, the test results will make a difference in clinical decision making. If you are testing because you just want to know, then please be emotionally and psychologically prepared to deal with a positive result.

Also, you have to bear in mind that the blood test can only tell you if you are infected with Herpes or not. It does not tell you where the infection is. If you test positive for HSV 2, then most likely you have genital herpes. This is because HSV 2 mostly infects the ano-genital region. However, HSV 2 has been found in the head and neck area too. HSV 1 is much more complicated as it can infect both areas just as frequently. If there are no symptoms, it will be impossible to determine where the Herpes infection is.

Follow this link for more information on Herpes.

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About Dr. Tan
Dr. Tan graduated from the National University of Singapore in 2001. His residency was in the two largest public hospitals in Singapore; Tan Tock Seng Hospital and Singapore General Hospital.

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93 Comments

  1. Dctr, i gone for test after 9 days exposure.

    And my IGG reading shows positive for HSV1. Does the antibody builds in such short timing?

    Or i was infected before this exposure?

    Can answer me?

    • No, it will not be so fast. HSV-1 is extremely common and you probably picked it up earlier in your life.

      • Confirm won’t appear so soon? I don’t have any symptoms previously but now i got small blister on my tongue. Not on the lips.

        Minor swollen lymph node on the neck.

        • No, HSV antibodies do not appear so fast.

          • Can explain what is happening to me here? Based on my IGG reading from Gribbles Lab and also private hospital.

            9days
            H1-6.8
            H2-6.0

            7weeks
            H1-8.4
            H2-0.0

            13weeks
            H1-12
            H2-0.0

          • Doctor, can you give me a conculusion to my results of what’s happening to me?

  2. Hi.

    Herpest Test IgG can test for the past infection?

    Example: If the person been infected two years ago, He still can be Test Positive for IgG now ?

    And What is the different between IgG and IgM?

    Thanks

    • Yes, IgG will demonstrate any previous exposure/infection. Herpes virus stays in the body for life so once you have contracted it, your IgG will always be positive. IgM is for acute infection stage.

  3. Hi. Can we get HSV 1 from an ENT Test Endoscope? If Yes, How Dangerous Is HSV 1? Thanks

    • I do not believe you will get HSV-1 from an ENT endoscope as all instruments should be properly sterilized before use. HSV-1 is very common and over 40% of the population would have been exposed already, usually in childhood. Overall it is not dangerous but of course there can be serious HSV infections such as meningitis or conjunctivitis.

  4. HSVTYPE1

    Doctor, i recently diagnosed with HSV Type 1 with IGG positive reading. I have few questions here where i hope can get soonest feedback from you.

    1. I got few blisters/ulcer at different spot inside my mouth. Any STD risk transmission by saliva spit into my mouth from surrounding unknown person when they are talking or by food? Not thru any sexual activities.

    2. Can herpes eye can just happen if there’s no touching of the sore from mouth to the eye by self transmitted? Just wanted to know the possibility.

    Hope to get your answer here. Anxiously.

    3.

    • No, you will not get any STD transmission just through talking or food. HSV eye infections also require direct contact with an infected surface.

      • HSVTYPE1

        Thank you for the answers here.

        Can i know how to read IGG reading for herpes? Whether am i recently been infected or after long time since i was a child?

        Above 20 points was positive, i got 240 points.

        And what could be the cause of meningitis?

        • You cannot determine when you were infected from IgG testing. HSV meningitis/encephalitis can occur if there is spread through the blood or nerves. It is rare and is much more likely to affect people with lower immunity such as young children, elderly, or those with other immunocompromised states.

          • HSVTYPE1

            Doctor,

            May i know any supplement i can take to prevent ocular herpes and meningitis to happen?

            Vitamin C? Lysine? Echinacea? Does online source reliable for me to take?

            As I don wan to take any anti viral as I’m afraid it will affect my liver.

  5. friend

    Hi Doctor, i went to the gp today because i was having severe pain in my genital area. it hurts a lot whenever i pee. the doctor took a look at my genitals and said there are some white ulcerations and said that i have herpes. however no testing was done. just a visual check and she prescribed me some medication. do you think i shld get a herpes test done to confirm whether it is indeed herpes? what about my husband? should he get tested as well. thank you

  6. HSV CURIOUS

    Dr tan,

    Does hsv can be transmitted by saliva spit? When an infected person talking to another..

    • Not by talking or spitting.

      • HSV CURIOUS

        Any supplements i can take to reduce the outbreak? Can i have family and baby like normal people?

        • A strong immune system will help reduce the frequency of outbreaks. You can also discuss suppressive therapy with your doctor. You can have a family and get pregnant as per normal. The only risk may be during delivery which you can speak to your doctor about.

          • HSV CURIOUS

            Thank you for your reply. Is there any medicine i can get from pharmacy? I don’t wish to see doc for this.

          • Unfortunately, for safety reasons I cannot advise on what to put on the lesion without evaluating it first. Certain treatments have potential side effects/toxicity and so should be prescribed by a medical professional.

          • HSVCURIOUS

            Any prevaution i should take? As i have HSV1?

            Will sleeping together or sharing bed sheet transmit to my partner?

          • No, sharing bed sheets will not transmit the virus. Only direct contact with an infected skin/mucosal surface area.

          • HSV CURIOUS

            Doc, can herpes transmitted by using the same bed sheet?

          • HSV CURIOUS

            DOC,

            ANY POSSIBLE INFECTION BY SALIVA SPIT INTO EYES TO CAUSE OCULAR HERPES?

            HAVE YOU HEARD OF THIS BEFORE?

          • No, the risk is extremely negligible. You need direct contact with an infected surface.

  7. sandep

    Dear Doctor
    i have taken Herpes simplex virus (HSV)1+2IgG, Serum (CLIA) test at 47 day after exposure and my index value is 0.50. Result is non reactive. In report index value is less then 0.90 is non reactive.

    how chances it will be change after 90 days please comment i wait.
    Thanks in advance for comment

    • It is a good indication but not conclusive. Herpes antibodies would be present in up to 90% of people at 3 months.

  8. Misnay

    Since the accuracy for Herpes are 96% and 97% and 99% for Western Blot, mean nobody in this world can claim that they are 100% uninfected 100% ?

    • I suppose this can be said of all tests which do not boast 100% sensitivity and specificity, but it is not a very practical way to live is it?

  9. Hi, when you mentioned about blisters occurrence in your article above, at which part of the body are you referring to?

    • Dear thw

      It is referring to genital Herpes (eg : penis, vagina ). Although, herpes can happen on other parts of the body eg: oral , anus

  10. Little Miss Worried

    Hi doctor, I’m a virgin but had given unprotected oral sex to my partner, also a virgin. I noticed little white bumps on the lining of my lips right after giving him a blowjob and it has formed into yellowish pus now (Day 6). Could it be oral herpes? If yes, how and why because we’re both virgins. Would you recommend me to do a HIV/herpes test?

  11. Hi Dr, if someone who has been tested positive for HSV type 1, assuming the infection was on the lips, is it risky to kiss that person briefly for 2 seconds on the lips?

    And what are the chances for genital-to-genital transmission of type 1 HSV?

    Thank you.

    • 1. Yes of course. HSV 1 on the lips is passed by kissing. What the difference in risk is between a 2 second kiss or a 3 second kiss or a 10 second kiss I do not know.
      2. If a person has HSV 1 of the genitals and has active symptoms, the risk of transmission is very high.

      • Hi Dr, thanks for your reply. For question 2, if the person does not have any active sores or symptoms and we have protected sex, what are the risks? Is it very high due to asymptomatic shedding?

        Is there a likelihood that I will contract HSV 1 orally if I avoid kissing someone on the lips but choose to kiss her on the cheek area as well as lick her on the neck area? I’m guessing the upper neck area is considered the facial area and asymptomatic shedding can occur there?

        Thank you.

  12. Hi Dr. Tan, I would appreciate some advice. I was considering treating myself to a tantric massage from an outcall service in Singapore from two masseuses at the same time.

    Given that I would be naked, and they would be rubbing their bodies on me (either in their underwear or naked), and thus there would be skin to skin contact of my buttocks, my thighs, and genitals when facing upwards, along with them giving me a handjob,

    Is there a chance of getting herpes? Would the masseuses definitely be clean so to speak coming from an outcall service from an online tantric service?

    I am a virgin and would like to experience a relaxing massage, but at the same time, I wouldn’t want to risk my future happiness and health if there was a really high risk?

    Also I have immunocomprised folks at home so wouldn’t want to risk them if I caught anything out there?

    • Yes there is a chance of getting Herpes. I do not know what your definition of “clean” is. Herpes is very common. Many people from all walks of life carry it. If your definition of “clean” is someone without Herpes then 90% of the world’s human population is unclean.

  13. Hi Dr.
    Will I get herpes from hand job thru a massage lady?
    If so, what test will you recommend and when should I go take the test?

    • You can if she has a Herpes outbreak on her finger (called a Herpetic Whitlow). I do not recommend screening unless there are symptoms. This cannot be taken as medical advice. Please see us for a formal consult on testing for herpes.

  14. Dr Tan, on day 25, i got the blood taken at your clinic and the result are:
    HSV TYPE 1 IgG = 0.09 and HSV TYPE 2 IgG = 0.26. Base on the result above, my questions are:
    1) what is your view and comment base on blood taken on Day 25?
    2) do you think that it will change at 3 mths?
    3)

    • drtan

      1. You are not infected with HSV
      2. It might

      • Dr Tan, as regarding to your anwer number 2, do you have any stastical number to comment base on your knowledge or journal?

  15. Hi Doctors.

    I’ve history of herpes outbreak 12 years ago treated and the symptom is gone. Suddenly a few weeks back, painfull blisters strikes back.

    1)It is possible?
    2)Pls advise me what should i do? Should i tell my wife?

    • 1) Of course it is. HSV stays with you for the rest of your life.
      2) Please see a doctor to get yourself checked and treated. Whether or not to tell your wife is your decision and your responsibility. If you are asking for our opinion, then yes, it is best to inform your sexual partner so things can be done to reduce the risk of transmission.

  16. Worried

    Doc I tested myself for herpes 1 and 2 and the result came back as positive.But this test did not interpret that whether this is herpes 1 or 2.I have not faced any severe symptoms.I had 3 pimple like things around my lip and those were filled with yellow fluid.From there I had tested for herpes.Just few days back I had cold sensation in my genital area.I looked carefully at my genital area there was no red spots or sores in my genital area.I am now worried .Igm for herpes came back as negative but igg for herpes came back as positive.What does this mean.Do I need treatment for this ?

  17. Worried

    Doc i had a herpes Igg test for 1 and 2 and the value came back as positive,i dont know if it is type 1 of herpes or type 2 as there is written on my report that it is test for Herpres IgG 1 and 2.my value came back as s/co ratio37.7 poitive and the test was performed on immulite 2000 instrument,chemiluminescent based.My question is how would i know that that if i had type 1 of herpes or type 2 of herpes .I had 3 pimples on my lips just above the top of the lip so i can assume that it might be type 1 of herpes?Please guide me what to do now?I have read that herpes is not fatal or serious disease and also that person can get marry and have chuldren.I am 23 years male and i want you to guide me properly.I also had a cmia ag/ab hiv test after 9 weeks from possible exposure.Tell me what is the accuracy of cmia ag/ab test after 9 weeks?Treat me like you younger brother i really need your help?Besides this i also had iGm herpes test and it came as negative but Igg antibodies test for iGg came back as positive?I did not have serious pimples and i have not faced or saw and pimple like thing on my gentials ?Please guide me ?

    • worried

      please doc reply?

    • It is usually very clear which herpes is positive (on your result). I am surprised your doctor did not explain this to you.
      Pimples are not caused by herpes. Herpes I typically causes painful cold sores/ulcers around the lips and oral cavity.
      Even if you have herpes I or II, you can still get married and have children. It is not a fatal disease.
      Your HIV test is accurate after 9 weeks.
      IgG positive means that you may have got infected more than 3 months ago.

  18. i need cure for herpes

    • Dr Elaine Loh

      Unfortunately there is no cure for herpes. We can only treat the symptoms and suppressive treatment to prevent transmission

  19. I had uprotected oral sex and kisses before 11 days. From yestrday i had ulcers in my mouth. If i do a herpes blood test is accurate now?

    • It will not be accurate. You can either do a ulcer swab test for herpes now, or wait for at least 1-2 months to get a blood test done.

  20. worried

    Hi Doctor,

    Like to check on the possibility of the below.

    1. Can we get hpv if our nipple is being sucked.

    2. What sort of STD can we get infected from a handjob, sensual massage when the the massues uses her exposed breast to seduce your naked body.

    • Dr Justin Sim

      1) No
      2) None. You need sexual intercourse of some sort for STD transmission.

      • Hello doc, i don’t know if my sores are because of going to a massage where she gave a handjob. I touched her breasts and thighs as well.
        Around 2-3 weeks back I went to massage parkour,, now suddenly I had yellow sore with red sorround on my middle and index finger of left hand- back side…
        Next day, I had a big yellow ulcer on my right calf followed by small sores on thigh and arm…..
        Went immediately to gp, he said its hand foot mouth disease but I am worried now as it’s been 4 th day and I don’t see them going but small one showing some or other place,,, don’t have anything as of now at genitals or mouth but I am worried what it could be,???
        Please share your advise

        • Dr Justin Sim

          I can’t tell you what the sores are without being able to examine them. I can say that STDs do not pass this way. You should see a doctor in person and get this looked at.

  21. Hi doc,

    Please explain must apply lots of swabs to get accurate info.
    Im gettin confused as i did a hsv pcr swab test on the area i think might be infected( pimple like surface on my penis head). If it is just a normal pimple, do i have to retest again and swab the correct area i think high probably could be herpes sores/blister?
    2) how long will i have to wait to get the result.did my swab hsv pcr at ur robertson on 10/6/15.

    Thank you

  22. Dear Dr Tan,

    I have been told by my doctor i have herpes, currently waiting for appt at the STD Clinic. I already have the sores, blisters, pimples like rashes. N feel pain during passing urine. What should i do?

    • If your symptoms are quite severe and you are experiencing a lot of pain and your appt with the STD clinic is still quite a wait, then I would advice that you see another doctor or try and get an earlier appt as you should start treatment as soon as possible otherwise your symptoms may get worse. You are also welcome to visit us for treatment.

  23. worried expecting mom

    Hi Doctor,

    I just found out that my maid has boyfriend and I am afraid that she is sexually active. I am currently expecting and recently I read an article about a baby that died due to cold sores (herpes). Since she will be helping me to take care of my baby, this news makes me feel very worried.

    So should I bring my maid for herpes test? Is there any other test that you recommend? And what should I do if the test comes out positive?

    Thanks.

    • Dr Justin Sim

      If you want to be sure that your maid is clear of Herpes then you should have her tested. If you want to be thorough we would recommend screening for other STDs. At least if she is clear from those then you can have peace of mind. If the tests are positive we can advise when the results come out.

  24. Getting confused.

    Hi Dr,

    I’m a little confused by the info I have read regarding on “When to test” for herpes. You said it is detectable by 2 to 3 weeks but it can take up to 16 weeks as well. So should I go for testing by 16 weeks or by 12 weeks is good as conclusive?

    • What we state here are medical facts based on current medical data. As for when you need to screen, this depends on your particular clinical scenario. For this kind of specific medical advice, you should see your doctor. You are of course welcome to visit any of our clinics.

  25. so confuse

    Could someone be affected due to bad gum viruses that’s not related to any STD?…, if oral sex was preform?…. thanks for your help.

    • Dr Justin Sim

      If you have poor oral hygiene then you may be more prone to pick up certain STDs since the body’s own defence barriers are broken.

  26. My partner has genital herpes HSV2. If I give him unprotected oral sex, will I get infected in my mouth?

    • Yes you will. Your mouth and anywhere on your face. HSV 2 can infect the mouth and face just like HSV 1 can infect the genitals. The “good news” is HSV 2 in the mouth and face causes fewer recurrences and less severe symptoms compared to HSV 1.

  27. Needed help

    Dr Tan,

    Will a person HSV 1 positive in the mouth region get infected with HSV 1 at the genital area if an oral sex act is perform by a person who is also HSV 1 positive in the mouth region.

    Also, will a person (herpes positive) without any out break infect others (age 3 months and above) by kissing on the cheek and forehead.

    Hope you may clarify me on this. Thank you.

    • You are asking me if having oral HSV 1 will provide protection against genital HSV 1? It does decrease the risk because of the presence of circulating antibodies but this is not 100%. If a person has HSV 1 of the mouth, he/she can easily pass it to others (including children) via kissing. This is also possible when there are no symptoms. This is because a person is shedding HSV virus even when there are no symptoms. This is called asymptomatic vial shedding. This is the reason why HSV 1 is so rampant in the world.

  28. Dear Dr. Tan,

    I had an outbreak for either HSV-1 or HSV-2 around 9 years ago. Never had any outbreak after 7 years ago. What do I need to know and what test should I take to prepare for premarital check? Anything I should do to prevent negative impacts for my marriage and children later? I don’t know much about this and the information I have read is various about herpes. I don;t really know my condition, what I know is I had a big outbreak 9 years ago, mild ones came after, but very one or two and never had any outbreak for these 7 recent years. I took Hepatitist A and B and cervix vaccine in Tan Tock Seng. Please let me know what I should do. Thank you.

  29. Hi Dr Tan,

    I visited a massage parlour on 4 January 2015. I was without clothes. She was not wearing anything on top but her pants was on. I got a massage, a happy ending (by hand only, and i kissed the messauer on her cheeks only plus hugged her.

    After a few days, I feel that my body is very itchy, some pimples (some looks like pass, some look like red rashes – all small in size),my throat is dry, my urine is dark yellow in colour plus at times i feel some pain at the tip of my penis. my groins also itch at times.

    Is the a chance that i could have contracted herpes or any other std? Urgently need your comments. Thanks.

    • Your symptoms certainly sound sinister. I cannot make a diagnosis over the internet. Please see your doctor.

      • Hi Dr Tan,

        Thanks for your reply. Can this be serious? What checks will you recommend me to do?

      • Sebastian

        Hi doc,

        One week ago I had unprotected oral sex with a massage lady. The massage lady did analingus on me for some time. I fear I may hv herpes from this encounter.
        1. Does the increase length of exposure increases the chances of herpes.
        2. Which has a higher chance of being infected with herpes? Is it analingus or receiving a fellatio?
        3. What is the percentage of catching herpes via analingus if the lady did not show symptoms assuming she has oral herpes?

  30. Help Needed

    Dr Tan,

    Can I get a test 1 week post exposure?

    • You mean for herpes? The blood tests will be inaccurate. If you have blisters or sores, you can see a doctor for a swab test.

      • Help Needed

        Thank you for the reply Dr.

        In that case will 4 weeks suffice?

        Is a HSV TTST test the same as an IgG test?

        • I think a HSV test at 4 weeks is very good. However there have been reports that some tests or patients take up to 16 weeks to become positive. TSST is a type of IgG test. Not all IgG tests are TSSTs.

  31. Need Help

    Hi DrTan. I would like to know will the herpes test after 6 weeks of exposure be conclusive? If I had a chicken-pork vaccination will this affect the outcome of the result.

    Thank you.

    • Rarely it takes up to 16 weeks. The chickenpox vaccine can make the HSV 1 sero false positive.

      • Need Help

        Thank you drtan. In this case how may I be able to determined if I was infected with Herpes if there is no symptoms at all. What about HSV 2 will the chickenpox vaccine effect the result for HSV 2 too. However I was given chickenpox vaccine more than 10 years ago.

        Kindly advice me which screening test should I be doing to avoid false positive result.

        Thank you once more for your kind advice.

        • Since you do not have symptoms, I think you should not screen. If you really have to screen, do a HSV TSST Antibody test.

          • Need Help

            Thank you for the advice doctor. I would like to do this test is because would like to prevent the virus from spreading to my love ones. However may I know where can I get the HSV TSST antibody test in Singapore? Do your clinic provide this test, if yes may I know the cost for the test and how long will I get the result?

          • Yes we do. $80 before consult and GST. 1 week for results.

  32. Hi doc, I noticed there wasn’t any genital warts test over at your clinics. Therefore, I will like to ask is genital warts test available here and also does this a life threatening infection? I have read some articles mentioned that your body immune system will totally clear the genital warts virus away over a few years. Is that true? Thank for your advice in this matter.

    Regards

    • The diagnosis of genital warts is made clinically (i.e. by looking at the lesions) rather than tests. There is a simple test we can do if we are not sure and that is to put a chemical on the wart and see if it changes color. Rarely, we cut the wart off and send it off to the lab for histological examination to confirm the diagnosis. The test we have for HPV is for the cancer causing types and not the wart causing types. Warts is not a life threatening disease. But HPV infection with the cancer causing types may be if the patient does develop cancer. It is true that 80% of people will clear HPV from their systems within 2 years.

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