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Shang Hai'd in Shang Hai - Please read - Prevention !!!!
Dec 1, 2007

Dr. Bob,

It was a relief to find The Body, especially your forum; you provide information with wit and humor that is greatly needed.

I wanted to share what happened to me so hopefully others may learn form my experience and take or at least be aware of some preventative measures they should take when you are in an unfamiliar environment. Regardless if you are straight, gay, promiscuous or not, the following is worth keeping in mind:

1. Try to really know who you are with traveling abroad or not. 2. Identify the intention of who you are with, and if you do not want to participate, act on your gut feelings and get out of the situation quickly, business or friendship loss dont compare to your physical wellbeing. 3. Be very aware of the environment around you, you can quickly become a target. 4. Be immunized to viral risk, I thought my risk for Hep A or B would be from a potential infusion after a traffic accident in the remote places I travel, not the following.

I work in the Healthcare industry, and over the past 20 years I have traveled in Asia quite frequently. I am also familiar with Blood borne pathogen guidelines and after being in areas that had contaminated blood supplies, (and driving where there are no rules) I decided to be immunized for at least Hep A & B.

My story starts when I was traveling with a business acquaintance in China. After working late one evening, we went to a Bar area that was not familiar to either of us. After going through a few of the Bars, we ended up at a little raunchier than normal Karaoke Bar that are very common in China. The young ladies typically sit next to you; give you beers, talk, generally nothing beyond that from my previous experience.

I soon learned that my business acquaintance clearly wanted to bring the young lady back to the Hotel, and I thought that it was no big deal, thats his decision not mine (Im married kids minivan dog . (Monogamous since marriage for several years)). So at this point were ready to leave, so I went to the rest room, when I came back to the table, they had set me up with a mixed drink, so I thought one more before we go. (At this point I had had 4 beers from bottles over about two hours)

Next thing I know, Im very dizzy, cant talk or think and zero inhibitions, pretty much a zombie. The young lady - now sex worker - starts saying all kinds of stuff including your friend say we go, I go too. Long story short, I wish I had passed out! Im not sure what date rape drugs do or what I was given, but it was bad, at least for me I could remember most of what happened, but I just didnt care, I definitely have issues now remembering and at times thinking, this is not right, but not acting to somehow get out of it.

What I do know for sure is that I was exposed to some amount of blood through unprotected oral and protected (? Latex) vaginal sex. The next morning there was a significant amount of blood on the bed (pie plate size spot) were both acts took place, she did vomit then came back so there was some exposure during oral and the majority of the blood was from the vaginal (menstrual blood or another issue). The next day I felt obviously felt mentally and physically terrible, face and hands were numb and no appetite, seemed the numbness was obviously from drug wearing off. I started an antibiotic that I carry when traveling, certainly not for this, but I thought it could possibly do some good against the bacterial STDs. One week later I returned home and had the last of the three Hep B vaccines. I was still in a daze trying to figure out what the hell happened and didnt discuss it with my wife, GP or anybody except the business &^()*, who said that he too was drugged, but I doubt that, since I can remember him talking at the bar when I could not and somehow we made it to the hotel, it wasnt from zombies directions.

The issues / symptoms that followed: During week 1 my groin area was very sore and by weeks end the soreness was gone, but the lymph nodes between the groin and thighs were swollen on both sides. The numbness in my face and forearms continued. During week 3, traveling overseas again, Meatal ulcers appeared and Ulcer on the saliva glands under my tongue, 3 nights of drenching! Night sweats with a foul stale (not BO) odor, fever, thrush. These symptoms lasted about 4 days. Also, weeks 1 thru 4 - I had zero appetite and went from 195 to 175.

End of week 3, I went on the internet to try to determine symptoms of HIV & other STDs. 2nd day of week 4 returned from travels, leveled with wife, pastor, GP, and had an appointment with HIV ID MD. ID Doc ran Antibody Test - neg, RNA PCR RT - neg, Hep A immunization OK, Hep B immunization OK, Hep C neg, other STDs neg except HSV 1 pos, Liver Panel normal. Since possible new genital infection of HSV 1 (past herpes on lips) Doc prescribed Valtrex. Week 4, I started having a solid red rash on my neck and upper torso. The red rash on my neck has white spots where the hair follicles are but the rash is flat. My face has some red dry spots similar to eczema and the numbness in face and forearms continues. Week 6, returned to the ID Doc. I was still feeling bad, and took another Antibody test neg. Also prescribed something to help me chill that I have taken a few times, especially when my internet self - diagnosis skills were at work...

At this point, I found and read Dr. Bob's forum and now Im waiting out the 3 month / 12 week time period, same advice provided by the ID Doc, who is a very good man.

There were some questions that I didnt have at my Doctors visit, but would greatly appreciate your answers to them, since others may have similar questions:

1. Does HIV have its own distinctive genital or oral ulcers? Or are the ulcers described as potentially early symptoms from a co-infection from another ulcer causing STD, oral or genital? 2. In regards to testing for antibodies, do other viral STDs have similar seroconversion times as HIV? a. Specifically Hep C or HSV 2? b. If so, do you then recommend testing for the viral STDs at the 12 week point as well? 3. I continue to have very mild shaking, especially in bed in the morning until I get going, is this some kind of symptom? It is almost like a low vibration with in your body, it seems like a similar feeling to when I first started having issues with RA when my sed rate was high, could be related back to RA, who knows? 4. Ive seen a lot of questions about RA and TNF blocking drugs, due to my exposure, where there was certainly blood exposure would you recommend testing out to the 6 month mark? 5. Have you ever heard about the strange odor during the drenching night sweats? It seems as though the subcutaneous layer has broken down in certain areas forehead, neck and arms I know stress can do a lot of strange things and can trigger additional autoimmune issues, but the odor was strange stale not a chemical smell.

Dr, Bob, thank you for your time and compassion and working for such a worthy cause. My eyes have been certainly opened to what people go through in dealing with this unknown period of time. I look forward to donating to your worthy foundation!

Shang Haid

Response from Dr. Frascino

Hi Shanghaied in Shanghai,

Frightening story! I'm glad you leveled with your wife and are getting appropriate medical follow-up. I'm also delighted you found the information here helpful and reassuring.

Regarding your specific questions:

1. HIV does not have its own distinctive or diagnostic genital and oral ulcers.

2. No, different STDs are screened in different ways. Many do not use antibody-related techniques. I'm confident your ID doctor will screen you for all potential STDs as indicated and at the appropriate time interval.

3. The shaking is most likely related to anxiety and stress, not HIV or rheumatoid arthritis.

4. No. Three months is sufficient.

5. No. This is not HIV related.

From the information provided and the results of your laboratory studies to date, your chances of having dodged the proverbial bullet are excellent! Thank you for your donation to The Robert James Frascino AIDS Foundation to help those who weren't so lucky. In return I'm sending you my good-luck karma that your definitive HIV and other STD tests remain negative.

Be well!

Dr. Bob



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