Hi, Dr. Rob!!

As a pre-med undergrad I have so much respect for you and everything you do for you people! Not too long ago I had a sexual encounter with a male of unknown status (he claims to be neg but who really knows - he was fairly defensive when I called recently to re-enquire) and my condom broke as I topped him. It couldn't have been for more than 1-2 minutes but I didn't realize it had happened until I pulled out and noticed I had ripped straight through it. Also I should say that I hadn't sleep for 24 hours before that and fear that my immune system might have been low as a result. Anyway, 7 days later i started to feel extremely rundown and unwell. I started having hot and cold flushes throughout my body. Most notably my arms and hands would alternately flush ice cold and then I'd get a flush of warmth and felt really light-headed throughout the day. I didn't have chills just that weird flushing that lasted a day or two. Sometimes I'd experience blurred vision in the light. I immediately started taking my temperature but it never increased. In fact it stayed around 97.6 (even bought too different thermometers to be sure.) I still went to class and work every day and it was NOTHING like having mono but I was very nervous because I was definitely coming down with something. Five days later they symptoms went away. My question is when do ARS symptoms usually begin. In one post you say 1-3 weeks but then in the others I've read you 2-4 weeks. In your experience is it 1) possible/likely to see symptoms starting as early as 6 or 7 days post exposure? 2) Is it possible that a low immune system from pulling all-nighters could make one have early ARS? And 3) do some people experience ARS febrile symptoms without an actual fever (or is it possible that some people don't get fevers at all)? My experience really freaked me out and I'm seeing a lot of conflicting info on ARS timing but trust your expertise as the final word. Thanks so much.

Hi,

1. ARS is variable from case to case. Generally symptoms become manifest two to three weeks following primary infection (hence the expanded range from one to four weeks to catch the outliers). It's not "likely" for ARS to begin six or seven days after exposure.

2. No. A few all-nighters do not have a significant effect on the body's immune system!

3. Febrile means fever! It is, however, possible to experience ARS without fever (this occurs in only four percent of cases, so it's quite rare).

Good luck with your premed studies.

Dr. Bob