Documentation Guidelines

• Appearance, location, and number of lesions; drainage from lesions

• Presence of flulike symptoms that accompany outbreaks

• Patient's knowledge of cause, treatment, and prevention of HSV

• Patient's reaction to the diagnosis of an STD

• BOX 1 Living with Genital Herpes: What Patients Need to Know

Background

Each patient's symptoms are different; lesions can resemble blisters, cuts in the skin, or spider bites on the buttocks; flulike symptoms that accompany lesions also vary, as do the frequency and duration of outbreaks.

Transmission

• Patients are at the highest risk of transmitting HSV to a partner during the time an active lesion is present until complete healing takes place.

• Condoms are not a safe barrier for transmission if an active lesion is present.

• During the time when active lesions are present, patients should engage in sexual activities that avoid contact with the lesions. Abstinence is encouraged if an active lesion is present.

• When lesions are active, extreme caution needs to be taken to avoid transmission by contact with articles such as towels, washcloths, and razors. Good hand washing with soap and water helps prevent the spread of the virus.

• Patients can prevent self-infection to other areas of the body by not touching the sores and using good hand washing.

• It is a myth that if one person has herpes, so does his or her partner.

Outbreaks

• Patients should be aware of prodromal symptoms—tingling, itching, pain, numbness— and should begin pharmacologic treatment earlier to better alleviate symptoms

• Patients should be aware of events that can trigger a repeated outbreak: pregnancy, menses, stress, fever, infectious illness.

• For more information, patients should contact the Herpes Resource Center Hotline: 1-415-328-7710.

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