Dr. Keith Roach

DEAR DR. ROACH: Are the current strains of COVID and monkeypox similar to the AIDS virus? I’m confused about the manner of spreading it and where these strains came from. — Z.B.
ANSWER: SARS-CoV-2 (the virus that causes COVID-19), monkeypox virus, and HIV (the virus that causes HIV infection and, ultimately, AIDS) are all viruses, but they are all transmitted differently and have very different effects on the body. However, all three of these viruses were originally found in other animals and were then transmitted to humans.
SARS-CoV-2 is spread mostly by large respiratory particles, which means person-to-person contact usually within six feet of each other. The disease may also be spread by smaller particles that can travel longer distances, but that seems to be much less common. It does not seem to be easily transmitted by blood, by secretions or on surfaces. The virus mutates, and so far, the worldwide trend has leaned toward the more infectious variants, rather than more aggressive or lethal variants. The best evidence shows this was an animal virus that was transmitted to humans, probably from bats.
Monkeypox virus is closely related to smallpox, but not nearly as dangerous or infectious. It is transmitted mostly through close skin-to-skin contact. Sexual transmission has been the most common mode of transmission, but sexual contact is not necessary for transmission of infection. It’s much more infectious when a person has the sores and scabs from the infection. Monkeypox can be transmitted from surfaces, especially from materials such as clothing or linen that have come in contact with the infectious materials from the sores. Monkeypox can also be transmitted by respiratory particles, but it seems that prolonged face-to-face contact is needed. Monkeypox was also thought to have been transmitted from an animal (not necessarily a monkey). Many animals carry the virus, and scientists think the most common animal that monkeypox is found in is likely a rodent.
HIV viruses (there are two: HIV-1 is the dominant virus in North America and Europe, while HIV-2 is uncommon outside Africa) are spread through blood or sexual contact. HIV is not spread by saliva or casual contact, but objects that might contain small amounts of blood (such as a razor or a toothbrush) can potentially transmit HIV. Once again, the virus originally came from an animal (chimpanzees).
DEAR DR. ROACH: I have passed out five times and have been diagnosed with vasovagal syncope. The last time, I ended up in the emergency room, and they put in a pacemaker. What can you tell me about this, and is a pacemaker a cure for this condition? The doctors tell me it can happen again. — A.R.D.
ANSWER: Vasovagal syncope is the most common type of faint. Fainting is very common and often needs no more treatment than keeping oneself hydrated, taking precautions about getting up slowly, and avoiding triggers that have caused fainting in the past.
Pacemakers are only occasionally used, most commonly when a thorough evaluation of the heart has shown that the heart rate becomes dangerously low (such as a pause of greater than three seconds between heartbeats, causing a faint). When used appropriately, pacemakers reduce the risk of fainting by half or more, but may not completely prevent further fainting.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected] or send mail to 628 Virginia Dr., Orlando, FL 32803.
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