Greetings, Dr. Roach When our granddaughter returned home from college over Christmas, my husband and I got norovirus. Despite getting really unwell, neither of us experienced any negative side effects. As it has been in the news lately, I would like to know if we are immune to getting it again. We are concerned about this illness because we are organizing a cruise for June. — L.S.
The majority of experts believe that immunity to a particular strain of the norovirus lasts for just roughly six months, which is unfortunate because norovirus protection is strain-specific. Therefore, any immunity you may have had prior to the trip will be lost. Even worse, each of the more than 40 genotypes has its own variations. Therefore, immunity alone won’t be enough to keep you from getting infected again.
On a cruise ship, the chance of contracting norovirus is minimal; on a 10-day voyage, the risk is less than 0.5%. By practicing good hand hygiene, which entails washing your hands with soap and water, you can lower this risk. Before eating, and much more frequently if there is an outbreak aboard, you should wash your hands.
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Greetings, Dr. Roach In a few months, my spouse will turn 80. I worry that he may have primary progressive aphasia (PPA). He refuses to consent to being tested. He was diagnosed with mild cognitive deficits by a neuropsychiatrist five years ago. He has a bad sense of timing, finds it difficult to find words, and employs the wrong words. He has poor short-term memory.
He is capable of carrying out every ADL (activities of daily life).
Three years ago he suffered a heart attack that required two stents, and four years ago he experienced a transient ischemic attack. According to what I’ve read, the only treatment for PPA is speech therapy, and he wouldn’t accept it since he doesn’t think anything is wrong. I want to know what you think about the prognosis and the course of treatment. — B.E.
ANSWER: PPA belongs to the class of brain diseases known as frontotemporal dementias. Although these were formerly known as Pick’s disease and resemble other dementias, a specialist is able to look for certain traits of frontotemporal dementias.
There are situations when diagnosing PPA is not simple. The illness typically begins in the 50s, which is a younger age than Alzheimer’s. Early and progressive language impairment is a feature of PPA. In the early stages of the illness, the patient can frequently perform their ADLs. Although the loss of language function seems to be a problem for your husband, many patients seem indifferent to it.
Making the diagnosis is crucial, but I recognize that he is preventing you from doing so. An MRI can help rule out alternative explanations and corroborate the diagnosis.
Regretfully, frontotemporal dementia cannot yet be slowed down or prevented by any medication. Although each person’s prognosis is unique, many PPA patients experience isolated language impairments prior to the onset of a more widespread form of dementia. Some persons have a lack of motor control, and behavioral abnormalities are common.
I’m sorry I can’t be more certain of his diagnosis, and I’m even more sad you have to deal with it without being able to provide him with the home care and medical attention that could assist him (and definitely support you).
Although he regrets not being able to respond to each letter individually, Dr. Roach will try to include them in the column. Questions can be sent by mail to 628 Virginia Dr., Orlando, FL 32803 or by email to [email protected].
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