Truth about monkey pox
Q I am a frequent traveller to the US. I read about a new disease called monkey pox. Is this something to be worried about and, if so, how do I take precautions?
A You're more likely to be hurt by a flying hamburger. Monkey pox is a virus, first identified 30 years ago in a monkey. It sometimes affects humans, though until recently, all reported cases had been in Africa. In humans, it can cause a disease which seems identical to smallpox. That means fever, sore throat, headache and a blistering rash which usually clears up within three weeks. If you're unlucky, you can get complications such as pneumonia, diarrhoea and vomiting. The disease is most common in rural west Africa but even there, there have only been 400 recorded cases over 16 years. Most people recover fully but death rates have reached 10% among vulnerable individuals such as young children.
In the US, 33 cases have recently been reported, all in the midwest. The likely source of infection is wild prairie dogs. All the victims in the US are expected to live, though there is no specific treatment. If you have been vaccinated against smallpox, you'll be protected from monkey pox. And so long as you stay away from wild, ill, midwest prairie dogs, you should be fine.
Must I go under the knife?
Q I've got a small swelling in my groin that comes and goes. My GP thinks it's a hernia and wants me to see a surgeon. I'm very reluctant to get involved in surgery, as I can't afford time off work and prefer to leave things alone unless action in essential. Would it be dangerous to leave it?
A Chances are it's an inguinal hernia. This is a bulging of your intestines through a weakness of the abdominal muscle wall. The reason it commonly happens in the groin is because of your testicles. The male foetus grows its testicles high up in the abdomen. They head south before birth, pass through the abdominal wall in the groin and take up position in the scrotum. There's a potential weakness in the abdominal wall at that exit point. Abdominal contents, such as your intestines, can bulge though the weakness and that's called a hernia. Anything that pushes up the pressure in your abdomen, such as coughing or constipation, increases the chances of a hernia popping out.
One in 10 men get one in the course of a lifetime, and most get it fixed. The risk of the operation is less than the risk of leaving it alone. Left alone, loops of bowel can get stuck or twisted, which cuts off the blood supply to that bit of bowel. This gives you the most almighty stomach pains, vomiting and no bowel movements. It can also endanger your life, as the loop of bowel can become gangrenous. Some men opt not to have an op and push the hernia back in when it pops out, or wear a truss. Neither offers a long-term solution. There are various surgical techniques but the one that gives least pain and numbness round the scar and the quickest return to work is keyhole surgery using a mesh to patch up the abdominal wall.
No magic wand
Q I have read about a wand that can swipe the body and find early cancer. Is it available in this country and is it a useful test to have?
A The idea of being frisked for early cancer without even having to take your clothes off has a certain appeal. The stories that have appeared are loosely based on unpublished research from Italy that have been discussed in the New Scientist. One has looked at detecting prostate cancer, the other at breast cancer. It's all pie in the sky at the moment.
· These answers are intended to be as accurate and full as possible, but should never be used as a substitute for visiting a doctor and seeking medical help. If you have a question for Dr Robinson, email drann@dircon.co.uk or write to her c/o The Health Editor, The Guardian, 119 Farringdon Road, London EC1R 3ER. She regrets that she cannot enter into personal correspondence.
