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Q: I am 80 years old and in very good health. In early September I developed nausea, vomiting and an itchy sore throat making it hard to swallow.

After examining my throat, my doctor, who I have total faith in, to my amazement told me I had herpes and shingles in my throat. I have never heard of such a disease, especially inside the mouth. -- N.W., Erie, Pa.

A: I think you may have another disease, but before I get to that let me clear up the herpes story that is confusing to many people.

There are many types of herpes viruses, but the three that are the main causes of disease in humans are type 1, type 2 and type 3 -- not very creative naming but easy to remember.

Type 3 causes two different diseases: chicken pox -- also known as varicella zoster and shingles -- also known as herpes zoster. Whereas chicken pox occurs in children, shingles occurs in adults.

Type 1 and type 2 herpes viruses, on the other hand, infect the mouth and genital regions. Both types can infect either area, but type 1 usually infects the mouth and type 2 the genitals.

Herpes infections of the mouth usually cause sores on the lips, but the tongue and gums can be affected also. Sometimes herpes will also infect the esophagus, but this almost always occurs in people with immune system problems.

One of the problems with type 1 and type 2 infections is that they rarely cause any other symptoms like you describe. So someone can infect someone else without even knowing they are sick.

The symptoms you describe, including the sores on your throat that looked like herpes, can be caused by another virus called coxsackievirus. When this occurs in adults it is called herpangina.

Both infections will typically go away, with or without treatment, within a few days. Fortunately for you, if my guess is correct, herpangina won't return, whereas herpes infections often do.

Herpes can cause severe problems in people with immune problems such as AIDS or leukemia. If someone has repeated recurrence of herpes sores it's wise to talk with a doctor about their situation and get evaluated.

Update on social support: I have previously reported on the improvement of health for those who attend religious services. And now further studies point to the importance of social support in general.

A social support system is one of the most effective means of reducing the impact of stress on the immune system, according to studies recently presented at the annual meeting of the American College of Allergy, Asthma & Immunology.

Cells of the immune system fight infectious diseases such as the flu. These cells in turn are modified by hormones produced by the adrenal gland and the nervous system.

In one study people were deliberately infected with a cold virus. It was found that those with more social ties were four times less likely to develop a cold than those with fewer social ties.

The researcher went on to say that this protective effect may decrease relapses in people with autoimmune diseases such as lupus and arthritis as well as possibly influencing the start of these diseases.

These types of scientific studies serve to reinforce what many of us already firmly believe. Helping people stay healthy and helping people with medical problems cope better is largely influenced by their own attitudes and interactions with friends and family members.

In this postholiday time it is especially important for many people to get even more support, whether they have medical problems or not. So please consider making extra efforts to reach out now. Then someone you know will be able to say "I really am lucky to have people who care about me."

Update on cancer treatment: For the first time, a monoclonal antibody -- rituxamab -- has been approved for use as a cancer-fighting agent. This treatment for non-Hodgkin's lymphoma is just the beginning of many new treatments for cancer and other immune system diseases.

An antibody is a chemical that binds to a cell, in this case a cancer cell. When this happens it changes the appearance of the cell. This causes the body's immune system to attack and kill the cancer cell.

Monoclonal is a term that describes how the drug was manufactured from a single line of cells. In this case, genetic engineering was used to induce mice to make a human antibody in their own immune system.

It's not the perfect drug, however. It only helps in about half the people with non-Hodgkin's lymphoma. But further studies are expected to determine if another type of antibody will work for the other half.

Fortunately rituxamab has much fewer side effects than the chemotherapy, radiation and bone marrow transplants that have been the standard therapy. These side effects include flulike symptoms and a greater risk of infections.

Improved treatment of non-Hodgkin's lymphoma with this genetically engineered drug will greatly improve the health and well-being of people with this disease. Plus it's also setting the stage for the approval of many new drugs in the future.

Dr. Allen Douma welcomes questions from readers. Although he cannot respond to each one individually, he will answer those of general interest in his column. Write to Dr. Douma in care of the Better Health & Medical Network, 585 Grove St., Herndon, Va. 20170.

This column is for informational and educational purposes only. It is not intended to provide medical advice or take the place of consultation with a doctor or other health-care provider.

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