Are these two epidemics killing us?

Obesity

The World Health Organization estimates that more than 1.5 billion adults worldwide are overweight or obese. Once considered a problem only in high-income countries, overweight and obesity are now dramatically on the rise in low- and middle-income countries. Obesity increases the risk of several major diseases, including cardiovascular disease, cancer, and diabetes, and increases rates of mortality in iniduals with these diseases. Obesity is quickly overtaking tobacco as the leading preventable cause of cancer.

Overweight and obesity are leading risks for global deaths. Around 3.4 million adults die each year as a result of being overweight or obese.

Among non-Hispanic black and Mexican-American men, those with higher incomes are more likely to have obesity than those with low income. Higher income women are less likely to have obesity than low-income women.

There is no significant relationship between obesity and education among men. Among women, however, there is a trend—those with college degrees are less likely to have obesity compared with less educated women.

Ebola

The Ebola virus epidemic in West Africa is currently a leading headline in both the medical and popular media, and each day seems to bring more ominous news. To date, there have been nearly 9000 reported cases of infection with Ebola in Africa, with more than 4000 of those cases resulting in death. In the United States, the case of the Liberian citizen who eventually died of Ebola infection and the subsequent infection of 2 nurses who cared for him receives constant coverage.

Highlights

One of the difficulties in identifying potential cases of Ebola infection is the nonspecific presentation of most patients. Fever/chills and malaise are usually the initial symptoms, so all medical personnel should maintain a high index of suspicion in these cases.

The most common symptoms of patients in the current outbreak of Ebola include fever (87%), fatigue (76%), vomiting (68%), diarrhea (66%), and loss of appetite (65%).

Other symptoms may include chest pain, shortness of breath, headache or confusion, conjunctival injection, hiccups, and seizures.

Bleeding does not affect every patient with Ebola and usually presents as small subcutaneous bleeding vs. frank hemorrhage.

One of the most critical ways to prevent the spread of Ebola is the appropriate use of isolation and personal protective equipment (PPE). However, a study of Canadian pediatric emergency medicine physicians serves as a warning regarding our collective preparedness for a serious infectious disease. This research, which was published in the March 2011 issue of the Canadian Journal of Emergency Medicine, found that 22% of physicians had not received training in the use of PPE and 32% had not been trained in the past 2 years. Finally, given 6 case scenarios in which PPE was recommended by national standards, physicians selected an average of 1 case in which they would actually wear PPE. Another review of infection control practices of healthcare workers published in the American Journal of Infection Control following the SARS (severe acute respiratory syndrome) outbreak revealed that failure to implement appropriate PPE is responsible for most hospital-acquired infections.

This evidence is frightening in a climate that had already witnessed fairly recent outbreaks of H1N1 influenza and SARS. Ebola is another lethal virus that needs to be addressed through diligent and unwavering prevention practices. The current report from the American Hospital Association and the US Centers for Disease Control and Prevention highlights facts regarding Ebola-related disease and its prevention.

Conclusions

Both diseases are not related, but both are causing many health problems. Overweight and obesity are leading risks for global deaths. Around 3.4 million adults die each year as a result of being overweight or obese. In addition, 44% of the diabetes burden, 23% of the ischaemic heart disease burden and between 7% and 41% of certain cancer burdens are attributable to overweight and obesity.


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