HUMAN DEATH AND SERIOUS DISEASES

HUMAN DEATHS

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When the core body temperature reaches 107.6 degrees F heatstroke can’t be reversed and death occurs. People can survive after losing 30 percent of their blood. At 40 percent people need an immediate transfusion or they run they risk of dying. People can go without food for 45 days. If one loses 30 percent of one’s body weight death is imminent though disease is more likely to kill a person before they starve. People rarely can go for more than a week without water. Every cell in the body needs water. The body need to replace the liter or more of water it loses every day. People don’t need to necessarily drink water or another liquid if they get enough water from the food they eat.

In 2019, the top 10 causes of death accounted for 55 percent of the 55.4 million deaths worldwide. In order of total number of lives lost, these causes fell into with three broad groups: 1) cardiovascular (ischaemic heart disease, stroke), 2) respiratory (chronic obstructive pulmonary disease, lower respiratory infections) and 3) neonatal conditions – which include birth asphyxia and birth trauma, neonatal sepsis and infections, and preterm birth complications. [Source: Top 10 causes of death, World Health Organization, December 9, 2020]

Websites and Resources Centers for Disease Control and Prevention (CDC) cdc.gov/DiseasesConditions ; World Health Organization (WHO) fact sheets who.int/news-room/fact-sheets ; National Institute of Health (NIH) Library Medline Plus medlineplus/healthtopics ; Merck Manuals (detailed info many diseases) merckmanuals.com/professional/index ; Health Map healthmap.org ; Disease Pictures (old, dated, bad links, but maybe provide some leads) hardinmd.lib.uiowa.edu/pictures

Causes of Death

The world’s biggest killers in 2019 (percent of the world’s total deaths) were: 1) ischaemic heart disease (16 percent); 2) stroke (11 percent); 3) chronic obstructive pulmonary disease (6 percent); 4) Lower respiratory infections (5 percent); 5) Neonatal conditions (4 percent); 6) Trachea, bronchus and lung cancers (3 percent); 7) Alzheimer’s disease and other forms of dementia (3 percent); 8) diarrhoeal diseases (3 percent); 9) Diabetes (3 percent); and 10) Kidney diseases (2 percent).

Since 2000, the largest increase in deaths has been as a result of ischaemic heart disease, rising by more than 2 million to 8.9 million deaths in 2019. Deaths from neonatal conditions are one of the categories for which the global decrease in deaths in absolute numbers over the past two decades has been the greatest: these conditions killed 2 million newborns and young children in 2019, 1.2 million fewer than in 2000. Diabetes has entered the top 10 causes of death, following a significant percentage increase of 70 percent since 2000. Diabetes is also responsible for the largest rise in male deaths among the top 10, with an 80 percent increase since 2000.

Deaths from noncommunicable diseases are on the rise.Trachea, bronchus and lung cancers deaths have risen from 1.2 million to 1.8 million. In 2019, Alzheimer’s disease and other forms of dementia ranked as the 7th leading cause of death. Women are disproportionately affected. Globally, 65 percent of deaths from Alzheimer’s and other forms of dementia are women.

The top 12 killers worldwide in 2009 (percentage of total deaths) were: 1) heart disease (12.6 percent); 2) stroke and similar diseases (9.7 percent); 3) pneumonia and lower respiratory diseases (6.9 percent); 4) HIV/AIDS (4.8 percent); 5) chronic obstructive pulmonary disease (4.8 percent); 6) perinatal conditions (4.3 percent); 7) diarrheal diseases (3.3 percent); 8) tuberculosis (2.7 percent); 9) trachea, bronchus and lung cancers (2.2 percent); 10) road accident injuries (2.1 percent); 11) diabetes (1.7 percent); 12) malaria (1.6 percent). [Source: World Health Organization data]

Leading causes of death (percent who die): 1) cardiovascular diseases (31 percent); 2) infectious diseases (25 percent); 3) cancers (13 percent); 4) injuries (11 percent); 5) respiratory and digestive disease (9 percent); 6) complications at birth (5 percent); 7) other (6 percent). [Source: World Health Organization]

Leading Causes of Death In Middle-Income Countries

Lower-middle-income countries have the most disparate top 10 causes of death: five noncommunicable, four communicable, and one injury. Diabetes is a rising cause of death in this income group: it has moved from the 15th to 9th leading cause of death and the number of deaths from this disease has nearly doubled since 2000. [Source: Top 10 causes of death, World Health Organization, December 9, 2020]

As a top 10 cause of death in this income group, diarrhoeal diseases remain a significant challenge. However, this category of diseases represents the biggest decrease in absolute deaths, falling from 1.9 million to 1.1 million between 2000 and 2019. The biggest increase in absolute deaths is from ischaemic heart disease, rising by more than 1 million to 3.1 million since 2000. HIV/AIDS has seen the biggest decrease in rank among the previous top 10 causes of death in 2000, moving from 8th to 15th.

In upper-middle-income countries, there has been a notable rise in deaths from lung cancer, which have increased by 411 000; more than double the increase in deaths of all three other income groups combined. In addition, stomach cancer features highly in upper-middle-income countries compared to the other income groups, remaining the only group with this disease in the top 10 causes of death.

One of the biggest decreases in terms of absolute number of deaths is for chronic obstructive pulmonary disease, which has fallen by nearly 264 000 to 1.3 million deaths. However, deaths from ischaemic heart disease have increased by more than 1.2 million, the largest rise in any income group in terms of absolute number of deaths from this cause.

There is only one communicable disease (lower respiratory infections) in the top 10 causes of death for upper-middle-income countries. Notably, there has been a 31 percent fall in deaths from suicide since 2000 in this income category, decreasing to 234 000 deaths in 2019.

Leading Causes of Death In High-Income Countries

In high-income countries, deaths are increasing for all top 10 diseases except two. Ischaemic heart disease and stroke are the only causes of death in the top 10 for which the total numbers have gone down between 2000 and 2019, by 16 percent (or 327 000 deaths) and by 21 percent (or 205 000 deaths) respectively. High-income is the only category of income group in which there have been decreasing numbers of deaths from these two diseases. Nonetheless ischaemic heart disease and stroke have remained in the top three causes of death for this income category, with a combined total of over 2.5 million fatalities in 2019. In addition, deaths from hypertensive heart disease are rising. Reflecting a global trend, this disease has risen from the 18th leading cause of death to the 9th. [Source: Top 10 causes of death, World Health Organization, December 9, 2020]

Deaths due to Alzheimer’s disease and other dementias have increased, overtaking stroke to become the second leading cause in high-income countries, and being responsible for the deaths of 814 000 people in 2019. And, as with upper-middle-income countries, only one communicable disease, lower respiratory infections, appears in the top 10 causes of death.

Deadly Diseases

20110306-malaria cdc mother_baby_jabalpur_250w.jpg
mother and baby
with malaria Causes of death can be grouped into three categories: 1) communicable (infectious and parasitic diseases and maternal, perinatal and nutritional conditions), 2) noncommunicable (chronic, such as cancer, dementia and heart disease) and 3) injuries. At a global level, 7 of the 10 leading causes of deaths in 2019 were noncommunicable diseases. These seven causes accounted for 44 percent of all deaths or 80 percent of the top 10. However, all noncommunicable diseases together accounted for 74 percent of deaths globally in 2019.[Source: Top 10 causes of death, World Health Organization, December 9, 2020]

Leading communicable (infectious) diseases: 1) acute respiratory infections; 2) diarrhoeal diseases; 3) AIDS and HIV; 4) tuberculosis; 5) malaria; 6) measles. [Source: World Health Organization]

Lower respiratory infections are the world’s most deadly communicable disease. However, the number of deaths has gone down substantially: in 2019 it claimed 2.6 million lives, 460 000 fewer than in 2000. One of the largest declines in the number of deaths is from diarrhoeal diseases, with global deaths falling from 2.6 million in 2000 to 1.5 million in 2019. [Source: Top 10 causes of death, World Health Organization, December 9, 2020]

Other diseases which were among the top 10 causes of death in 2000 are no longer on the list. HIV/AIDS is one of them. Deaths from HIV/AIDS have fallen by 51 percent during the last 20 years, moving from the world’s 8th leading cause of death in 2000 to the 19th in 2019. Kidney diseases have risen from the world’s 13th leading cause of death to the 10th. Mortality has increased from 813 000 in 2000 to 1.3 million in 2019.

Preventable poverty-related diseases killed an estimated 17 million people a year in the 2000s. The six maladies that accounted for 90 percent of the deaths from infectious diseases worldwide at that time were: 1) influenza; 2) HIV/AIDS; 3) diarrheal diseases; 4) tuberculosis; 5) malaria; 6) measles — are most destructive in the developing world.

As it stands now vaccines have been developed that successfully fight bacteria and viruses but none have been conceived that prevent parasitic diseases. Although many kinds of antibiotics can be used to fight bacteria there are relatively few effective agents against viruses and fungi.

Heart and Cardiovascular Diseases

Cardiovascular diseases and heart disease are the leading cause of death worldwide and in the United States. The term “heart disease” refers to several types of heart conditions. In the United States, the most common type of heart disease is coronary artery disease (CAD), which affects the blood flow to the heart. Decreased blood flow can cause a heart attack. About 659,000 people in the United States die from heart disease each year — which works out to about 1 in every 4 deaths.

According to the World Health Organization (WHO):Cardiovascular diseases (CVDs) are the leading cause of death globally, taking an estimated 17.9 million lives each year. CVDs are a group of disorders of the heart and blood vessels and include coronary heart disease, cerebrovascular disease, rheumatic heart disease and other conditions. More than four out of five CVD deaths are due to heart attacks and strokes, and one third of these deaths occur prematurely in people under 70 years of age.

There are four main types of CVD: 1) coronary heart disease; 2) stroke; 3) peripheral arterial disease; and 4) aortic disease Coronary heart disease (CHD) occurs when your heart muscle's blood supply is blocked or interrupted by a build-up of fatty substances (atheroma) in the coronary arteries. The coronary arteries are the major blood vessels that supply your heart with blood. If your coronary arteries become narrow due to a build-up of atheroma, the blood supply to your heart muscle will be restricted. This can cause angina (chest pains). If a coronary artery becomes completely blocked, it can cause a heart attack. This is a medical emergency. [Source: NHS inform, Scotland's national health information service]

A stroke is a serious medical condition that occurs when the blood supply to the brain is disturbed. Like all organs, your brain needs a constant supply of oxygen and nutrients to function properly. This is provided by the blood, so if your blood flow is restricted or stopped, brain cells will begin to die. This can lead to brain damage and possibly death. Therefore, a stroke is a medical emergency and prompt treatment is essential. The sooner a person receives treatment, the less damage is likely to occur.

The main stroke symptoms can be remembered with the word FAST which stands for: 1) Face – the face may have drooped on one side, the person may not be able to smile or their mouth or eye may have drooped. 2) Arms – the person with suspected stroke may not be able to lift their arm and keep it raised due to weakness or numbness. 3) Speech – the person's speech may be slurred or garbled, or they may not be able to talk at all despite appearing to be awake

Peripheral arterial disease, also known as peripheral vascular disease, occurs when there is a blockage in the arteries to your limbs (usually your legs). The most common symptom of peripheral arterial disease is pain in your legs when walking. This is usually in one or both of your thighs, hips or calves. The pain can feel like cramp, a dull pain or a sensation of heaviness in the muscles of your legs. It usually comes and goes and gets worse during exercise that uses your legs, such as walking or climbing stairs.

Aortic disease affects the aorta, the largest blood vessel in the body, carrying blood from your heart to the rest of your body. The most common type of aortic disease is aortic aneurysm, which is where the wall of the aorta becomes weakened and bulges outwards. You will usually experience pain in your chest, back or abdomen (tummy).

Cancer

Cancer is second leading cause of death after heart disease. It is defined as a disease in which some of the body’s cells grow uncontrollably and spread to other parts of the body. Normally, human cells grow and multiply as the body needs them. When cells grow old or become damaged, they die, and new cells take their place. Sometimes this orderly process breaks down, and abnormal or damaged cells grow and multiply when they shouldn’t. These cells may form tumors, which are lumps of tissue. Tumors can be cancerous or not cancerous (benign). Cancerous tumors spread into, or invade, nearby tissues and can travel to distant places in the body to form new tumors (a process called metastasis). Cancerous tumors may also be called malignant tumors. Many cancers form solid tumors, but cancers of the blood, such as leukemias, generally do not. [Source: National Cancer Institute National Institutes of Health, U.S. Department of Health and Human Services]

Cancer is not one disease. It is many. There are more than 100 types of cancer. Types of cancer are usually named for the organs or tissues where the cancers form. For example, lung cancer starts in the lung, and brain cancer starts in the brain. Cancers also may be described by the type of cell that formed them, such as an epithelial cell or a squamous cell.

Steven Shapin wrote in The New Yorker: Cancer is “the modern disease” not just because we understand it in radically new ways but also because there’s a lot more cancer about. For some cancers, the rise in incidence is clearly connected with things that get into our bodies that once did not—the causal link between smoking and lung cancer being the most spectacular example. But the rise in cancer mortality is, in its way, very good news: as we live longer, and as many infectious and epidemic diseases have ceased to be major causes of death, so we become prone to maladies that express themselves at ages once rarely attained. At the beginning of the twentieth century, life expectancy at birth in America was 47.3 years, and in the middle of the nineteenth century it was less than forty. The median age at diagnosis for breast cancer in the United States is now sixty-one; for prostate cancer it is sixty-seven; for colorectal cancer it’s seventy. “Cancer has become the price of modern life,” an epidemiologist recently wrote: in the U.S., about half of all men and about a third of women will contract cancer in their lifetime; cancer now ranks just below heart disease as a cause of death in the U.S. But in low-income countries with shorter life expectancies it doesn’t even make the top ten. [Source: Steven Shapin, The New Yorker, November 8, 2010]

The cancers of the past were visible on the body’s surface; now we have visual access to the enemy within at a micro level. Modern technologies—advances in microscopy, histological staining, biopsies, X-rays, computed tomography (C.T.) and magnetic resonance imaging (M.R.I.) scans—have given us new possibilities for understanding cancer, but also a new vocabulary of fear. In “The Illness Narratives,” the psychiatrist and anthropologist Arthur Kleinman recorded conversations between cancer victims and their physicians. A dying patient with metastasized rectal cancer told his doctor about his feeling that “there is something not me in me, an ‘it,’ eating its way through the body. . . . These cancer cells are me and yet not me.” The more science tells us about the cancer cell, the more it resembles us. It wants to grow and multiply, as we do, but it doesn’t know how to stop.

Researchers, in their more detached moments, can’t help admiring the cancer cell, the way that Sherlock Holmes admired Moriarty, as a worthy opponent. Toward the end of his book—surveying the patterns thrown up by modern cancer genetics. In his book “The Emperor of All Maladies: A Biography of Cancer”, Siddhartha Mukherjee writes: “Cancer’s life is a recapitulation of the body’s life, its existence a pathological mirror of our own. Down to their innate molecular core, cancer cells are hyperactive, survival-endowed, scrappy, fecund, inventive copies of ourselves”, which can be “quite beautiful.”

Book: “The Emperor of All Maladies: A Biography of Cancer” by Siddhartha Mukherjee (Scribner; $30);

History of Cancer

Imhotep, an Egyptian physician who lived 4,600 years ago, describes what appears to be cancer. According to Herodotus (484-425 B.C.), Queen Atossa of Persia, ordered a Greek slave to cut off her tumorous breast and lived. Even so, cancer remained relatively rare until the early 20th century, when many killer diseases were conquered and life spans increased, paving the way for cancer — often a disease of aging cells — became the second-leading cause of death — a position it has held since 1940 — after heart disease. [Source: Susan Okie, Washington Post, November 19, 2010]

Steven Shapin wrote in The New Yorker: Cancer has always been with us, but not always in the same way. Its care and management have differed over time, of course, but so, too, have its identity, visibility, and meanings. Pick up the thread of history at its most distant end and you have cancer the crab—so named either because of the ramifying venous processes spreading out from a tumor or because its pain is like the pinch of a crab’s claw. Premodern cancer is a lump, a swelling that sometimes breaks through the skin in ulcerations producing foul-smelling discharges. The ancient Egyptians knew about many tumors that had a bad outcome, and the Greeks made a distinction between benign tumors (oncos) and malignant ones (carcinos). In the second century A.D., Galen reckoned that the cause was systemic, an excess of melancholy or black bile, one of the body’s four “humors,” brought on by bad diet and environmental circumstances. Ancient medical practitioners sometimes cut tumors out, but the prognosis was known to be grim. Describing tumors of the breast, an Egyptian papyrus from about 1600 B.C. concluded: “There is no treatment.” [Source: Steven Shapin, The New Yorker, November 8, 2010]

“The experience of cancer has always been terrible, but, until modern times, its mark on the culture has been light. In the past, fear coagulated around other ways of dying: infectious and epidemic diseases (plague, smallpox, cholera, typhus, typhoid fever); “apoplexies” (what we now call strokes and heart attacks); and, most notably in the nineteenth century, “consumption” (tuberculosis). The agonizing manner of cancer death was dreaded, but that fear was not centrally situated in the public mind—as it now is. This is one reason that the medical historian Roy Porter wrote that cancer is “the modern disease par excellence,” and that Mukherjee calls it “the quintessential product of modernity.”

“At one time, it was thought that cancer was a “disease of civilization,” belonging to much the same causal domain as “neurasthenia” and diabetes, the former a nervous weakness believed to be brought about by the stress of modern life and the latter a condition produced by bad diet and indolence. In the eighteenth and nineteenth centuries, some physicians attributed cancer—notably of the breast and the ovaries—to psychological and behavioral causes. William Buchan’s wildly popular eighteenth-century text “Domestic Medicine” judged that cancers might be caused by “excessive fear, grief, religious melancholy.” In the nineteenth century, reference was repeatedly made to a “cancer personality,” and, in some versions, specifically to sexual repression. As Susan Sontag observed, cancer was considered shameful, not to be mentioned, even obscene. Among the Romantics and the Victorians, suffering and dying from tuberculosis might be considered a badge of refinement; cancer death was nothing of the sort. “It seems unimaginable,” Sontag wrote, “to aestheticize” cancer.”

Treating Cancer

Steven Shapin wrote in The New Yorker: There are basically three ways to treat cancer: you can cut it out surgically; you can burn it up with radiation; and you can poison it by suffusing the body with cytotoxic chemicals that knock out cancer cells without such extensive damage to normal cells that the attempted cure kills. The therapeutic triad can be combined in any number of ways. The fight is hard and the assessment of progress is not easy.” In his book Mukherjee’s “sympathy for failed therapies matches his compassion for the patients they could do so little to help. [Source: Steven Shapin, The New Yorker, November 8, 2010]

Over time, surgeons learned more about what to cut out and what to leave. The far less extensive “lumpectomy” operation for breast cancer, pioneered in the nineteen-twenties by the English surgeon Geoffrey Keynes, was given its name as a sneer—to American Halstedians, it seemed insufficiently aggressive. But by the nineteen-eighties it was accepted that outcomes among patients receiving “simple mastectomies” were statistically identical to those for patients undergoing the radical operation. The latter group paid heavily in disfigurement and ancillary ill health, but, Mukherjee writes, they “accrued no benefits in survival, recurrence, or mortality.”

And there's the astonishing recent history of breast cancer treatment: the gradual eclipse of surgery by chemotherapy, radiation therapy and especially by drugs such as tamoxifen and Herceptin that target proteins on or inside cancer cells to help shut off their growth.

In 1986, epidemiologists John Bailar and Elaine Smith published a devastating progress report on the war on cancer. Despite 35 years of intense effort, they wrote in a medical journal, there was no evidence of "much overall effect on the most fundamental measure of clinical outcome — death." But meanwhile, a parallel scientific and political drama had been unfolding concerning efforts to prevent cancer by attacking its environmental causes. Its central events — the unexpected discovery of the link between cigarette smoking and lung cancer by twin studies in 1950; the tobacco industry's decades-long campaign of denial, deceit and obfuscation; the courage of surgeon general Luther Terry in releasing his bombshell 1964 report on the dangers of smoking; a tide of anti-tobacco lawsuits; and in recent decades, a steady decline in U.S. smoking rates — are riveting both for their public health impact and for their importance in focusing more resources on cancer prevention.

As researchers identified other external triggers of cancer development — a liver virus, a stomach bacterium, exposure to X-rays, even sunbathing — they also explored the sequence of genetic events that such environmental factors set off deep inside normal cells. Mukherjee recounts how, during the 1970s and '80s, researchers elucidated "a unitary cause" of cancer — describing how a healthy cell gradually accumulates mutations in certain key genes regulating its growth and behavior, until it becomes insensitive to signals and instructions from the cells around it and is able to survive, attract a blood supply, reproduce and spread its progeny seemingly without limits. Advances in understanding this sequence of events on a molecular level have slowly begun to yield targeted therapies — at least two dozen so far — that deserve, for the first time, the overworked nickname "magic bullet." Gleevec, the prototype medicine in this group, is a pill with almost no side effects that turned a particular type of leukemia from a universally fatal disease to one that most patients keep in check, living essentially a normal life.

There are still many shortcoming and inadequacies with cancer detection and treatment. Liver cancer is usually diagnosed when it is farly advanced because symptoms surface late. "Most who are diagnosed have advanced cancers, like stage 4, so they only get palliative care. It is very difficult to detect early lesions because there are no symptoms. Deaths often occur within six months to a year after diagnosis, with zero survivors after five years.

Tobacco-Related Disease

Playing a part in the deaths of up to half of its users, tobacco kills more than 8 million people worldwide each year. More than 7 million of those deaths are the result of direct tobacco use while around 1.2 million are the result of non-smokers being exposed to second-hand smoke. Over 80 percent of the world's 1.3 billion tobacco users live in low- and middle-income countries. [Source: World Health Organization (WHO), July 26, 2021 who.int/news-room/fact-sheets

According to the WHO: The tobacco epidemic is one of the biggest public health threats the world has ever faced. All forms of tobacco are harmful, and there is no safe level of exposure to tobacco. Cigarette smoking is the most common form of tobacco use worldwide. Other tobacco products include waterpipe tobacco, various smokeless tobacco products, cigars, cigarillos, roll-your-own tobacco, pipe tobacco, bidis and kreteks.

Waterpipe tobacco use is damaging to health in similar ways to cigarette tobacco use. However, the health dangers of waterpipe tobacco use are often little understood by users. Smokeless tobacco use is highly addictive and damaging to health. Smokeless tobacco contains many cancer-causing toxins and its use increases the risk of cancers of the head, neck, throat, oesophagus and oral cavity (including cancer of the mouth, tongue, lip and gums) as well as various dental diseases.

Cigarette smoking causes about one of every five deaths in the United States each year, including:1) More than 480,000 deaths annually (including deaths from secondhand smoke); 2) 278,544 deaths annually among men (including deaths from secondhand smoke); 3) 201,773 deaths annually among women (including deaths from secondhand smoke). [Source: Centers for Disease Control and Prevention (CDC), April 28, 2020]

According to the World Health Organization (WHO) smoking killed an estimated 100 million people in the 20th century and could kill 1 billion in the 21st century. Governments around the globe earn $200 billion a year in taxes but spend less than one forth of one percent of that amount on tobacco control. The WHO recommends that all countries should do more to prevent young people from smoking, ban tobacco advertising, shield nonsmokers from second-hand smoke, warn people about the dangers of smoking and help those who want to quit.

Tuberculosis

Tuberculosis (TB) kills more people than any other treatable infectious disease, with the exception, in recent years, of Covid-19. Approximately 1.5 million people died from tuberculosis in 2020 (including 214 000 HIV positive people). This was an increase from the previous year, the first such increase in a decade. The increase occurred mainly in the 30 countries with the highest burden of TB, with death rates from the disease projected to much higher in the early 2020s [Source: World Health Organization (WHO), October 14, 2021]

Tuberculosis is an infectious disease that can infect any body tissue, but is especially damaging to the lungs. Caused by the bacteria Mycobacterium tuberculosis, it can spread when people who are sick with TB expel bacteria into the air. Most people who develop the disease are adults. In 2020, men accounted for 56 percent of all TB cases, adult women accounted for 33 percent and children for 11 percent. Many new cases of TB are attributable to five risk factors: undernutrition, HIV infection, alcohol use disorders, smoking and diabetes.

Tuberculosis usually attacks the lungs but can spread to other organs. In typical severe cases it destroys patients' lung tissue, making them cough and sneeze, and spread germs through the air. Anyone with active TB can easily infect another 10 to 15 people a year. The disease spreads through invisible respiratory droplets when an untreated person coughs, shouts, laughs or talks. Eight hours in the same room with someone with active TB is thought to be necessary to become infected.

Diabetes

Diabetes is a chronic disease that is caused by an inherited or acquired inability to produce enough insulin. It results in high concentrations of glucose in the blood, which can damage many of the body's systems, in particular blood vessels and nerves. Diabetes is among the leading causes of kidney failure. Heart disease accounts for 50 percent of all deaths of people with diabetes in industrialized countries, according to WHO data.

The most common type of diabetes is type 2 diabetes. The main difference between the two types of diabetes is that type 1 diabetes is a genetic disorder that often shows up early in life, and type 2 is largely diet-related and develops over time. If you have type 1 diabetes, your immune system is attacking and destroying the insulin-producing cells in your pancreas. With type 2 diabetes, your body still produces a small amount of insulin, but it isn’t effective enough. The pancreas can’t keep up with the high blood sugar levels resulting from poor diet and lack of exercise.

Diabetes is a chronic disease which first disables its victims and then slowly kills them. According to International Diabetes Federation, diabetes caused 6.7 million deaths in 2020 and almost 1 in 2 (240 million) adults living with diabetes are undiagnosed. In the 2000s, about 3 million deaths worldwide were attributable each year to diabetes. Globally, there were an estimated 462 million people affected by type 2 diabetes, 6.28 percent of the world's population, in 2019 according to U.S. National Institute of Health There were 246 million cases of type 2 diabetes worldwide in 2007, up from 194 million in 2003 and 108 million in 1980.

Type II diabetes is linked to a host of illnesses including heart disease, stroke, kidney failure, high blood pressure, blindness, kidney and nerve damage, infections and gum disease. The good news is that it can be controlled with prevention and treatment. Diabetes is best controlled and managed with drugs, exercise and a proper diet to avoid serious complications such as heart disease and strokes. Type 2 diabetes is harder to manage over time and drug compliance is vital. It is not uncommon for diabetes sufferer to have a stroke after stopping his medication. [Source: Tan Ee Lyn, Reuters March 12, 2007]

Diabetes is now as big problem in poor countries as it is in rich countries. Once regarded as a “disease of affluence,” it doesn’t seem to be that anymore. Now more than 70 percent of cases are in the developing world. In the developing world urbanites are twice as likely to have diabetes as rural residents in part because they are less active and eat less fruits and vegetables. In poor countries old fashion drugs are still 80 percent to 90 percent effective.

International Diabetes Federation idf.org

Diphtheria, Typhoid and Typhus

Diphtheria is a potentially fatal throat infection, generally caused by inhalation of sneeze droplets from an infected person. Symptoms include throat inflamation, coughing, shortness breath and a swollen pharynx. Vaccinations are available that prevent the disease. Treatment involves intravenous infusion of diphtheria antitoxin and needs to be administered by a doctor.

Typhoid is an infectious often fatal disease characterized by a high a fever, headache, sore throat, and intestinal inflammation. It is spread by food and water contaminated by someone with the disease.

Victims suffer from dehydration which can lead to fatal complications unless a patient is given antibiotics. The disease can be avoided with a the oral vaccine that is taken in four separate doses over seven days. Typhoid shots cost $70 to $120 or live. An oral vaccine costs $50. The Ty21a vaccine is only 70 to 90 percent effective. The treatments for the disease is antibiotics (usually Chloramphenicol or ampicillin).

Typhus is an acute, infectious disease caused by a family of germs transmitted by lice, ticks and fleas and characterized by an unusual rash of red spots all over the body. Other symptoms in include a fever and headaches. The disease can be effectively treated with antibiotics. Production of the typhus vaccine in the United States has been discontinued.

Meningitis

Meningitis is an infection and inflammation of the meninges, the layered membranes that cover both the brain and the spinal chord. There are two kinds of meningitis: viral and bacterial. Most cases of meningitis are viral and the symptoms are so mild victims don't realize they have the disease and don't feel the necessity to seek medical help. Most cases are caused by an enterovirus spread from hand to mouth, usually in warm weather. No vaccine is available. A treatment of antiviral medicines (not antibiotics) is usually aimed at the relieving the symptoms, usually headaches, until the body recovers naturally.

Bacterial meningitis is much more serious and potentially fatal. Symptoms include severe headaches, progressive drowsiness or confusion, vomiting, irritability, high-pitched crying (especially among very young children), a stiff neck and sometimes painful sensitivity to light and a sore throat. In the days before antibiotics, most victims died. Today the survival rate is 90 percent (most fatalities occur among the very young and very old). The disease is treated with antibiotics and diagnosed with a spinal tap (after a local anesthesia for pain is administered a hollow needle is inserted in the vertebrae and a small sample of spinal fluid is collected).

Meningococcal Meningitis

There are several kinds of bacterial meningitis. Meningococcal meningitis is a type of bacterial meningitis which can cause epidemics (mostly in sub-Sahara Africa but can occur any place regardless of climate). The disease-causing-agent, Neisseria meningitis, is spread by direct contact with the respiratory secretions of people that have the disease. Without treatment from antibiotics the mortality rate is 50 percent. Fortunately there is a single dose vaccine for meningococcal meningitis that last for about three years.

The leading cause of meningitis as well as wide variety of other disease such as pneumonia and pericarditis is Haemophilus Influenzae Type B (Hib), ironically is not an influenza. The Hib bacterium can cause pneumonia, blood poisoning and fever-like symptoms. Bacterial meningitis occurs when the bacteria invades the membranes covering the brain and spinal cord, the disease triggers headaches, fevers, and vomiting. In serious cases it can cause permanent physical and mental damage and kill infants.

A very safe and effective Hib vaccine was introduced in 1985 and has been very effective in reducing the incidence of the disease. The Hib vaccine is routinely given in a series of four shots (two, four and six months with a booster between 12 and 15 months). The Hib vaccine is credited with the reducing the number of bacterial meningitis cases in the United States to one percent what they were before the vaccine.

Image Source: Centers for Disease Control and Prevention cdc.gov/DiseasesConditions except smoker Ray Kinnane

Text Sources: Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services; World Health Organization (WHO) fact sheets; National Geographic, New York Times, Washington Post, Los Angeles Times, The New Yorker, Time, Reuters, Associated Press, AFP, Lonely Planet Guides and various websites books and other publications.

Last updated May 2022