Vegan Diet: 7 Key Takeaways from ‘What the Health’

Conclusion:

High-carbohydrate and high-sugar diets predispose you to obesity and insulin resistance. Obesity is a risk factor for type 2 diabetes, and insulin resistance causes it.

BUT a purely vegan diet

What the documentary said was that high fat in the diet is the real issue. And this is true. The traditional way to help patients control their disease is by controlling their sugar and carb intake. The issue with this is that diets low in carbs make you eat more fats and protein, so you feel appropriately energized. By minimizing fat, especially saturated fat, in the food, insulin resistance is improved. This means that even if you are eating sugars and lots of carbs, by lowering your amount of fat consumption, your body can deal with the sugar more adequately.

A study was conducted on diets higher in grains, veggies, and fruits and lower in dairy and meat consumption. Results showed that many diabetic patients were able to reduce their medications or go off them entirely. Studies on muscle cell fat content show that athletes and people with diabetes have higher levels of muscle cell fat, BUT only athletes have higher sensitivity for insulin.

I take this info like this:

Yes, overeating sugar and carbohydrates may predispose you to obesity, but only if your body cannot adequately deal with the amount of sugar you are putting in it.

How can you help your body deal with sugar and carbs? 

Exercise! And lower saturated fats, like the ones found in animal proteins (dairy, steak, chicken, and even fish)

Impact of Public Awareness on Smoking and Chronic Disease

This impact is evident from what happened after the Surgeon General reported that smoking caused cancer in 1964. Since then, smoking prevalence has decreased from almost 45% to 19%, according to a CDC report. Adults lowered their smoking rates because of this announcement? Maybe. It seems like a likely correlation. Oddly enough, in 1998, a Master Settlement Agreement with tobacco companies led to the elimination of billboards, transit, and written advertisements targeting underage youth.

After this settlement, youth smoking dropped quite quickly from its peak of almost 40% down to nearly 17%. Awareness affects! Whether or not it’s a quick one is an entirely different story. The changes in adults were gradual too. The decline was a bit quicker among teens. This demonstrates the remarkable effectiveness of informational interventions in bringing about change! So is this documentary a fix to the high levels of chronic disease? NO, not quite. But it’s a step in the right direction to bring awareness to how a diet can impact your health in good and bad ways.

Rabies Transmission

Rabies is a viral disease that is usually spread to humans by contact with infected animals. The virus waits in the salivary glands of the animal. Once they bite someone, it travels into the broken skin and into the brain tissue, where it wreaks havoc. According to the Center for Disease Control (CDC, 2011), in the last 100 years, there has been a change in the types of animals, causing the most rabies transmission in the United States. Although the most common culprits worldwide are domestic animals such as dogs, especially in underdeveloped countries, in the United States, the most common hosts are “wild carnivores and bats.”

Wild carnivores include raccoons, foxes, coyotes, and skunks (CDC, 2011). This change of host is likely due to the rabies vaccines administered to domestic animals on their routine veterinarian visits, which began in the 1940s (Finnegan, C. J., S. M. Brookes, et al., 2003).

Since the 1900s, rabies mortality in the United States has decreased from approximately 100 fatalities annually to about one or two (World Health Organization [WHO], 2017).

Previously, veterinarians could diagnose the disease in animals only after death, meaning they had to euthanize the animal—if it wasn’t already dead—to collect brain samples and confirm the diagnosis (CDC, 2011). Today, instead of euthanizing a perfectly healthy animal, the animal can be watched for ten days after it bites someone. If no symptoms of rabies appear, it means the animal is rabies-free (CDC, 2011). That not only decreases harm to healthy animals but also reduces the need to treat prophylactically, which, according to the WHO, is high, “typically exceeding 3,000” (WHO, 2017). Diagnosing rabies in humans is quite different, and although there are many diagnostic tests available, the WHO reports that those available are not “suitable for detecting rabies infection before the onset of clinical disease.”

Fatal Infestations

“Fatal Infestations,” a video about the rabies outbreak, was devastating, mainly because rabies is a preventable and curable disease if caught before symptoms of the infection emerge.

Since rabies is an infection of the nervous system, symptoms include seizures, erratic behavior and aggression, excessive salivation (drooling), aversion to water (hydrophobia), and even paralysis and coma. Once any of these symptoms manifest, the disease is too far gone, and recovery is unlikely (CDC, 2011). Although physicians likely know the symptoms of rabies well, they often miss the diagnosis. In medicine, there’s a saying: “If you don’t think of it, you won’t diagnose it.” Rabies was not considered, as the video suggested.

An epidemiological investigation requires specific steps to be taken in whichever order the investigator deems necessary (Gregg, Michael B, 3-13).

The video shown in class showed a small portion of what an actual investigation entails. The investigation began when local health departments called the CDC because of concerns of an outbreak. The CDC arrives and speaks with the families to gather descriptive epidemiology by identifying when and where the outbreak occurs, who is affected, and how many people are involved (Gregg, Michael B, 156–157). They looked for connections between all three victims now in a coma, intubated, and in the ICU. They then conducted a series of lab tests and imaging on all patients to diagnose the cause, but their efforts remained unsuccessful, and they could not make the diagnosis.

When the first fatality occurred and officials identified the organ donor as the source, they continued descriptive epidemiology, now focusing on the donor himself.

The CDC went to the patient’s home and spoke to friends and family. Luckily, this led to information about a bat bite on the donor’s chest in the previous weeks. The CDC then requested an autopsy and sent investigators to the donor’s home looking for the bats with infrared lenses. CDC officials found multiple bats and tested them for the rabies virus. They discovered the same rabies virus in both the donor and the bat, confirming the source of the infection (“Fatal Infestations”).

The video ends with the death of the last living victim. Any situation where an individual is still alive and on the brink of death due to an unknown cause, which has already killed others, the involvement of local health departments and the CDC is crucial to determine the cause and source to treat and prevent further spread. Any initial investigation requires a case count and case definition (Gregg, Michael B, 157). In this situation, the case definition would have been erratic behavior, seizures, and coma. The count would have been three with the first victim as patient zero. The video revealed that the symptoms began approximately 3-7 days after the organ transplant surgery, meaning that whatever the cause, its symptoms occur rapidly and effects are catastrophic.

Descriptive epidemiology

This would add pressure on me as an investigator to conduct my work not only accurately but also very quickly (Gregg, Michael B, 10-13). My next step would be to begin data collection. Descriptive epidemiology involves analyzing demographics, exposures, and similarities among the three cases, as well as gathering hospital information and discussing with doctors to determine whether the infection originated from the surgical room, the tools used, or the staff present. Since it’s unclear if any of these are the cause, I’d worry about a wider exposure and possible

epidemic.

This information helps form a hypothesis of the possible source of infection and diagnosis; it would also help me decide whether or not to launch a full investigation (Gregg, Michael B, 186). In this case, I would because of the high risk of an epidemic of an unknown disease that can kill within 3-7 days. Once I ruled out the organ recipient hospital as the source of infection, I shifted my hypothesis to the donor hospital and the donor himself as the possible sources.

I would use visual aids and maps to help graph the case count and orient them in place (Gregg, Michael B, 191-196). Will help as I gather information from the donor hospital. Doing this may show the point of origin of infection and narrow down the possible source. This shows that as investigators progress through the investigation, they will also change and narrow the hypothesis until they find the true source.

Key Information Required About the Donor

The information I would require about the donor includes his symptoms on arrival at the hospital, which included erratic behavior, seizures, and drooling. Information gathered from friends and family on recent exposures, which would reveal the bat bite weeks back. The combination of the bat bite and the symptoms, the doctor in me, would immediately be concerned about rabies.

Just as the CDC did, I would request an immediate biopsy of the donor looking specifically for Negri bodies in the brain (CDC, 2011), as well as send investigators to the home to look for bats. After confirmation of the diagnosis of rabies, no one can do much for the surviving victim who received an organ from the infected donor. Unfortunately, they already presented with symptoms, and as mentioned previously, recovery is not likely.

Rabies is a viral disease that usually spreads to humans by contact with infected animals.

It is imperative to continue assessing risks of exposure to other people besides the initial victims. Assess any bodily fluid exchange with the donor, as rabies symptoms typically appear within 1 week to 3 months. Administer rabies PEP promptly before neurological symptoms appear to effectively prevent transmission, reduce fatalities, and save lives. Furthermore, I would be concerned about the presence of bats in the neighboring areas of the donors’ homes. If bats are in one home, others may be at risk; a written report is vital for epidemiological investigations.

Educational Outreach and Preventive Measures

Executing recommendations and implementing prevention measures are crucial to keeping healthy individuals safe and free from disease risk. This includes surveillance for bat, wild carnivore, and rabid dog sightings. Bats and rabid animals can infect domestic animals, so monitoring changes in domestic animal behavior is essential for surveillance.

I would distribute pamphlets educating the public on rabies risks and immediate steps to take if bitten by animals. 2) Make an appointment with your doctor to evaluate your risk of exposure and receive PEP if needed. I would seek help from Animal Control to remove raccoons, bats, and other rabies reservoirs from the streets.

The above includes what I would do if I were the investigator on the rabies case. 

As explained, I would do some things differently from what was seen in the video. With my medical background, I could have identified rabies symptoms earlier and helped prevent the delay in diagnosis. I would have also used visual aids to help identify the common area of exposure and the pattern of transmission. U.S. research prioritized bat risks, but international studies face added challenges like language barriers, cultural differences, and political issues. These would cause significant delays in acquiring data and arriving at a diagnosis quickly.

Challenges in International Rabies Investigations

In international settings, focus on vaccinating domestic dogs against rabies, monitoring street dogs, and addressing data trust issues globally. They are teaching the population about ways to protect themselves and others. Inform families that those most at risk of acquiring rabies are their children (Finnegan, C. J., S. M. Brookes, et al., 2003).

Community Education and Prevention

Educating the public about all potential rabies reservoirs is crucial to prevent challenges like those experienced in Thailand. Preventing re-emergence and epidemics of a disease is the goal. They implement prevention measures. They will struggle to provide enough rabies vaccines for all dogs and cannot eliminate every potential risk of exposure. Another thing to consider is access to health care.

If a dog bites someone, do they know where to go to get PEP? Can they get there quickly and safely? Will it be affordable? Public health officials must overcome obstacles, especially internationally, where limited healthcare access requires a clear, well-prepared plan. Overall, the investigation conducted during the rabies video does show the typical course of an epidemiological investigation.

Delays in reporting and diagnosis led to three rabies transmissions; raising awareness among the public and physicians is crucial.