LANCAO

Scurvy, a disease last prevalent in the 18th century, is making a surprising comeback — and it could be because the cost of living is so expensive.

The disease, which killed more than two million sailors between the 16th and 18th centuries alone, has now been diagnosed in a man in Perth, Australia, much to the surprise of doctors.

Doctors believe the cost of living crisis, obesity and ultra processed foods may be to blame for people not getting enough vitamin C in their diet and developing the disease.

What is scurvy?

Scurvy occurs when people do not have enough vitamin C in their diet, which is needed to produce collagen in the body.

Collagen is used to maintain the health of skin, blood vessels, bones and connective tissue.

And without enough vitamin C, the body cannot properly repair tissues, help heal wounds or fight infections, which can lead to a range of potentially fatal infections.

There are a range of reasons why people may not get enough vitamin C in their body.

This could be because they consume no fresh fruit or vegetables, eat very little food at all, smoke – which reduces how much vitamin C your body gets from food – or have a long dependency on drugs or alcohol which affects their diet.

What happened?

The doctors revealed a case study in the journal BMJ Case Report of a middle aged man who arrived at Sir Charles Gairdner hospital in Australia with unexplained red-brown pinpoints that looked like a painful rash, and bruising on his legs.

After extensive investigations, including blood tests, scans, biopsies and a CT scan, staff were still baffled as to what the mysterious illness could be, as the patient was getting worse and his rash continued to spread. 

After spending a few days in hospital, it came to light that the man, who was unemployed and lived alone, had hardly eaten any fruit and vegetables and survived mainly on processed foods due to financial issues.

Previously, the patient had undergone bariatric surgery eight years prior to this incident which reduced the size of his stomach. And due to his financial constraints, he had stopped taking the vitamin and mineral supplements prescribed to him after surgery. 

So the doctors made a diagnosis of scurvy, which if left untreated, can lead to fatal bleeding. 

Another report from Canada, which was published just over two weeks ago, revealed the case of a 65 year old woman who was diagnosed with scurvy at a Toronto hospital last year. 

The report revealed the woman, who had little family support and limited mobility, had been living almost entirely on canned soup, canned tuna, white bread and processed cheese – with no fresh produce. 

The woman reported that she had discolouration on her legs which had been present for around three months. 

Lead author of the Canadian report Dr Sally Engelhart said: ‘This isn’t the first case of scurvy that I’ve seen in my career so far.’ 

Why is scurvy re-appearing?

Despite having access to much more fresh produce, scurvy is still being seen in the Western world. Why?

The BMJ Case report’s author, Dr Andrew Dermawan, wrote: ‘Scurvy is still seen as a disease of the past, especially in developed countries.

‘However, sporadic cases of scurvy occur, especially in the elderly, patients with alcoholism and children with psychiatric or developmental problems.

‘Scurvy is a re-emerging disease with the rising cost of living. It can present as early as a month after a vitamin C-deficient diet.’ 

Due to the cost of living crisis people may have more restricted diets, as they are unable to afford fresh fruit and vegetables so they do not get enough vitamin C in their diet.

There are also parts of the world where people do not have access to fresh produce, which is known as ‘food deserts’, meaning people are unintentionally not receiving enough vitamin C in their diet.

How do you treat scurvy?

After the doctors prescribed the Australian patient 1,000mg of vitamin C daily, as well as a vitamin D3 supplement, folic acid, and a multivitamin, in addition to a meal plan created by a dietitian, his symptoms resolved.

He also started eating a lemon daily. 

After being prescribed a high dose of vitamin C, the patient’s symptoms disappeared. 

The patient from Canada was also given high doses of vitamin C (1,000mg per day for at least a week) which led to improvements in her symptoms and eventually a full recovery.

Why is scurvy linked to sailors?

Until its re-emergence, scurvy has largely been wiped out of the Western world after it proved to be fatal for sailors throughout history.

It is thought that the disease killed more than two million sailors between 16th and 18th centuries, with more than half of ship’s crew often killed on major voyages due to the lack of access to fresh food.

When a royal Navy Surgeon, by the name of James Lind, ran a trial on board a boat in 1747, he found that oranges and lemons were a cure for scurvy.

In 1795, lemon or lime juice rations were made compulsory to prevent scurvy on warships. 

This also led to British nickname of ‘Limeys’ among American sailors.