Scurvy plagued the Royal Navy during the 16th and 17th centuries, killing more sailors than shipwrecks and wars combined. Now, the disease is making a 21st-century resurgence, but this time it’s due to poor diet rather than months at sea.
Doctors detailed in the journal BMJ Case Reports the case of a middle-aged man who came to the hospital with an unexplained painful rash and bruises on his legs. After blood tests and scans ruled out various illnesses and infections, the patient continued to deteriorate, leaving staff baffled.
Eventually, after several days in the hospital, it was discovered that he ate few fruits and vegetables and was surviving mainly on processed foods. Doctors later diagnosed him with scurvy, a condition caused by long-term vitamin C deficiency that can cause fatal bleeding if untreated.
The cases occurred in an Australian hospital, and the article warned doctors in the UK and other Western countries to be on the lookout for similar symptoms, including a mysterious rash. He added that the cost of living crisis, obesity and diets high in ultra-processed foods mean many people don’t get enough vitamin C, meaning scurvy is a “reemerging disease”.
Last summer, The Times revealed that around 11,000 people had been treated in hospital for malnutrition in the previous year, including 171 people with scurvy. The number of cases has increased significantly over the past decade.
Dr Andrew Darmawan, of the Sir Charles Gairdner Hospital in Perth, Western Australia, and author of this case report, said: “Scurvy is still considered a disease of the past, especially in developed countries. However, sporadic outbreaks of scurvy occur, especially in the elderly, alcoholics, people with mental illness and developmental disorders. It is often seen in troubled children.
“Scurvy is a disease that is re-emerging as the cost of living rises. It can develop as early as a month after a vitamin C-deficient diet.”
Fruits and vegetables are the key to preventing scurvy, which can develop after just one month of poor diet
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He said risk factors include poor diet, alcoholism, smoking, obesity, and having undergone weight loss procedures such as bariatric surgery.
The anonymous patients in the new study were diagnosed after tests showed their vitamin C levels were “undetectable” low.
“Further follow-up revealed that the patient’s living conditions were poor. Due to financial constraints, he neglected his eating habits,” the report said. “His diet was mostly processed foods and lacked vegetables and fruits. He sometimes skipped meals, but more often in recent weeks. I stopped taking vitamin and mineral supplements because I couldn’t afford them.
The patient, who is in his 50s, was given 1,000 mg of vitamin C tablets daily, and the rash disappeared.
Symptoms of scurvy include red or blue spots on the skin, usually on the legs and feet. It can also cause joint and muscle pain, swollen and bleeding gums, easily bruised skin, as well as fatigue and weakness.
Scurvy has been nearly eradicated in the Western world after proving fatal to sailors throughout history. The disease killed more than 2 million sailors between the 16th and 18th centuries, often killing more than half of a ship’s crew on major voyages.
In 1747, a British naval surgeon named James Lind conducted experiments on board his ship and discovered that oranges and lemons were a cure for scurvy. In 1795, lemon or lime juice was required to be distributed on warships to prevent scurvy, and British sailors earned the nickname “Limey” among American sailors.