Scurvy makes an unexpected comeback

The scourge of 18th century sailors, thought to be a bygone disease, is popping up in well-off kids with horrible diets

Fresh fruits (photo credit: Miriam Alster/Flash90)
Fresh fruits (photo credit: Miriam Alster/Flash90)

In a recent case at Rambam Hospital in Haifa, a child from a “good” (read: well-off) family was found to be suffering from all the classic symptoms of scurvy, much to the surprise of doctors.

It turns out that the scourge of the high seas in the colonial era is back, and it’s showing up in kids living in modern, wealthy countries, and whose diets consist of processed foods, with almost no fruits or vegetables.

Scurvy was common among sailors plying the oceans, as European rulers dispatched their navies to stake claim to the treasures of the New World. Surviving chiefly on preserved meat and fish, the sailors found themselves suffering from bruising, gum disease, loss of teeth, poor healing of wounds, and eventually death. It wasn’t until the 1800s that sailors, captains and admirals figured out that fresh fruit could alleviate scurvy, and only in 1932 was Vitamin C established as the key to curing the disease.

Since then, scurvy had virtually disappeared in the Western world, but in recent years it’s been making a comeback.

In the UK, doctors have reported that consumption of fresh fruits and vegetables has fallen significantly since the beginning of the recession in 2008. An 8-year old boy died of scurvy in Wales, in 2011. In the US, children as young as five, whose diet consists chiefly of junk food, have been diagnosed with the disease.

Like the plague, scurvy is widely seen as a disease whose time has come and gone, and so doctors often have trouble diagnosing it. The disease simply isn’t on their radar. That’s what happened to Prof. Riva Brick, the Director of one of Rambam’s pediatric departments, in a recent case that came her way.

Professor Riva Brick (Photo credit: Courtesy)
Professor Riva Brick (Photo credit: courtesy)

“A couple came to me with their young autistic child,” said Brick, who specializes in rheumatological diseases in children. “The child was having difficulty walking and was clearly in pain. After a few days, [he] was confined to a wheelchair. Blood tests and X-rays of the child’s skeleton seemed to be normal; next came an MRI scan. The results were surprising, generated concern, and were quite unknown to us. The scan showed inflammation in the bones, but we were unable to identify the cause.”

The hospital released the young patient, with Brick prescribing anti-inflammatory drugs. But the child’s parents brought him back to Rambam several days later, in noticeably worse condition, suffering from severe inflammation and bleeding gums.

It was those latter symptoms that set off an alarm for Brick. She asked the child’s mother what she was feeding him, and to her amazement, discovered that the mother basically allowed the child to set his own diet. He ate only the foods that he liked, such as schnitzel and burgers. His diet did not include fruits or vegetables, and according to Brick, the child had rejected nutritional supplements and vitamins that his parents tried to administer.

Once Brick had her diagnosis, treatment — and a cure — were as simple as getting the kid to drink some orange juice.

“I’ve been working for thirty years as a physician and the Director of the Department of Pediatrics at Rambam, [I’ve] checked thousands of children over the years, and I do not remember a case like this,” said Brick. “It is rare to meet a child whose food-obsessive preferences so totally remove Vitamin C from his diet.”

According to Brick, kids with autism are at special risk for nutritional diseases such as scurvy, because they often refuse to eat anything but their favorite foods, and harried parents do not have the resources or ability to get them to eat fruit.

While fresh foods are the best and easiest way to get sufficient levels of Vitamin C, according to Brick, there is still hope for kids, and their parents, who refuse to eat fruits and veggies. “Today industrial foods are packed with so many added vitamins, that a child can get enough vitamin C just from eating cornflakes,” said Brick.

“Of course, as a physician, I recommend the consumption of fresh fruits and vegetables,” she added.

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