XXI Century: Scurvy on the rise in the United States…

In a recent review published in the journal JAAOS: Global Research and Reviews, researchers compile available information on the symptoms, diagnosis, radiological evidence, and treatment of Scurvy, a disease caused by the severe deficiency of vitamin C (ascorbic acid), reports News Medical.

They further conducted a retrospective investigation of pediatric patients from the United States (US) National Inpatient Sample Database (n = 19,413,465) between 2016 and 2020. Their findings highlight an alarming trend – in the span of just five years, the incidence of Scurvy in children more than tripled from 8.2 to 26.7 cases per 100,000.

More than half (64.2%) of scurvy patients were found to suffer from concomitant autism spectrum disorder, with male obese individuals, especially those in the lowest income quartiles, representing the highest-risk population.

Scurvy is a nutritional disorder caused by the severe and prolonged deficiency of ascorbic acid (vitamin C), characterized by mucocutaneous and musculoskeletal symptoms such as petechiae, bone pain in lower appendages, and gingival bleeding. Formerly a common and often lethal disease plaguing ancient mariners and responsible for millions of maritime deaths, particularly in the Ages of Sail and Exploration, Scurvy is now a rare disease thought to be restricted to underdeveloped regions and in refugee populations with limited access to fresh fruits and healthy nutrition.

Data collection comprised demographic data (age, sex, ethnicity and race, household income, and insurance status) and medical data (including International Classification of Diseases [ICD-10] codes for scurvy or comorbidity identification). Patients identified as having Scurvy were compared with the general inpatient population using statistical analysis comprising analysis of variance (ANOVA) or chi-square tests (with Kendall tau).

Nineteen million four hundred thirteen thousand four hundred sixty-five patients met the study inclusion criteria for the period under investigation and were included in statistical analysis. Of these, 265 individuals were diagnosed with Scurvy. Time series analyses revealed that during the course of the five years under study, the incidence of Scurvy increased from 8.2 per 100,000 (2016) to 26.7 per 100,000 children (2020). Population demographic data revealed that the mean age of scurvy patients was 2.15 years, with most being male (69.8%) and belonging to the lowest economic quartile (36.5%).

Despite being written off as an ancient disease or one restricted to the underdeveloped world, pediatric Scurvy seems to be making a comeback even in developed nations like the US. The present study highlights that in a span of just five years between 2016 and 2020, scurvy incidence more than tripled in the documented inpatient population.

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