What is Scurvy?
Scurvy is a disease caused by a severe and prolonged deficiency of vitamin C, also known as ascorbic acid, which is essential for collagen synthesis. Vitamin C must be obtained through diet, primarily from fresh fruits and vegetables, as the body cannot produce it. A deficiency typically develops after about three months of inadequate intake.
The Historical and Modern Reality of Scurvy
Historically, scurvy was common among sailors on long voyages without fresh produce. James Lind linked citrus fruits to prevention in 1747. While rare in developed countries today due to better nutrition, scurvy still affects specific vulnerable groups.
Who is at risk of getting scurvy?
The odds of getting scurvy are low for most people, but certain groups have a higher risk. These include:
- Infants: Especially those not receiving adequate vitamin C from breast milk or fortified formula.
- The Elderly: Due to factors like isolation and restrictive diets.
- Individuals with Eating Disorders: Severe dietary restrictions limit vitamin C intake.
- Alcohol and Drug Dependents: Substance abuse often leads to poor diet and nutrient absorption issues.
- Those with Malabsorption Issues: Conditions like Crohn's or celiac disease can hinder absorption.
- Patients with Chronic Illness: Conditions such as diabetes or kidney disease may increase needs or reduce intake.
- Individuals with Autism Spectrum Disorder (ASD): Selective eating patterns increase risk.
- Smokers: Increased oxidative stress requires higher vitamin C intake.
Risk factors for scurvy: then vs. now
Scurvy's risk profile has shifted from a widespread issue to one affecting specific subgroups.
| Feature | Historically (Age of Sail) | Modern Era |
|---|---|---|
| Primary Cause | Lack of fresh produce on voyages. | Poor diet, malabsorption, and substance abuse in high-risk groups. |
| Socioeconomic Status | Widespread among sailors and those with limited access. | Affects lower-income individuals and those in institutions or refugee settings. |
| Incidence | Very high, often with mass fatalities. | Generally rare, but isolated cases and small outbreaks occur. |
| Diagnosis | Often late, based on severe symptoms. | Can be misdiagnosed; requires clinical suspicion in at-risk groups. |
Symptoms and progression of scurvy
Scurvy symptoms develop gradually. Early signs, such as weakness and fatigue, can be non-specific. Intermediate signs include skin changes like perifollicular hemorrhages and corkscrew hairs, along with easy bruising and potential anemia. In advanced stages without treatment, severe gum disease, poor wound healing, and internal bleeding can occur. Severe cases can be fatal.
How to prevent scurvy
Preventing scurvy involves ensuring sufficient vitamin C intake.
Dietary Sources:
- Consume plenty of citrus fruits, berries, kiwi, melons, sweet peppers, broccoli, tomatoes, potatoes, and spinach.
- Prioritize fresh, raw produce as cooking can reduce vitamin C levels.
Supplementation:
- Supplements may be necessary for individuals with risk factors.
- Consult a healthcare provider for appropriate dosages.
Lifestyle Changes:
- Address underlying issues like addiction or chronic illness.
- Seek nutritional counseling if needed.
Conclusion: Scurvy remains a risk for the vulnerable
While the average person in a developed nation has low odds of getting scurvy due to accessible vitamin C, it continues to pose a risk for specific vulnerable populations, including those who are malnourished, substance abusers, elderly, and individuals with highly selective diets. Early diagnosis is vital, particularly in those with risk factors. Scurvy is treatable with vitamin C supplementation, leading to rapid symptom improvement. Prevention focuses on a balanced diet rich in fresh produce, supplemented when necessary.
