Scurvy is a disease caused by a profound vitamin C deficiency. © Yann Khatchadourian on Unsplash
The teams from the general pediatrics department and the reference center for inflammatory rheumatism and systemic autoimmune diseases in children (RAISE) at the Robert-Debré AP-HP hospital, Inserm, and Paris Cité University and the pediatrics department of the Cayenne hospital in Guyana, coordinated by Drs Zein Assad, Maelle Trad and Professor Ulrich Meinzer, carried out a study on the increase in scurvy disease among children in France since the Covid-19 pandemic. The results of this study were the subject of a publication published on December 6, 2024 in the journal The Lancet Regional Health – Europe.
Scurvy is a disease caused by a profound deficiency of vitamin C and which had practically disappeared by the end of the 20th century.e century in high-income countries, particularly in Europe. Scurvy can cause, among other things, intense bone pain and disabling muscle weakness, hemorrhages and a deterioration in general condition. The worrying return of this disease highlights the possible consequences of the increase in socio-economic insecurity since 2020 on the nutritional status of children in France.
The main objective of the study was to assess trends in the incidence of scurvy in hospitalized children in France over a nine-year period and to examine the impact of the Covid-19 pandemic. The study also analyzed the evolution of malnutrition, differentiating severe forms from moderate and mild forms.
This study is based on data collected from the national PMSI system (program for medicalization of information systems). It included patients aged 18 and under, suffering from scurvy and severe malnutrition, between January 2015 and November 2023. The study covers two distinct periods: pre-pandemic (2015-2020) and post-pandemic (2020- 2023). Socioeconomic factors such as the consumer price index were incorporated to assess correlations with disease incidence.
A total of 888 scurvy patients were hospitalized, whose average age was 11 years. The increase in hospitalizations is estimated at 34.5% after the start of the Covid-19 pandemic. Furthermore, the increase in cases of severe malnutrition, estimated at 20.3%, reinforces the link of scurvy with a deterioration in the nutritional status of children. The increase in cases of scurvy and severe malnutrition was associated with worsening socio-economic insecurity and inflation. This association does not necessarily constitute a causal relationship, although plausible.
The re-emergence of scurvy can be linked to different causes including environmental and social factors but also linked to eating habits. It is also necessary to underline the unexpected impact of the pandemic and the global socio-economic and political crises that followed it, on the worsening of food insecurity. Thus, in France, food price inflation reached 15% at the start of 2023, particularly affecting precarious families.
Following the results of this study, recommendations could be proposed, particularly with regard to the implementation of targeted food aid programs, improving access to nutritious and affordable foods, as well as strengthening clinical training for the prevention and early detection of dietary deficiencies.
