Between January 2015 and November 2023, some 888 children with scurvy were hospitalized in France. The return of an illness that had disappeared.
It was nicknamed “the plague of the seas” and wreaked havoc on sailors who went on expeditions for months: scurvy. We thought he had disappeared, but he is back. The number of cases among children has increased in France since the Covid-19 pandemic, according to a study carried out by several medical teams from the Robert Debré hospital (AP-HP), Inserm, Paris-Cité University and the pediatrics department of Cayenne hospital in Guyana.
In detail, 888 minor patients suffering from scurvy were hospitalized between January 2015 and November 2023. An increase linked to inflation and the increase in precariousness.
What exactly are we talking about? The word scurvy comes from the language of the Vikings: “skyrbjurg”, composed of the words skyr, “curdled milk”, and bjugr, “edema”. “The appearance of edema was attributed to the large consumption of curdled milk by sailors during their travels,” explains the National Center for Textual and Lexical Resources. If the causes of scurvy are indeed dietary, they are not of this order.
“It is estimated that scurvy caused 2 million deaths between the 16th and 20th centuries,” Ulrich Meinzer, coordinator of the study on the increase in cases of scurvy among children, assures BFMTV.com.
“It’s a disease from another time.”
Bleeding gums, tooth loss
Scurvy, often associated with episodes of malnutrition or starvation, is caused by a profound and prolonged deficiency of vitamin C, also called ascorbic acid. “Vitamin C allows collagen to maintain its structure. Without it, tissues such as blood vessels lose their cohesion and end up being damaged,” explains Sciences et futur.
Among the symptoms: severe fatigue, bleeding gums, hair and tooth loss, hemorrhages and joint pain. “I saw children arrive with pain in the skeletal muscles, fragility of the vessels, small hemorrhages in the gums,” recalls Ulrich Meinzer, coordinator responsible for the general pediatrics department, pediatric rheumatology specialty at the Robert-Debré hospital. (AP-HP).
“Scurvy is an extreme disease but one that has almost disappeared. These cases were really surprising and unexpected. We should not encounter this disease in France.”
The doctor discusses with other pediatric rheumatologists who confirm that they have also encountered cases of scurvy. This is the starting point of the study. “Our results certainly underestimate the reality of the situation since we only took into account cases which underwent hospitalization,” worries Ulrich Meinzer.
Citrus fruits, tomatoes, broccoli
A potentially fatal disease. For the example of Vasco da Gama’s voyage in 1497 which made it possible to find the route to India by circumventing the Cape of Good Hope: “scurvy appeared after twelve to fifteen weeks of navigation and resulted in eleven month the loss of 120 sailors out of 160”, counts The Revue de Biologie Médicale.
Because vitamin C is essential for metabolism. However, the human body is not capable of producing it, so it must be supplied through food. It is found in fruits, particularly in citrus fruits (orange, lemon, clementine) but also in strawberries, kiwis or blueberries. During the 19th century, scurvy disappeared from the navy thanks to the addition of lemon or orange juice to sailors’ rations.
Vegetables also contain it – tomatoes, potatoes, broccoli, Brussels sprouts, cauliflower, watercress and even sauerkraut. But cooking partly destroys vitamin C. In 2016, in Australia, eleven patients were diagnosed with scurvy. They ate vegetables but overcooked them.
“Gentle cooking limits the loss of vitamin C,” explains doctor Ulrich Meinzer.
110 mg per day for an adult
From a consumption of less than 10 mg per day, symptoms appear. “Such deficiencies in our time are really confusing,” says pediatrician Ulrich Meinzer. One to three months of this profound vitamin C deficiency is enough for the person to become ill.
However, the disease can be cured relatively well: in ten to fifteen days with one gram of vitamin C (medication) daily. The symptoms even disappear within forty-eight hours. As a reminder, the recommended nutritional intake of vitamin C is 110 mg per day for an adult, indicates Anses. For children, these are 20 mg from 1 to 3 years old, 30 mg for those from 4 to 6 years old, 45 mg from 7 to 10 years old and 70 mg from 11 to 14 years old.
Vitamin C cannot be stored, so intake must be regular. “A person taking several times this daily dose will not necessarily be in better health, because beyond 1000 mg the body no longer absorbs vitamin C as effectively and the excess is evacuated in the urine,” développe National Geographic.
No need for food supplements, the food largely covers the needs. For information, an orange contains on average 90 mg of vitamin C, a kiwi 80 mg and a clementine 20 mg. “By eating five fruits and vegetables a day, there is no risk of scurvy,” adds Ulrich Meinzer, who nevertheless remains worried.
“Scurvy is not a childhood illness,” reminds the doctor. “That children suffer from scurvy means that they do not have a diet that allows them to be in good health, that their parents do not have the means to feed them properly, some even told me that they were depriving themselves of food. There is an emergency.”
