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A poverty-linked bone disease that disappeared over 80 years ago, but resurfaced in northern parts of the UK this year, is now being discovered in high numbers of young patients in Southampton.
Rickets, a condition that causes children’s bones to become weak and bowed, was endemic in poor Victorian England, but was written off by many orthopaedic surgeons by 1928 following the discovery of vitamin D in 1922.
However, the disease is now making a comeback around the world due to low vitamin D levels caused predominantly by lack of exposure to sunlight and also poor diet – though it had not been uncovered in Southampton until now.
This vitamin, found in a small number of foods, is important in supporting growth and maintaining strong bones.
“The return of rickets in northern parts of the UK came as a surprise despite the colder climate and lower levels of sunshine in the north, but what has developed in Southampton is quite astonishing,” said Professor Nicholas Clarke, consultant orthopaedic surgeon at Southampton General Hospital and professor of paediatric orthopaedic surgery at the University of Southampton.
He explains that despite being historically linked with poverty-stricken communities, rickets is now appearing in children from all backgrounds.
“In my 22 years at Southampton General Hospital, this is a completely new occurrence in the south that has evolved over the last 12 to 24 months and we are seeing cases across the board, from areas of deprivation up to the middle classes, so
there is a real need to get national attention focused on the dangers this presents.”
Professor Clarke says he and colleague Dr Justin Davies, a consultant paediatric endocrinologist, have checked over 200 children for bone problems and more than 20% of them have significant deficiencies.
“A lot of the children we’ve seen have got low vitamin D and require treatment,” he said.
“This is almost certainly a combination of the modern lifestyle, which involves a lack of exposure to sunlight, but also covering up in sunshine, and we’re seeing cases that are very reminiscent of 17th century England.”
“We are facing the daunting prospect of an area like Southampton, where it is high income, middle class and leafy in its surroundings, seeing increasing numbers of children with rickets, which would have been inconceivable only a year or so ago.”
Professor Clarke says vitamin D supplements should be more widely adopted to halt the rise in cases.