Perth man treated for scurvy, condition linked to cost-of-living crisis

Scurvy, the scourge of seafarers in the 15th and 16th Centuries, is making a comeback in WA amid the cost-of-living crisis.

A middle-aged Perth man, who’d been eating hardly any fruit or vegetables and often skipping meals, was treated for scurvy at Sir Charles Gairdner Hospital.

The case prompted a scientific report which warned scurvy was a risk with rising food prices. Scurvy is caused by vitamin C deficiency.

The patient, in his early 50s, presented at the hospital with his legs covered with tiny painful red-brown pinpoints, resembling a rash. Blood was also present in his urine and he was anaemic.

He tested negative for inflammatory, autoimmune, and blood disorders, and scans revealed no evidence of internal bleeding. Similarly, a skin biopsy returned no diagnostic clues.

His rash continued to spread while he was in hospital. Further questioning revealed that he was short of money and neglected his diet, eating little in the way of fruit and vegetables. He said that he sometimes skipped meals altogether.

Doctors reported he had also stopped taking the nutritional supplements prescribed for him after previous weight loss surgery because he said he couldn’t afford them.

Blood tests confirmed no detectable levels of vitamin C and very low levels of other key nutrients.

He was diagnosed with scurvy and treated with daily vitamin C (1000 mg), vitamin D3, folic acid and multivitamin supplements, after which his painful rash and other symptoms cleared up.

“Scurvy is still seen as a disease of the past, especially in developed countries,” said Dr Andrew Dermawan, one of the treating doctors at Sir Charles Gairdner Hospital and lead author of the BMJ report.

“However, sporadic cases of scurvy occur, especially in the elderly and patients with alcoholism.

“In Australia, the rising cost of food is making it harder for families to afford meals. The increasing cost of living means that people are more reliant on lower-cost foods, which tend to be poor in nutritional value.

“Patients who have undergone bariatric surgery are also at risk of developing micronutrient deficiency ... There are multiple case reports of patients developing scurvy as a complication post-bariatric surgery.

“Our patient had multiple risk factors, namely, poor dietary habits, obesity, previous bariatric surgery, use of proton pump inhibitors and low-income status,” Dr Dermawan added.

“His history of iron, vitamin D and folate deficiencies were also clues to his underlying nutritional deficiency,” they conclude.

He was discharged home on regular vitamin supplements.

WA Council of Social Service (WACOSS) chief executive Louise Giolitto said the scurvy case was “incredibly alarming but, sadly, not surprising.”

“We know that those hit hardest by food insecurity are people who are already struggling to make ends meet. Especially those in regional WA, where remoteness makes food insecurity even worse.

“It’s a cruel cycle; hunger and poor diet lead to long-term health and well-being problems, and in turn, strain our already stretched health system. And this is all against the backdrop of WA’s booming economy, so it begs the question: who is it booming for?

“WA is rich, but if we don’t ensure that everyone can afford the basics – like fresh, healthy food – what’s the point of all that wealth? We’re talking about the simple stuff: ensuring families can buy fruits, vegetables, and proteins without them being discretionary items.

“Households are currently having to make impossible choices, paying the rent to ensure they have a safe place to live or buying enough food to feed themselves or their families for a week.”

Signs of scurvy can appear as early as a month after a daily intake of less than 10 mg of vitamin C.

If left untreated, sufferers can die.

Scurvy, which was reported as far back as ancient Egypt, was a curse on long-distance sea voyages during the Age of Sail. It was assumed that half the sailors on long trips would succumb to it.

“Clinicians should be aware of this fatal but easily curable condition that may still occur in this modern age,” the report’s authors added.