Scurvy

Introduction

What is Scurvy?

Scurvy is a disease resulting from Vitamin C deficiency. A deficiency of vitamin C prevents the normal synthesis of collagen, thus causing widespread and significant changes in connective tissue throughout the body. The name scurvy comes from the Latin scorbutus, and humans have known about the disease since ancient Greek and Egyptian times. Scurvy commonly is associated with sailors in the 16th to 18th centuries who navigated long voyages without enough vitamin C and frequently perished from the condition. Modern cases of scurvy are very rare. 

Humans are unable to synthesize vitamin C - which is necessary for collagen production and iron absorption - and so they must obtain it from external sources (such as citrus fruits). Therefore, people must consume fruits and vegetables that contain or are fortified with vitamin C in order to avoid the vitamin C deficiency known as scurvy.

The first signs and symptoms appear after about 20-40 days on vitamin C-free diet.

Who gets scurvy? 

Though scurvy is a very rare disease, it still occurs in some patients - usually elderly people, alcoholics, or those that live on a diet devoid of fresh fruits and vegetables. Similarly, infants or children who are on special or poor diets for any number of economic or social reasons may be prone to scurvy. 

What causes scurvy? 

The primary cause of scurvy is insufficient intake of vitamin C (ascorbic acid). This may be due to ignorance, famine, anorexia, restrictive diets (due to allergies, food fads, etc.), or difficulty orally ingesting foods. Historically, scurvy was the result of long sea voyages where sailors did not bring along enough foods with vitamin C.

Symptoms of scurvy

• Pinpoint haemorrhages (petchiae) around hair follicles and back follicles on the back of the arms and legs.
• General fatigue 
• Bleeding in the gums and joints making them painful
• Loose teeth 
• Dry skin with Spots 
• Dry hair 
• Longer healing time for wounds 
• Growth retardation in children 
• Bleeding around the bases of the hair on the legs (Perifollicular haemorrhage). There may also be swelling of the bone joints

Treatment and Prevention

Prevention and treatment is all about getting sufficient Vitamin C. Citrus fruits, potatoes, and green vegetables in general are good sources of vitamin C. At least 5 servings of fruits and vegetables a day provides ample Vitamin C. The most nutrient dense sources of Vitamin C are green pepper, cauliflower, broccoli, strawberries, papayas, lettuce, oranges, spinach and other green vegetables.

Vitamin C is easily lost in processing and cooking. Juices are good to fortify with Vitamin C because there acidity reduces Vitamin C destruction. Vitamin C is very unstable when in contact with heat, iron, copper and oxygen.

Recommended Dietary Allowance (RDA) for Vitamin C

Vitamin C rich foods

Vitamin C is also found in juices of fresh fruits and in certain commercial soft drinks.

Remember, Vitamin C is easily destroyed by heat (cooking).

When do you need extra Vitamin C?

• After serious injury
• After serious Burns 
• After major surgery

Review process

1. Draft supplied by Dr Mukuhi Nganga Aug 2009 
2. Review by Dr Alice Ojwang-Ndong. M.Nutr Stellenbosch, Nutritionist and Dietetic Consultant May 2012
3. Formatting by Infonet March 2011

Information Source Links

• Ministry of Medical Services, GOK. Kenya National Clinical Nutrition and Dietetics Reference manual. Nairobi, Kenya: Ministry of Medical Services Republic of Kenya; (2010).
• www.medicalnewstoday.com May, 2012