The bone-deforming disease rickets is making a comeback in British children. In the last 15 years, the number of reported cases of rickets in hospitalized children has increased fourfold — from 183 cases in 1995 to 762 cases in 2011. Experts say the actual number is probably even higher since there's no official surveillance system and it's unknown whether the disease has peaked.
Last month, Britain's chief medical officer, Dr. Sally Davies, described the return of rickets as “appalling.” She proposed the country give free vitamins to all children younger than 5.
Rickets, which can lead to bowed legs, swollen painful wrists, curved spines, and other skeletal deformities, was common in 19th-century England because of dawn-to-dusk child labor practices during the Industrial Revolution. Today, the combination of endlessly cloudy British days and a generation of indoor, computer-oriented children is contributing to the resurgence of the disease.
Adequate sunshine is all that is necessary to prevent rickets, which is caused by a vitamin D deficiency. During the summer months, less than 10 minutes of midday sun exposure a few times a week is required for the human body to manufacture its own supply vitamin D for normal bone formation and maintenance. Unfortunately, any latitude north of Atlanta doesn’t get enough ultraviolet light in the winter months to do the job.
And, unlike the United States and other countries, England does not add vitamin D to milk.
Colin Mitchell of The Guardian reports that vitamin D supplements have been available to needy families in Britain for years, but they are not being used. “The disgrace is that we already have a political response to the vitamin D problem … but the scheme has been a failure: the numbers of infants with seizures or toddlers with rickets appear to have actually increased since 2006,” Mitchell reported. “In the majority of London boroughs less than 10% of eligible mothers have used the free vitamins.”
Mitchell concluded, “If we cannot rid one of the richest countries in the world of nutritional rickets in children, the problems with our health services are bigger than we thought.”
After almost eradicating rickets in the 1950s, the United States also has seen a recent resurgence, though there is no reliable national count of cases. Dr. Laura Tosi, an orthopedic surgeon at Children's National Medical Center in Washington, D.C., said some well-intentioned public health campaigns—like the drive to remove flavored milk from schools—could hurt children's bone health.
“It's a product of our changed society,” Tosi said. “Kids with rickets are children who don't have exposure to safe places to play and stop drinking milk as soon as they're weaned.”