Scurvy – the classic disease of sailors and malnourished populations – appears to be making a quiet comeback in the modern world. A new Italian study has documented eight cases of the condition in young children, and a review by the same doctors of 253 other recent cases confirms that severe vitamin C deficiency is far from being extinct. Yet most doctors still consider scurvy to be a disease of the past, and their training gives them little reason to think otherwise. In most medical schools, nutrition is barely taught. Doctors can therefore be forgiven for missing a diagnosis that should, in theory, be easy to make.
The new research, conducted in Catania, Sicily, examined cases of childhood scurvy diagnosed between 2021 and 2023 at two pediatric hospitals. All eight children showed symptoms such as leg pain, refusal to walk, gum bleeding, and fatigue. In some, X-rays revealed the typical bone changes caused by vitamin C deficiency. Blood tests confirmed critically low levels of vitamin C in every case. Symptoms disappeared rapidly once the children received vitamin C supplements and fresh citrus fruits were added to their diets.
The authors of the study also carried out a systematic review of 126 scientific papers covering 253 cases of childhood scurvy worldwide. The typical patient was a young boy aged between two and three. Many had restrictive diets or underlying health problems affecting food absorption, but others were simply picky eaters. In some cases, harmful myths about citrus fruits – such as the idea that mixing orange juice with milk causes illness – had prevented parents from giving their children one of the richest natural sources of vitamin C.
This picture shatters the common medical assumption that scurvy “doesn’t happen anymore” in wealthy countries. The condition may be uncommon, but it is certainly not obsolete. Its symptoms can mimic many other diseases – from arthritis to leukemia. This often leads to unnecessary investigations, misdiagnosis, and delayed treatment. In one previous review, more than two-thirds of patients were initially misdiagnosed.
A vital nutrient, a preventable disease
Vitamin C, also known as ascorbic acid, plays a vital role in human health. Unlike most animals, humans cannot produce it internally and must get it from fruits and vegetables. It supports immune function, helps absorb iron, protects cells against oxidative damage, and is essential for making collagen – the protein that holds our tissues together. Without enough vitamin C, gums swell and bleed, blood vessels become fragile, skin and bones weaken, and the body struggles to heal.
Early symptoms of scurvy are vague: tiredness, irritability, loss of appetite, and general discomfort. As the deficiency progresses, more specific signs appear, including bleeding gums, easy bruising, joint pain, rashes, and in children, refusal to walk because of bone pain. These symptoms often appear within just a few months of an insufficient vitamin C intake. Treatment is simple, cheap, and fast: large daily doses of vitamin C lead to rapid improvement, often within days. Full recovery is the rule rather than the exception.
Why scurvy gets missed
So why might doctors miss something so well understood? In short: they are rarely properly trained to recognize it. Despite a century of research demonstrating the importance of nutrition, most medical schools devote only a few hours to the subject over the course of a degree. As a result, doctors learn to prescribe drugs for complex diseases but not to identify the root causes of malnutrition.
This educational gap has real consequences. When a child presents with fatigue and leg pain, doctors are taught to think of infections, autoimmune diseases, or even cancer. They may order scans, blood counts, and expensive specialist consultations, but vitamin deficiencies are generally seen as low on the list of possibilities.
Modern diets and misinformation
While scurvy is historically linked to extreme deprivation, modern cases often arise from subtler causes. One growing problem is restrictive eating patterns among children. Some have neurodevelopmental conditions such as autism spectrum disorder that make them avoid certain textures or tastes. Others are simply “picky eaters” whose diets consist largely of processed carbohydrates, with few fruits or vegetables.
Cultural beliefs and misinformation can also play a role. In the Sicilian cases, several parents avoided giving citrus fruits because they wrongly believed oranges and lemons cause bladder infections or become “toxic” when mixed with milk. Such myths, combined with modern convenience foods low in nutrients, create the perfect conditions for vitamin C deficiency – even in regions famous for growing citrus fruits.
Obesity, too, can mask underlying malnutrition. In several reported cases, children who were overweight were found to have scurvy, highlighting the fact that a calorie-rich diet is not necessarily nutrient-rich. Ultra-processed foods often supply energy but lack essential vitamins and minerals.
An old disease in new clothes
Scurvy has a long history. It was notorious among sailors in the Renaissance era, when long voyages without access to fresh produce led to devastating outbreaks. The simple discovery that citrus fruits could prevent and cure the disease saved countless lives. But while it is no longer epidemic, the underlying biological reality hasn’t changed. Humans still depend on vitamin C, and if they don’t get it, they will inevitably develop deficiency symptoms sooner or later.
In children, the consequences can be serious if not recognized promptly. Bone and joint pain can interfere with growth and mobility. Fragile blood vessels can lead to bruising and internal bleeding. Gum disease can cause tooth loss and infection. Yet all of this can be prevented with a proper vitamin C intake.
The need for change in medical education
The real tragedy is that preventing and treating scurvy isn’t difficult. Medical students are trained for years to diagnose rare diseases but receive almost no practical education about nutrition, despite its fundamental role in health. This gap is particularly dangerous because vitamin deficiencies often present with non-specific symptoms that mimic other conditions.
If doctors were systematically trained to consider nutritional deficiencies early on, children like those in the Sicilian study could be spared months of pain, unnecessary investigations, and anxiety. Their families could receive practical dietary advice rather than complex medical interventions. And healthcare systems could save considerable resources.
But the current situation persists in part because nutrition-based approaches do not align with the financial interests of the pharmaceutical industry. Teaching doctors to prevent disease through nutrition is far less profitable than treating symptoms with drugs. This imbalance has left generations of clinicians unprepared to deal with something as basic as scurvy.
Beyond scurvy: vitamin C and heart disease
The importance of vitamin C extends far beyond the gums, skin, and bones. Decades ago, Dr. Matthias Rath made a groundbreaking discovery showing that chronic vitamin C deficiency is the primary cause of cardiovascular disease. When vitamin C levels are too low, the body cannot properly maintain and repair the walls of blood vessels, leading to damage and plaque buildup. This insight reframes heart disease – the world’s leading cause of death – not as a mysterious or inevitable condition, but as a preventable deficiency disease.
Yet this concept, like scurvy itself, remains absent from medical training. Doctors learn to prescribe cholesterol-lowering drugs but not to address the underlying nutritional weakness that makes blood vessels vulnerable in the first place.
Putting nutrition back where it belongs
Modern-day scurvy is a stark reminder that even in high-income countries, good health cannot be taken for granted. The Scillian cases highlight the urgent need to bring nutrition into the heart of medical education and public health policy.
For families, the message is simple: vitamin C is essential, and a diet containing plenty of fresh fruits and vegetables is vital for obtaining it. For doctors, the lesson is equally clear: don’t dismiss scurvy as a disease of the past. For medical schools, it is time to stop treating nutrition as an optional extra and start teaching it as the cornerstone of health that it truly is.
If this shift happens, preventable diseases like scurvy could finally become the relics of history that many wrongly assume they already are. Until then, the quiet reappearance of this life-threatening deficiency disease is likely to continue.