Scurvy might not be a thing of the past in Canada due to food insecurity, according to a new report.

The Canadian Medical Association Journal (CMAJ) published a report on Monday detailing the case of a 65-year-old woman who was diagnosed with scurvy at a Toronto hospital last year.

Authors of the report say this case emphasizes the possible comeback of scurvy and are advising doctors to have "a higher index of suspicion" in patients with low socioeconomic status who are experiencing food insecurity.

Scurvy:
Initial manifestations of hypovitaminosis C are often nonspecific, including fatigue, lethargy, weakness, irritability, and low mood.
➡️ https://t.co/OpMnKtOrgi@kevin.ryan.murray @TKiebalo @sallyengelhart pic.twitter.com/VvtVVMQmoV

— CMAJ (@CMAJ) October 7, 2024

What is scurvy and how does it develop?

Scurvy may make you think of pirates living in filthy conditions on a ship, but it's a result of having a severe vitamin C deficiency.

This could mean a lack of vitamin C-rich foods in your diet, which are citrus fruits like oranges and strawberries, as well as vegetables like broccoli and bell peppers.

According to the authors, the initial symptoms of a lack of vitamin C are usually non-specific, such as fatigue, lethargy, weakness, irritability and low mood.

"With sustained deficiency, classical signs of the condition begin to manifest, including corkscrew hairs, perifollicular hemorrhages, ecchymosis, hematoma formation, musculoskeletal pain and gingival disease, which are predominantly related to disruptions in capillary wall structure secondary to impaired collagen synthesis," reads the report.

For example, the 65-year-old woman detailed in the report had an eight-day history of progressive leg weakness and poor mobility.

Her examination also found gingival ecchymosis, also known as gum bruising, and bruising located at the groin and extending to her upper leg despite having no history of easy bruising.

How food insecurity might be contributing to the comeback of scurvy

The authors say the 65-year-old's social history showed long periods of limitations in important activities of daily living, including grocery shopping and meal preparation, due to the pain she experiences when she walks.

"She reported little social and family support," reads the report. "This social isolation had resulted in a sustained period of dietary intake limited to predominantly nonperishable foods — specifically, canned soup and tuna fish, along with white bread and processed cheese."

She wasn't taking any supplements or vitamins at the time, according to the authors.

"Rhis case presents a complex example of food insecurity manifesting as an uncommon diagnosis," reads the report.

While the authors found several signs of scurvy, the unifying diagnosis was only confirmed after a detailed assessment of her social and dietary history.

"Factors predisposing patients to poor nutrition intake are often complex and multifactorial," reads the report. "Given her functional impairments and limited external support, our patient's diet was devoid of fresh produce and largely limited to canned soup and fish."

Canadians reacted to these alarming findings online.

"Isn't capitalism great. It is working so well people in Canada are developing scurvy," reads one post on X.

"This should not be happening! The fruits are available but rot away on the shelves because no one can afford them. I honestly cannot remember the last time I bought an orange — I can't justify the price!" reads a caption from a @loblawisoutofcontrol post on Instagram.