Many 19th century diseases were wiped out, but many seem to be making a worrying return
And while immunisation and treatments mean outbreaks are contained before they become the uncontrollable killers they once were, it is still alarming to see Victorian diseases in the headlines.
Among the maladies currently having a resurgence are:
“Rickets affects bone development in children and is caused by vitamin D deficiency,” says Dr Jeff Foster, GP at Spire Parkway Hospital, Solihull. With improvements in nutrition, the condition was considered all but eradicated.
However, 4,638 children admitted to NHS hospitals in 2013 and 2014 were found to be suffering from vitamin D deficiency, compared to 1,398 cases in 2009 and 2010.
Disease prevention seems to be making a full circle as common Victorian diseases return
Why is it on the rise? “Children spend less time outdoors so they have less exposure to sunlight – and vitamin D,” says Dr Foster. Poor diet is also a factor, he adds.
How do you catch it? You don’t. It’s caused by a lack of vitamin D, which is naturally produced in the skin by exposure to sunlight.
Symptoms: Pain in the legs because of weakened bones and muscles along with poor growth, deformity and a delay in teeth emerging in young children.
Treatment: Regular calcium and vitamin D supplements.
Who is at risk? Those who don’t get enough sunlight, have a deficient diet or who are over-vigilant about applying high-factor sunscreens and covering up before going outside.
How to avoid it: Getting outside in sunlight for 15 to 20 minutes daily is enough to allow the body to produce vitamin D.
Eat foods rich in vitamin D, such as oily fish, eggs, liver and fortified cereals. Public Health England advises adults, and children from the age of one, to take a 10 microgram vitamin D supplement daily, particularly in autumn and winter.
Those with dark skin or with little exposure to the sun, such as care home residents or people who cover themselves outside, should take a supplement all year round.
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Cases of this infection, caused by streptococcal bacteria, have soared to the highest level in England for 50 years, with more than 19,000 cases reported in 2016.
Why is it on the rise? It’s unclear.
How do you catch it? It’s spread by coughs and sneezes or by touching infectious droplets.
Symptoms: “The initial symptoms are a sore throat, headache and fever,” says Dr Foster.
“After a few days a florid, red rash appears on the face and chest and the patient develops a red, swollen tongue.”
Treatment: Antibiotics. Untreated, the disease can lead to pneumonia, throat abscesses, sinusitis, meningitis and sepsis.
Who is at risk? Most cases occur in children under 10, although people of any age can get it.
How to avoid it: This is difficult as it is highly contagious and by the time the telltale rash appears, many people will be infected. Wash and dry hands thoroughly and regularly.
The hallmark of Scarlet fever is a red, swollen tongue
“TB is caused by a bacterium,” says Dr Foster. In Victorian London this lung infection, that can also attack other parts of the body, accounted for one in five deaths. In England in 2016, there were 5,664 TB cases, 39 per cent of which were in London.
Why is it on the rise? A recent report claimed a “clear link” to migration, with 74 per cent of cases occurring in non-UK born people. Antibiotic resistance is another factor and the fact the BCG vaccine is no longer provided routinely.
How do you catch it? It’s passed on through coughing and sneezing. “One person with untreated TB can infect 15 other people in a year,” warns Dr Foster.
Symptoms: A persistent cough progressing to chest pain, breathlessness, night sweats and coughing up blood. In advanced TB there may be extreme weight loss.
Treatment: A two-pronged approach of antibiotics to treat the active disease and tracing to test, treat and vaccinate others who may have come into contact with it.
Who is at risk? Although anyone can catch TB – even if vaccinated as a child – 60 per cent of adults with a healthy immune system can suppress the TB bacteria. People with compromised immunity, such as those with chronic health conditions, are at risk.
How to avoid it: Good hygiene, a healthy diet and adequate ventilation are important factors. The vaccine is available to people at risk.
Scurvy, caused by vitamin C deficiency, used to affect sailors on long journeys who lacked fresh food in their diet for months on end. Although the number of cases remains small, the disease is on the increase in England. From 2009 to 2014, hospital admissions for scurvy rose by 27 per cent.
Why is it on the rise? “While we have access to an abundance of food, many people eat a diet high in junk food with little nutritional value, and no fruit and vegetables,” says Dr Foster.
How do you catch it? You don’t. It’s caused by a lack of vitamin C.
Symptoms: Anaemia and fatigue progresses and leads to painful limbs and swollen, spongy gums, which can eventually cause the teeth to fall out.
Treatment: Vitamin C supplements.
Who is at risk? Children and the elderly with unhealthy diets or those dependent on alcohol or drugs.
How to avoid it: Eat a healthy, balanced and varied diet that includes fresh fruit and vegetables.
Scurvey was common among sailors of old without access to vitamin C
Measles is the highly infectious viral disease that was virtually unstoppable in Victorian England. The MMR vaccination has dramatically reduced the number of deaths from measles, but cases are climbing again with outbreaks occurring among young people at large public events.
Why is it on the rise? Vaccination uptake has fallen, according to Dr Foster. “When a high percentage of the population is vaccinated it is difficult for contagious, infectious diseases to spread. This is called herd immunity and it protects the vulnerable, such as newborn babies, the sick and elderly.”
However, health scares have led many parents to decide against having their children vaccinated in recent years.
How do you catch it? Through direct contact with an infected person or coughs and sneezes.
Symptoms: Fever, a cough, runny nose and flu-like symptoms and sometimes Koplik spots, small greyish-white dots in the mouth. The telltale rash on the body appears two to four days later.
Treatment: Fluids and paracetamol to reduce the fever. Doctors can monitor for complications such as pneumonia and encephalitis (inflammation of the brain).
Who is at risk? About 90 per cent of children who have not been immunised will catch measles if they come into contact with an infected person.
How to avoid it: Vaccination in at least 95 per cent of the population is needed to prevent outbreaks.
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Although virtually wiped out in the 1950s following a nationwide vaccination programme, a whooping cough epidemic in 2012 saw more than 9,300 cases in England alone. Following a reduction in the number of cases, they rose again in 2015 and 2016.
Why is it on the rise? A drop in the uptake of immunisation.
How do you catch it? It’s spread by infected coughs and sneezes.
Symptoms: Early cold-like symptoms (sore throat, sneezing, temperature and an irritating cough) for up to two weeks followed by long bursts of severe coughing and choking, then “whooping” when inhaling, and vomiting. It can last for about three months and is also known as the 100-day cough.
Who is at risk? Although anyone can get the disease, it is most dangerous to newborn babies.
How to avoid it: Vaccination.
Whooping cough can be incredibly dangerous for infants, so vaccination is vital
Cases of this sexually transmitted disease, rampant in the Victorian era, have reached their highest levels in England since 1949. Numbers have almost doubled since 2012, according to Public Health England information.
Why is it on the rise? Failure to practice safe sex, says Dr Foster. “Numbers of all STIs declined during the 90s because of public awareness campaigns about HIV. There is now less education about the dangers of unprotected sex.”
How do you catch it? Through unprotected sex.
Symptoms: Sufferers may be symptom-free for years then a painless ulcer can develop followed by a flu-like illness. Untreated syphilis can lead to serious complications, including dementia, cardiovascular problems and paralysis.
Treatment: Antibiotics. All partners should also be tested and treated to prevent reinfection and spread.
Who is at risk? Anyone who has unprotected sex with multiple partners.
How to avoid it: Use condoms, get regularly tested for STIs and avoid overlapping sexual relationships.