Research by a young Canadian doctor working in Hamilton suggests that scurvy, a disease we mostly associate with life on sailing ships centuries ago, may be more prevalent in modern Canada than we might have thought.

Scurvy is a caused by vitamin C deficiency, usually due to a poor diet that doesn't include enough fruits and vegetables. Symptoms include bruising, weakness, anemia, difficulty in wound healing, gum decay and loose teeth. Untreated it can lead to hemorrhage and death.

It also takes very little vitamin C to prevent scurvy. A single orange has five times the daily dose of vitamin C necessary to prevent scurvy.

Dr. Kayla Dagdar, then a medical student at McMaster University, looked at records from hospitals in Hamilton, Ontario covering a period of nine years. She found that 52 patients with low Vitamin C levels, 13 of whom were diagnosed with scurvy. The remaining 39 tested positive for scurvy but did not have documented symptoms.

There was a common theme among the patients. They all had poor diets, as a result of a range of factors including alcohol abuse, mental illness, social isolation, purposeful dietary restrictions and dependence on others for food.

Even though the study looked only at patients in hospitals in Hamilton, Dr. Dagdar, now a resident at the Ottawa Hospital, thinks there's no reason to think that if we look we won't find scurvy in the rest of Canada. In fact, she thinks its likely underdiagnosed generally. Her study only found cases where patients had been tested for vitamin C levels.

The lesson, she suggests, may be that clinicians and other healthcare workers caring for at-risk patients should be aware of scurvy and how to diagnose the disease. It may be easily missed due to the perception that it is not a disease of the modern world.