Researchers diagnose 27 cases of scurvy in northern Sask. community
Jeremy Warren | CBC News | Posted: November 16, 2024 1:43 PM | Last Updated: November 16
Unusual number of cases in La Ronge raises concerns about food security in rural and remote communities
The discovery of 27 cases of scurvy in a northern Saskatchewan community is raising concerns about grocery prices and access to fresh food as income inequality worsens.
Earlier this year, a doctor in La Ronge had a hunch that a patient was suffering from scurvy, a disease caused by vitamin C deficiency. The test came back positive and it raised questions about the prevalence of scurvy in the community.
The Lac La Ronge Indian Band partnered with Dr. Jeff Irvine and the Northern Inter-Tribal Health Authority to investigate. Irvine is a physician in La Ronge and works with Northern Medical Services, an off-shoot of the University of Saskatchewan college of medicine.
They tested 51 blood samples — all but one taken in 2023 or 2024 — and found 27 cases of low or undetectable levels of vitamin C. These results were followed with a physical exam, which confirmed a scurvy diagnosis in all 27 cases. Patient ages range from 20-80, and 79 per cent are Indigenous.
Confirmed cases of scurvy are rare, with single cases often forming the basis of entire studies.
"There aren't really these large groups of populations that have been tested, let alone diagnosed with scurvy like this in the past," Irvine said in an interview.
Scurvy isn't just a disease sailors developed during long voyages centuries ago. It happens when one doesn't eat enough foods with vitamin C, like fruits and vegetables. Symptoms include fatigue and joint pain, which can easily be misdiagnosed, but more severe signs include bleeding gums, loose teeth and wounds that are slow to heal.
The findings indicate more serious health and social issues are at play, Irvine said.
"It's just sort of the tip of an iceberg," Irvine said. "Vitamin C is not the only thing that's ever going on. So what other health concerns are there or what other things within people's lives are sort of stopping them from having the proper nutrition that they need?"
Scurvy is treatable with supplements or eating more food rich with vitamin C, such as citrus fruit and green vegetables.
Preventing scurvy basically comes down to eating your fruit and veggies. Irvine said traditional consumables in the north that help ward off scurvy include rosehip and Labrador tea, as well as the heart, liver and kidneys of some animals.
"People want more traditional foods and want more access to healthy foods, but there's been studies that show that people can't afford to eat balanced meals," Irvine said.
Scurvy cases are indicators of larger problems, such as income equality and rising cost of living, said Dr. Rachel Engler-Stringer, a professor of community health and epidemiology at the University of Saskatchewan.
"What we know from research is that when people are struggling financially, they tend to cut fruits and vegetables first, because they are relatively expensive to how satiating they are," Engler-Stringer said.
That means people on limited budgets might be choosing processed foods, which are cheaper and fulfilling but lack nutrition. Choices dwindle the further north one lives.
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A Saskatchewan Health Authority report from 2022 found northern residents pay more for quality food on average than residents in the south when it compared the price of the "national nutritious food basket" — minimally processed items such as fresh and frozen fruit and vegetables, cheese, milk, rice, meat, beans, and lentils — across the province.
That basket costs an average family of four in the north $358.79 per week, compared to $279.89 for the same family in the province's south.
"And not only are food costs higher, but the foods themselves may not even be available at all," Engler-Stringer said. "And so the more remote you get, the fewer vegetables and fruits you tend to find in whatever stores are available locally."
A University of Toronto study measuring food security across Canada found 20 per cent of Saskatchewan households — or about 224,000 people — experienced some level of food insecurity in 2022.
Last month, the Saskatoon Food Bank said it has seen a 40 per cent increase in users in the past five years. Nationally, Food Banks Canada said more than two million people visited a food bank in March this year, breaking the previous record.
Irvine said the research team is not calling for broad testing of vitamin C levels in patients, but he hopes the findings show that doctors should test for scurvy in specific cases of patients with symptoms.