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Thursday, 18 April, 2002, 12:59 GMT 13:59 UK
Rickets returns in England
X-ray of rickets
Lack of Vitamin D causes softening of bones
A study has discovered high levels of rickets, a disease associated with Victorian slums, in an urban area of England.

The doctor who led the research says the condition would be virtually non-existent if Department of Health guidelines were followed.

Dr Nick Shaw, who studied cases in the West Midlands, said a national survey was now needed to establish the UK-wide picture.

The condition gives babies bow legs and can need surgery if it is not corrected when victims start to walk.

Skin factor

Rickets results from a lack of Vitamin D, which is stored in the body after being absorbed from sunlight.

Most of the cases in the study were in black or Asian families. Dark skin is more resistent to the effects of sunlight.

These guidelines have been in existence for many years and I think they are being forgotten

Dr Nick Shaw
Consultant endocrynologist

Between May 2000 and May 2001, researchers at Birmingham Children's Hospital (BCH) found 24 victims under the age of five. That amounted to 8.9 cases per 100,000 children.

Dr Shaw, a consultant endocrynologist, said: "That's high, in that it's a condition that was thought to have virtually disappeared.

"We are recommending a national survey. It is not just a problem in the West Midlands."

All 24 cases were successfully treated with Vitamin D supplements.

Dr Shaw said guidelines updated in 1991 said Vitamin D supplements should be taken by:

  • Pregnant women
  • Breast-feeding women
  • Breast-fed babies.

"These guidelines have been in existence for many years and I think they are being forgotten," said Dr Shaw.

"There is a lower level of awareness. People are not being advised to give supplements to breast-fed infants."

Preserved slum building
Rickets was associated with Victorian slums

Breast milk contains little Vitamin D. White European women probably have enough Vitamin D built up in their bodies during the summer to nurture their children in the womb.

"There was been a public health campaign to try to reduce rickets in black and Asian in the 1970s and early 80s," Dr Shaw said.

"We need a similar campaign now to raise awareness among the public and health professionals."

Soft bones

He said he thought there was a low awareness among doctors, midwives and health visitors.

Rickets is most common among children aged six months to two years.

It causes a softening of the bone and weakens bone structure.

The findings of the study have been put before the conference of the Royal College of Paediatrics and Child Health, meeting at the University of York this week.

Click here to go to BBC Birmingham Online
See also:

05 Feb 01 | Health
Rickets upsurge among UK Asians
21 Aug 00 | Health
Rickets makes a comeback
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