RICKETS ON THE INCREASE IN U K.

A PROBLEM THOUGHT LONG GONE.

As a Primary School pupil in the second half of the 1940"s, just after the end of World War Two, one of my abiding memories is a picture in a school book showing two children suffering from the condition termed Rickets.The disease is responsible for deformities in the bones, readily evident in arms and legs. As such, seeing visual images of afflicted children of similar age to myself, had a strong impact upon me at the time and I have retained those pictures and the textbook explanation of the causes with me throughout my life.

At school, I recall receiving free milk which we were told was to give us calcium to help our bones grow properly. As children ,we were not aware that we were living in the key period of eradicating this age old disease, as medical science came to grips with it at last. In medicine, diagnosis is everything and it was not until the 1940"s that the disease and the causes of it were finally formulated in a manner to enable eradication. So by the time I was a Secondary school pupil through the 1950"s, the disease became almost totally eradicated in the Country.

The process had begun in the 1940"s and rapid progress meant that by the 1950"s initial measures were able to be discontinued as the general health and diet of the overall population had improved so well after the war and the new understanding of what caused the disease. I n fact in 1955/6 there were recorded only 183 cases throughout the UK.

IT IS AMAZING TO LEARN NOW ,THAT DESPITE ADVANCES IN ALL SORTS OF AREAS SINCE THEN, THAT IN THE YEAR 2011/12 THE NUMBER OF CASES WAS 762.An amazing and disturbing increase.

VITAMINS AND SUNLIGHT ARE JOINT KEYS.

Back in the 1940" and 50"s in the early days of the eradication programme, children were given supplements, though none of us to my recollection were aware of it. The basis for this had been the identification of deficiency in Vitamin D as being the overall cause of the condition. Consequently, foods such as cereals and margarine were apparently fortified by adding Vitamin D to them. Sunlight is a big provider of Vitamin D also and to compensate for lack of it, I recall sessions of Ultraviolet rays being given as we all sat in front of a machine wearing eye protecting goggles whilst wearing only shorts. This in winter time. A far cry from my father"s day when he had his chest smeared with goose fat covered with brown paper and then effectively "sewn in" to his vest in November and the whole lot not removed till March, ostensibly to protect his vulnerable chest !

In the 1950""s , after the successful effects of the programmes instituted in the 1940"s, the fortifying of foods with Vitamin D was discontinued as things had improved so much and the general care in pregnancy and infant hood, followed by a freer lifestyle had, as previously stated virtually removed the former scourge from the UK.

NOW, IN 2012 ,THERE IS A SIGNIFICANT RISE IN THE NUMBER OF RECORDED CASES OF RICKETTS AND A GROWING CALL FOR THE RE-INTRODUCTION OF VITAMIN SUPPLEMENTS.

It is known that only 10% of the body"s need for Vitamin D is received via food and in winter in a climate such as exists in the UK, the other 90% that is absorbed through sunlight is not usually met. Also, children are spending less time out in the fresh air due to a combination of reasons, some social, some related to the explosion in the amount of recreational time now spent indoors using computerised games and the like.

NO NEED TO PANIC.

THE RISE IN THE NUMBER OF CASES OF RICKETTS IN 2012 DOES RAISE CONCERNS, BUT THEY SHOULD NOT LEAD TO PANIC MEASURES.

Vitamin D in the food sector can be found in eggs, oily fish like sardines, mackerel and salmon. Already, fat spreads, used widely now in place of butter may be fortified as they were years ago with the essential vitamin, as are cereals and, if used, powdered milk. The importance of ensuring Vitamin D enriched foods cannot be stressed highly enough for pregnant women and young children with developing bones. Parents should check any signs of swelling around wrists and ribs or muscular or bone pains. When I was young some of these were termed "growing pains". It now transpires they could be harbingers of Rickets and the advice of a GP should be obtained where these are noted.

However, as 90% of Vitamin D is absorbed through sunlight, what can be done in the British winter ? One piece of advice I find fatuous is to take a winter holiday in sunnier climes. If this is to be considered essential, then I fear for our Scandinavian cousins who live 6 months of every year in virtual darkness. Clearly Vitamin D levels will diminish in winter months but, ensuring that they are at a good level before then by ensuring opportunities to get out in the sunlight of Spring, Summer and Autumn will provide adequate compensation if supported by a good diet and where necessary, vitamin supplements.

Thus, we have to acknowledge the fact that Rickets is a disease which will not go away unless we take the sensible steps to ensure Vitamin D is absorbed in sufficient quantities. As with so many health issues it appears to come down in the end to ensuring that growing children, and adults as well, have a balanced diet and a sensible outdoor exercise activity content in their lives. A consultation with a GP will indicate if a blood test is required to identify if D levels are dangerously low and if so, what supplements may be necessary. I see no reasonable reason to fear widespread multiplication of Rickets in future if such simple steps are followed. Rickets thrived when there was no National Health Scheme and knowledge of the causes was non existent or limited. That is not the case today and there is no reason to project panic measures. Sensible parenting, of which we sadly seem deficient here, is the key way to ensure children grow with strong and healthy bones and free from any sign of the old disease of Ricketts.

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