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Inside the Lab Microbiology and immunology, Clinical care

It Was the Best of Times, It Was the Worst of Times

When was the last time you ran into a case of rickets or scurvy? How about typhus or scarlet fever? These diseases may sound archaic, but the truth is that, in many locations, they are actually on the rise (1). Even gout and cholera are on their way up. Fortunately, consumption – better known as tuberculosis – is slower to follow suit, although it too is making a comeback in some disadvantaged populations.

Why are these Victorian-era complaints coming up more and more frequently in the diagnostic process? There are multiple reasons, ranging from homelessness and economic inequality to vaccine hesitancy and poor nutrition education. Those who don’t fully understand the need to consume a wide variety of vitamins may find themselves deficient in some – and those who can’t or won’t seek out immunity against infectious disease remain vulnerable to contagion.

The resurgence of these Dickensian diseases lays a special burden on diagnostic professionals: the need to consider and test for these once-unlikely health concerns. When selecting and ordering laboratory tests, primary care providers must be open to the possibility of older diseases – and when analyzing test results, laboratory medicine professionals must be watchful for signs of them. Keeping the potential for these so-called “medieval diseases” in mind could be the key to diagnosing and treating earlier, preventing an even greater spread.

Figure 1. Percent increase in admissions for diseases previously in decline (2).

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  1. A Ward, “‘Victorian-era’ diseases on the rise in the UK, but why?” (2019). Available at: Accessed May 29, 2019.
  2. A Matthews-King, “Huge increase in ‘Victorian diseases’ including rickets, scurvy and scarlet fever, NHS data reveals” (2019). Available at: Accessed May 29, 2019.

About the Author

Michael Schubert

While obtaining degrees in biology from the University of Alberta and biochemistry from Penn State College of Medicine, I worked as a freelance science and medical writer. I was able to hone my skills in research, presentation and scientific writing by assembling grants and journal articles, speaking at international conferences, and consulting on topics ranging from medical education to comic book science. As much as I’ve enjoyed designing new bacteria and plausible superheroes, though, I’m more pleased than ever to be at Texere, using my writing and editing skills to create great content for a professional audience.

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