The number of people hospitalised with potentially deadly Victorian diseases has soared to a five-year high.
Experts are warning that anti-vaccine sentiment could see some of these Dickensian illnesses “bounce back” - while parents have been urged to be on the lookout for signs in children as cases continue to rise.
Exclusive figures from the NHS reveal that patients in England were diagnosed with one of 13 Victorian diseases when admitted to hospital on 421,370 occasions in the year to March.
They include all people admitted with these illnesses - which include gout, tuberculosis, malnutrition, whooping cough, measles, scurvy, typhoid, scarlet fever, diphtheria, mumps, rickets, cholera, and vitamin D deficiency - even if it wasn’t the primary reason for their admission.
The number was up by 25% from 338,216 hospital admissions in 2020/21, having dipped during the pandemic where previously it had been rising year-on-year.
It puts the number of in-patients diagnosed with these diseases at the highest level seen since at least 2017/18, when these figures begin.
In particular, there were 229,888 cases of gout diagnosed in the year to March 2022 - up 23% from 186,570 the year before - as well as 174,933 cases of vitamin D deficiency (up 28% from 136,314)
There were also 10,282 cases of malnutrition diagnosed, 4,663 cases of tuberculosis, 423 cases of rickets, 520 cases of scarlet fever, 188 cases of scurvy and 162 cases of typhoid fever.
A further 159 cases of mumps, 56 cases of whooping cough, 34 cases of measles, 49 cases of diphtheria and 13 cases of cholera were also diagnosed.
Diseases such as these were the greatest cause of Victorian mortality - and while their impact and spread has since been contained thanks to developments such as clean water, wholesome food, education, antibiotics and vaccinations, the truth is they have never really gone away.
Speaking to the Telegraph earlier this year, Stephen Baker, a professor of microbiology at the University of Cambridge, said it was “amazing that in 2021 people are still getting scurvy” and that was mostly due to “really poor diet”.
Meanwhile, many of the diseases are preventable through vaccination, including measles, whooping cough, diphtheria and mumps.
Mr Baker said: “These are all completely vaccine preventable, particularly with measles which is super transmissible.
"Often you get these communities with a lot of anti-vaxxers, and they often get outbreaks of measles and mumps with people that refuse to have themselves or their kids immunised.”
Difficulty accessing routine NHS vaccinations or choosing to stay away from the health service throughout the pandemic may have also impacted these admissions - but Mr Baker warned that if a large proportion of children remain unvaccinated “post-covid”, there will likely be a peak in cases.
He added: “If we stop immunising our children, then we go back to the Victorian era.
"We look upon these things as a bit of a thing in the past because they are a thing in the past, not because we've got rid of them. It’s because we've controlled them through immunisation. If we take away vaccines they will bounce back.”
The UK Health Security Agency has also highlighted a post-lockdown rise in Victorian diseases such as scarlet fever, as children continue to mix freely.
A total of 3,488 cases of scarlet fever were identified between September and March - lower than pre-pandemic levels, but compared to just 1,791 cases reported in the entire year to March 2021.
Rates have been highest in the North West of England, with officials in Warrington warning that cases are currently above pre-pandemic levels.
Speaking to the Warrington Guardian, cabinet member for public health and wellbeing, Cllr Maureen McLaughlin said: “This is since the removal of Covid-19 restrictions and the move closer to pre-pandemic levels of social mixing.
"While there could be a variety of factors driving this, our reduced exposure to bacteria and viruses during the pandemic may mean that we are experiencing an immunity deficit to some illnesses, leading to a higher susceptibility of infection.
"Although incidents of scarlet fever are relatively low, this includes a higher incidence of reported cases than pre-pandemic levels in Warrington.”
Public health officials in the area have been working to reduce transmission, sharing information with schools and parents on the signs to look for.
The three key symptoms of scarlet fever include a high temperature, a sore throat and swollen neck glands, and a bumpy, rough feeling rash that usually appears on the chest and tummy after 12 to 48 hours.
Other symptoms include a white coating on the tongue, which peels a few days after appearing, leaving the tongue red and swollen, known as “strawberry tongue”.
If your child is showing these signs, you should contact your GP or NHS 111.