The Resurgence of Victorian-Era Diseases

Victorian-Era diseases like scurvy, tuberculosis (TB), and scarlet fever, once synonymous with the squalor of 19th-century Britain, have indeed been making a notable comeback in recent years — particularly in the UK, but with echoes in the US and globally.

These Victorian-era diseases were largely tamed through public health reforms, nutrition improvements, antibiotics, and vaccination, but factors like poverty, disrupted healthcare during the COVID-19 pandemic, migration, vaccine hesitancy, and cost-of-living pressures have fueled their return. Below, I’ll break down the trends, causes, and data for each, drawing on the latest reports as of mid-2025.

Key Trends and Data

Hospital admissions and notifications for these conditions have risen steadily since around 2010, with accelerations post-2020. Here’s a snapshot of recent UK figures (England-focused, as data is most granular there):

Scurvy, a Vitamin C deficiency, saw 188 hospital admissions in 2022 (up from 80 in 2010); cases nearly tripled to 171 in 2020-21 and was linked to malnutrition in 10,000+ annual admissions. Scurvy is rare in the US but even still, it’s tied to food insecurity and the global rise in low-income groups.

Tuberculosis (TB), saw 5,480 cases in 2024 (a 13% rise from 4,850 in 2023; 11% rise in 2023 from 2022). Infection rates are the highest since 1970; urban areas like London hit hardest (rates up to 113/100,000). In the United States, provisional 2024 data shows 9,000 cases (stable but above pre-pandemic lows); at the global level: 10.6 million new cases in 2023 alone according to the World Health Organization.

Scarlet Fever (Group A Streptococcus infection), saw 12,176 case notifications from January to March in 2024 compared to 3,488 case notifications from September 2021 to March 2022 (up 35% from prior year). There was a seasonal peak in early 2025 at 1.07/100,000 consultations. There were only sporadic outbreaks in the United States.

Sources: UK Health Security Agency (UKHSA) reports 2024-2025; NHS England data; WHO Global TB Report 2024.

Why Are These Diseases Returning?

Experts attribute the resurgence to a mix of socioeconomic and systemic issues, not just “Victorian” nostalgia:

• • Poverty and Malnutrition: One in five UK adults lives below the poverty line, driving food insecurity. Scurvy stems from diets lacking fresh produce—exacerbated by rising food costs (up 25% since 2021). Rickets (related vitamin D deficiency) saw 423 admissions in 2022, often in children from low-sunlight, poor-diet households.
  • Healthcare Disruptions: COVID-19 lockdowns delayed screenings and treatments, leading to a “lag” in TB diagnoses (infections from 2020-2022 surfacing now). TB treatment completion rates dropped to 79% in 2023.
  • Infectious Spread: Scarlet fever thrives in crowded settings like schools; post-lockdown mixing caused spikes. TB spreads via airborne droplets in under-ventilated urban areas, with higher rates among migrants from high-burden countries (e.g., South Asia, sub-Saharan Africa).
  • Vaccine and Awareness Gaps: Scarlet fever has no vaccine, but TB’s BCG jab (routine until 2005 in low-risk UK areas) and general hesitancy post-COVID play roles. Antibiotic resistance complicates scarlet fever and TB.
  • Broader “Dickensian” Factors: Over 14 million in UK poverty; 4 million children affected. Discussions on various social media platforms and news broadcasts highlight public alarm, linking it to austerity and Brexit’s £100B+ annual economic hit.

In the United States, trends mirror the UK’s but are less acute — TB is stable at 2.4 cases/100,000, per CDC 2024 provisional data, though urban hotspots (e.g., California) see rises tied to homelessness.

Symptoms and Prevention

These diseases are treatable if caught early, but delays can lead to severe complications (e.g., heart issues from scarlet fever, organ damage from TB).

• • Scurvy: Fatigue, bleeding gums, joint pain. Prevent: Eat citrus, berries, veggies; supplements for at-risk groups.
  • TB: Persistent cough (>3 weeks), fever, night sweats, weight loss. Prevent: Free screenings in high-risk areas; BCG vaccine for newborns in endemic zones; avoid close contact with infected.
  • Scarlet Fever: Rash, sore throat, “strawberry” tongue, fever. Prevent: Handwashing, isolate sick kids; antibiotics if exposed.

Public health bodies like UKHSA urge annual TB testing in vulnerable communities and nutrition programs. Globally, WHO’s 2035 TB elimination goal requires 18% annual UK reductions—ambitious but feasible with funding.This isn’t inevitable regression; it’s a wake-up call for equitable healthcare and social support. If you’re in a high-risk group, consult a General Practitioner — early intervention works.

For more information about any of these Victorian-Era diseases you can check out UKHSA’s TB/scarlet fever dashboards.