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Rickets and consumption epidemics sound like plotlines from Downton Abbey but doctors are reporting a rise in 19th-century illnesses we thought were a thing of the past.

Cases of measles, gout and syphilis are soaring, while this month new figures reveal we are in the grips of the biggest whooping cough outbreak for decades. So why is this happening? "Before routine vaccinations and our understanding of how infections spread, diseases like these affected thousands of people every year," says the Health Protection Agency. "Now, their impact has significantly reduced, but this doesn't mean they've been eradicated."

ed, but this doesn t adicate " The reason for the increase is that some conditions are linked to lifestyle - children are getting less sunlight leading to rickets, or a rise in risky sexual behaviour is pushing up syphilis numbers.eo e ht a al up Other comebacks are down to reduced rates of vaccines, sometimes because routine jabs were stopped when cases fell, as with TB, or due to public anxiety as we saw with the MMR jab. are tes mes were l as Modern measures, including national health campaigns, vaccination programmes and effective treatments means outbreaks are contained before they become the uncontrollable killers they used to be.

But it's still frightening to see these forgotten diseases hitting the headlines. Here's how to reduce your risk.

THE DISEASES THAT WOULDN'T DIE Rickets This childhood bone disease, caused by vitamin D deficiency, reached epidemic proportions when smog-filled Victorian cities blocked natural sunlight.

There are no exact figures but cases of rickets are rising. Dr Benjamin Jacobs, consultant paediatrician at the Royal National Orthopaedic Hospital, London, says it was unheard of when he qualified in 1988. Now he sees one case a month. Why? As many as one in four children could be lacking in vitamin D, which aids calcium absorption, due to them getting less outdoor activity, widespread use of sunscreen and a fall in the intake of cod liver oil - a standard supplement used 50 years ago. The rise in breast-feeding is also a factor, as breast milk is low in the vitamin, as is the rise in immigrants from hotter climes because darker skin needs more sun to make enough D. Spot the symptoms: Soft Spo skull bones, bow legs, painful bones and breaks, muscle weakness, slowed growth and dental problems are all signs.

sku pa mu gro ar Re th re udcvb Reduce your risk: This year the Government changed its recommendations, saying under-fives should take daily supplements that contain 7-8.5mcg of vitamin D. Pregnant and breast-feeding women should take 10mcg, and a family should aim for 15-20 minutes daily sun without sunscreen.

Tuberculosis is an infectious lung disease that killed one in four people during its peak in Victorian times. The discovery of antibiotics in the 1940s and the BCG vaccine brought rates so low it was deemed almost eradicated. But HPA figures showed thousands of cases were diagnosed last year, the highest since 1979.

Why? The ageing population, and an increase in poverty and immigration from areas where TB is a problem, such as Eastern Europe, are both factors.

In 2005, it was decided infection rates low we no longer needed to give G vaccine to all children, but es are now being targeted at sk groups, including babies on.

were so the BCG vaccine high-ri in Lond Spot th longer th sweats, Reduce as diagn awarene TB Aler Babies in the vacc smoking he symptoms: A cough that lasts han three weeks, tiredness, night weight loss and appetite loss. e your risk: "Know the symptoms, nosis is often delayed because TB ess is low these days", says charity rt, n areas with high rates are offered cine - speak to your GP. Quitting g reduces your risk.

Hospita which ca in the pa of kings was link being se Why? Ex to exces by a bui waste pr of food, include Spot thin the jo larger jo Reduce Reduce a day with Goutal admissions for the condition, auses swollen joints, have doubled ast decade. Known as the disease s, as it afflicted Henry VIII and ked to overindulgence, it is now een in 30 and 40-somethings. xperts blame eating and drinking ss for the illness, which is caused ild-up of uric acid in the blood, a roduct formed by the breakdown beer and wine. Other risk factors obesity and high cholesterol. he symptoms: Pain and swelling oints, often the big toe, but also oints such as the knee.

e your risk.: Lose weight if needed, alcohol to three or fewer units a h two days a week off, and exercise for 30 minutes, five times weekly.

W Before a Whooping cough vaccine was introduced in the 1950s, the illness caused more than 1,000 deaths a year. This year, we have had the worse outbreak since 1959, with 5,000 cases and 10 infant deaths. It doesn't usually lead to serious complications in older children and adults.

Why? The main rise is in teenagers and adults. Although they have probably been vaccinated, the effect may have waned, making them vulnerable to milder forms. Parents have also been forgetting to get preschool booster jabs for children. Spot the symptoms: A runny nose, temperature and dry, irritating cough, which progresses to intense coughing fits accompanied by a "whoop" sound. Reduce your risk: Get babies vaccinated at eight weeks, followed by boosters at three and four months. The Government is offering the vaccine to all pregnant women in the hope they will pass on protection to their unborn children.

Syphilis It was thought this STI, which can cause madness, paralysis and death, had almost been wiped out with the advent of penicillin. But cases have risen tenfold in the past decade.

Why? Our great-grandparents were well aware of the dangers, but adults today are largely ignorant of the condition.

The latest figures show men, mostly gay men, in their late 30s and early 40s account for a third of cases. Experts suggest many who contract it could be divorcees returning to the dating scene and think that safe sex messages are only directed at teenagers.

Spots the symptoms: It is symptomless initially, but weeping sores on the genitalia or infected areas can appear several weeks later, clearing up in two to six weeks before a rash appears on the body. Swelling of the lymph glands may occur. It can damage the heart, joints and nervous system if untreated.

Reduce your risk: Unprotected sex puts you at high risk, so condoms are vital.

Measles used to be almost unstoppable. Cramped living conditions allowed the virus to spread quickly. Many victims died of complications such as meningitis or pneumonia. The MMR vaccination brought rates down but there were almost twice as many measles cases in the first six months of 2012 as in the same period last year.

Why? Vaccination rates plunged after now discredited claims that the MMR jab was linked to autism. Rates are back to 93% but the cases may be in teens and older children who missed vaccines during the scandal. Spot the symptoms: Cold-like symptoms appear 14 days after contact. The rash emerges two days later, first as tiny spots on the neck then as blotches on the chest.

Reduce your risk: Ensure kids and teenagers get the MMR jab. The higher the rates of vaccination, the better the so-called "herd immunity". If you think your child is infected, keep them at home and call a doctor.

I LOST ONE LUNG TO TUBERI LOST RCULOSIS.. I WISH I HAD KNOWN THE SIGNS Amy McCon diagnosed Amy McConville, 30, from Ealing, West London, was diagnosed with TB at university.

I went to see my doctor for a dry cough. He gave me antibiotics, but it just got worse and I lost a stone. The only person who mentioned TB at this stage was my uncle, but I didn't take him seriously.

only p my uW W notic havin When I went home for Christmas, everyone noticed how tired and thin I was. I'd also started having night sweats. I was referred to hospital and h three time five-a Wh teles diagn I tho My thing had an X-ray, but a missing letter meant it was e months before I had further tests. During that I dropped even more weight - from seven to and-a-half stone. I remember thinking I had cancer. hen the hospital did a bronchoscopy, where a scope views the lungs, and sputum test, I was finally nosed with TB. I was so shocked when they told me. ught it was a Victorian disease that had died out. y treatment involved 13 antibiotic tablets a day. But gs were about to get worse - an X-ray showed one of my lungs had collapsed, which meant more time in hospital. Not long after, a TB relapse in the collapsed lung meant the only option was to remove it.

It has been a long road back to health, but I finally have the all-clear. I try not to let having only one lung affect me too much. I just wish I had known what signs and symptoms to look out for, but even the doctors didn't see me as high risk. Everybody should have TB at the back of their minds to ensure early diagnosis and avoid the complications I had.

It's impossible to say we've eradicated anything


INFECTION: Whooping cough

RECOVERED: Amy McConville

Diseases ften fatal in an times KILLER: were of Victoria

RICKETS: Victorian children in cities fell prey
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Title Annotation:Features
Publication:The Mirror (London, England)
Date:Nov 13, 2012
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