THE bone disease rickets — which was last prevalent in the 19th century — is on the rise in Bolton.

A lack of exposure to sunlight is being blamed for the resurgence of the disease, which was virtually wiped out in the Western world in the 1940s.

Health bosses are now handing out vitamin D, which can help prevent rickets, to mums-to-be and families.

Plans are also being developed to give vitamin D tablets to all pregnant women, new mothers, and children under five.

A Freedom of Information request has revealed the number of people being treated in hospital for rickets has doubled in the last two years.

A total of 10 people in Bolton were treated in hospital with the illness between 2010 and last November.

There were three cases in 2010, one in 2011, and six last year.

Of those treated, two were aged under one, six were aged between one and 16, and two were aged 17 to 64.

An NHS Bolton spokesman said: “We are concerned by the rising numbers of cases of rickets in the region, and by the wide range of negative health impacts of insufficient vitamin D, especially in children.

“Our assessment has shown that diet alone cannot provide sufficient vitamin D, and regardless of deprivation or income the population of Greater Manchester do not get enough vitamin D through sunlight.”

The condition leads to a softening of the bones and occurs mainly in children.

It is caused by a lack of vitamin D, which comes from sunlight, and symptoms include muscle weakness, knock knees and bowed legs, cranial, pelvic, and spinal deformities and growth problems.

A GP would refer a child with rickets to paediatrics at a hospital where they would be given vitamin D supplementation, and referred on to an orthopaedic consultant if necessary.

Experts have also blamed the increase on children playing on computer games rather than outside, reducing the amount of sunlight they see.

An NHS Bolton spokesman said: “We have assessed how we could prevent more cases of vitamin D deficiency and rickets, and have increased the number of healthy start vitamins we provide to families with young children who are risk of vitamin D deficiency but not currently eligible under the national Healthy Start Scheme.

“Currently, these vitamins — which contain the recommended levels of vitamin D — are available for women who are pregnant or have given birth in the last year, and for children aged four and earning below a certain income. Therefore some key vulnerable groups will not be eligible.

“However, we are proposing to make this a universal offer and a group has been set up to look into making this happen.”

The disease is mostly associated with developing countries and was thought to have been consigned to the history books in the UK.

After reaching epidemic proportions during the industrial revolution when smog blocked out UV rays it was widely seen in Victorian-era slums.

It remained common in the 19th and early 20th Centuries but was largely eliminated in Britain by the 1950s following the development of vitamin supplements.

It is still rare in the developed world, where just one in 200,000 people suffer from it.

Bolton’s health bosses have blamed a lack of exposure to sunlight for the rise because of Britain’s “latitude”.

A Met Office spokesman said sunlight levels had been broadly average in Bolton since the year 2000.

Dr Tim Cheetham, senior lecturer in Paediatric Endocrinology at Newcastle University, has previously called for the vitamin to be added to milk and food products, as it was during the Second World War.

He said children playing on games consoles rather than playing outside, and people avoiding foods such as oily fish could be among the causes.

Dr Cheetham told The Bolton News: “Most of our vitamin D comes from sunshine but winter sunshine does not contain the right wavelengths and a decent vitamin D level in October is not enough to see us through the winter.

“People with dark skin — which doesn't make as much Vitamin D — or people who cover up or who live on the X-Box will be more likely to start winter with a suboptimal D level.

“Foods that contain decent levels of D are not foods that many eat, such as oily fish.

“Hence many of us will benefit from a supplement — particularly those with dark skin, those who spend a lot of time indoors, and pregnant women.”