The article by Ahmed et al1 confirms what many UK paediatricians already know, that in 2010 symptomatic vitamin D deficiency in children is flourishing. The article comes on the back of a succession of articles published over the last decade,2,–,6 which have indicated there is a resurgence of vitamin D deficiency in the UK paediatric population, despite the existence of a public health initiative to prevent this condition.

Vitamin D deficiency is now common in developed countries. In a large adult UK cohort study, up to 46.6% of white British adults were found to have vitamin D insufficiency (<40 nmol/l) with 15.5% having severe deficiency (<25 nmol/l) during winter or spring.7 A study from an inner city hospital showed that one in eight white people, one in four African-Caribbeans and one in three Asian adults had severe vitamin D deficiency (<25 nmol/l) at the end of summer.8 Recent prevalence data for vitamin D deficiency in UK children are lacking but are likely to be comparable. The article by Ahmed et al serves as a reminder of the varied and serious presenting features, and suggests that cases of severe vitamin D deficiency are still increasing.

Why has the UK accepted this disease burden so readily, when the health consequences are so well documented, the treatment is so cheap and we already know the preventive measures required? The disconnection between the observed deterioration in child health, the known evidence-based interventions and the need for effective public health measures could not be greater.

Editorial on the paper by Ahmed et al (see page …