oa South African Medical Journal - Bornholm disease, pleurodynia or epidemic myalgia : an outbreak in the Transvaal associated with coxsackie virus infection



In January and February, the late summer of 1952, an epidemic of an illness characterized by signs and symptoms of Bornholm disease or pleurodynia affected the children of a school hostel in Middelburg, Transvaal. The illness was sudden in onset in most cases with acute epigastric pain and tenderness often associated with severe headache, nausea, vomiting and fever. The fever lasted 1-3 days. In one third of the cases the illness relapsed with a recrudescence of the signs and symptoms, and in one tenth of the cases a second relapse occurred. In children the abdominal signs and symptoms were most obvious. In 5 adult cases chest signs and symptoms were more prominent. In a laboratory study it was shown that this illness was associated with an infection of a Coxsackie group B type 4 virus. In addition to being pathogenic to and producing characteristic lesions in baby mice, this virus was also pathogenic to adult mice, causing in some an extensive destruction and inflammation of the pancreas. The possibility of involvement of the pancreas in human cases is mooted, but no studies of this possibility were made in this outbreak. It is now becoming clear that outbreaks of Bornholm disease are caused by infection with Coxsackie virus, particularly by strains of the B group. This view has received further support from the results of this study.


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