Abstract

Bornholm disease or epidemic pleurodynia or epidemic myalgia is a disease caused by the Coxsackie B virus or other viruses.

It is named after the Danish island of Bornholm where an outbreak was one of the first to be described.

Signs and symptoms

Symptoms may include fever and headache, but the distinguishing characteristic of this disease is attacks of severe pain in the lower chest, often on one side. The slightest movement of the rib cage causes a sharp increase of pain, which makes it very difficult to breathe, and an attack is therefore quite a frightening experience, although it generally passes off before any actual harm occurs. The attacks are unpredictable and strike "out of the blue" with a feeling like an iron grip around the rib cage. The colloquial names for the disease, such as 'The Devil's grip' (see also "other names" below) reflect this symptom.

Cause

Inoculation of throat washings taken from people with pleurodynia into the brains of newborn mice revealed that enteroviruses in the Coxsackie B virus group were likely to be the cause of pleurodynia, and those findings were supported by subsequent studies of IgM antibody responses measured in serum from people with pleurodynia. Other viruses in the enterovirus family, including echovirus and Coxsackie A virus, are infrequently associated with pleurodynia.

Cause | Spread

As is typical with this virus family, it is shed in large amounts in the feces of infected persons. The disease can be spread by sharing drink containers, and has been contracted by laboratory personnel working with the virus.

Treatment and prognosis

The illness lasts about a week and is rarely fatal. Treatment includes the administration of nonsteroidal anti-inflammatory agents or the application of heat to the affected muscles. Relapses during the weeks following the initial episode are a characteristic feature of this disease.

Epidemiology

Coxsackie B virus is spread by contact and epidemics usually occur during warm weather in temperate regions and at any time in the tropics.

History

In 1872, Daae-Finsen reported an epidemic of "acute muscular rheumatism" occurring in a community called Bamble, giving rise to the name "Bamble disease" in Norway. Subsequent reports, published only in Norwegian, referred to the disease by this name. In 1933, Ejnar Sylvest gave a doctoral thesis describing a Danish outbreak of this disease on Bornholm Island entitled, "Bornholm disease-myalgia epidemica", and this name has persisted.

Other names

It is also known as "Bamble disease", the "devil's grip", "devil's grippe", "epidemic myalgia", "epidemic pleurodynia", "epidemic transient diaphragmatic spasm" or "The Grasp of the Phantom".