Bornholm disease or epidemic pleurodynia is a viral infection of the striated intercostal muscles. Caused by an enterovirus, the condition is a rare manifestation of an infection with a common virus. The name Bornholm disease derives from cases described by Dr. Sylvest in the 1930’s, which occurred on the Danish island of Bornholm. Prior to that in 1872, Drs. Homan and Daae described the disease in a case occurring in the Norwegian village of Bramble and they called the illness Bramble disease. Other synonyms for the disease include epidemic myalgia, Devil’s grip and Sylvest’s disease.
Infections with enteroviruses sometimes cause gastroenteritis or upper respiratory infections but are frequently asymptomatic. Bornholm’s disease classically involves infection with a Coxsackie B virus (B1, B2, B3, B4 or B5) sometimes Coxsackie A or echovirus types 6 or 19 may cause a similar infection.
Infections with enteroviruses start in the gastrointestinal tract then spread to other organs via the bloodstream. Enteroviruses spread in a population by fecal-oral contamination. Such spread is more common in places with poor hygiene facilities or overcrowded accommodation. They may also spread through saliva or nasal secretions. Spread within families is common.
Symptoms of Bornholm disease appear abruptly after an incubation period of about 2-5 days. The main symptom is a pain in the chest or upper abdominal area. This pain may be very intense and described as “grip-like” or “stabbing”. Periods of more intense pain lasting 15-20 minutes are separated by periods of dull pain. Movement, sneezing or coughing exacerbates the pain. Children more frequently experience abdominal pain while adults tend to develop chest pain. Other symptoms may include fever, headaches, gastrointestinal upset and sore throat. Symptoms persist for 3-5 days but may recur several times over a period of about a month.
Bornholm disease is more common in children and young adults than in older members of the population. It is also more frequently seen in males than females.
Occasionally epidemics of the disease occur. Such epidemics are seasonal occurring during summer and fall.
Doctors usually make their diagnosis on the clinical picture and by excluding other possible causes such as a cardiac condition. Occasionally the use of serological testing for antibodies to enteroviruses or the culture of the virus from fecal samples aids this diagnosis.
There are no specific treatments for Bornholm disease. Pain relief medication and the use of a heating pad on the painful area may ease the symptoms. Most patients make an uneventful recovery but a few may develop complications such as orchitis (inflammation of the testes), pericarditis, myocarditis and meningitis.