Bornholm disease epidemiology and demographics: Difference between revisions
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{{Bornholm disease}} | {{Bornholm disease}} | ||
{{CMG}}; '''Associate Editor(s)-in-Chief:''' [[User:AroojNaz|Arooj Naz, M.B.B.S]] | |||
==Overview== | ==Overview== | ||
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==Epidemiology and Demographics== | ==Epidemiology and Demographics== | ||
According to the CDC, strains of the [[Coxsackie B4 virus|Coxsackie B4]] virus were responsible for 1.9% of all [[enterovirus]] infections combined, which was equivalent to at least 54 cases in the United States alone. Bornholm disease is seemingly responsible for 20%-40% of all [[non-cardiac chest pain]].<ref name="pmid30364740">{{cite journal| author=Lal A, Akhtar J, Isaac S, Mishra AK, Khan MS, Noreldin M | display-authors=etal| title=Unusual cause of chest pain, Bornholm disease, a forgotten entity; case report and review of literature. | journal=Respir Med Case Rep | year= 2018 | volume= 25 | issue= | pages= 270-273 | pmid=30364740 | doi=10.1016/j.rmcr.2018.10.005 | pmc=6197799 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30364740 }} </ref> | According to the CDC, strains of the [[Coxsackie B4 virus|Coxsackie B4]] virus were responsible for 1.9% of all [[enterovirus]] infections combined, which was equivalent to at least 54 cases in the United States alone. Bornholm disease is seemingly responsible for 20%-40% of all [[non-cardiac chest pain]]; these statistics have been found to be similar in various countries, including Germany, USA, China, and Australia.<ref name="pmid30364740">{{cite journal| author=Lal A, Akhtar J, Isaac S, Mishra AK, Khan MS, Noreldin M | display-authors=etal| title=Unusual cause of chest pain, Bornholm disease, a forgotten entity; case report and review of literature. | journal=Respir Med Case Rep | year= 2018 | volume= 25 | issue= | pages= 270-273 | pmid=30364740 | doi=10.1016/j.rmcr.2018.10.005 | pmc=6197799 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30364740 }} </ref> Throughout history, there have been numerous [[epidemics]] of Bornholm disease, and it can be presumed that there were many other [[outbreaks]] that were not documented or remained unclassified as the cause of the disease was unknown till the 1950's. Several prominent outbreaks that were documented include: | ||
* 19th Century: Iceland and Norway<ref name="pmid148947274">{{cite journal| author=LAZARUS AS, JOHNSTON EA, GALBRAITH JE| title=An outbreak of epidemic pleurodynia, with special reference to the laboratory diagnosis of Coxsackie virus infections. | journal=Am J Public Health Nations Health | year= 1952 | volume= 42 | issue= 1 | pages= 20-6 | pmid=14894727 | doi=10.2105/ajph.42.1.20 | pmc=1525806 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14894727 }}</ref> | *19th Century: Iceland and Norway<ref name="pmid148947274">{{cite journal| author=LAZARUS AS, JOHNSTON EA, GALBRAITH JE| title=An outbreak of epidemic pleurodynia, with special reference to the laboratory diagnosis of Coxsackie virus infections. | journal=Am J Public Health Nations Health | year= 1952 | volume= 42 | issue= 1 | pages= 20-6 | pmid=14894727 | doi=10.2105/ajph.42.1.20 | pmc=1525806 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14894727 }}</ref> | ||
* 1888: United States of America<ref name="pmid14894727">{{cite journal| author=LAZARUS AS, JOHNSTON EA, GALBRAITH JE| title=An outbreak of epidemic pleurodynia, with special reference to the laboratory diagnosis of Coxsackie virus infections. | journal=Am J Public Health Nations Health | year= 1952 | volume= 42 | issue= 1 | pages= 20-6 | pmid=14894727 | doi=10.2105/ajph.42.1.20 | pmc=1525806 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14894727 }}</ref> | *1888: United States of America<ref name="pmid14894727">{{cite journal| author=LAZARUS AS, JOHNSTON EA, GALBRAITH JE| title=An outbreak of epidemic pleurodynia, with special reference to the laboratory diagnosis of Coxsackie virus infections. | journal=Am J Public Health Nations Health | year= 1952 | volume= 42 | issue= 1 | pages= 20-6 | pmid=14894727 | doi=10.2105/ajph.42.1.20 | pmc=1525806 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14894727 }}</ref> | ||
*1936: Cincinnati, Ohio<ref name="pmid13042253">{{cite journal| author=WARIN JF, DAVIES JB, SANDERS FK, VIZOSO AD| title=Oxford epidemic of Bornholm disease, 1951. | journal=Br Med J | year= 1953 | volume= 1 | issue= 4824 | pages= 1345-51 | pmid=13042253 | doi=10.1136/bmj.1.4824.1345 | pmc=2016648 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13042253 }}</ref> | *1936: Cincinnati, Ohio<ref name="pmid13042253">{{cite journal| author=WARIN JF, DAVIES JB, SANDERS FK, VIZOSO AD| title=Oxford epidemic of Bornholm disease, 1951. | journal=Br Med J | year= 1953 | volume= 1 | issue= 4824 | pages= 1345-51 | pmid=13042253 | doi=10.1136/bmj.1.4824.1345 | pmc=2016648 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13042253 }}</ref> | ||
*1944: South-Pacific Islands<ref name="pmid20271075">{{cite journal| author=MATHESON F| title=Bornholm disease in the South Pacific. | journal=Br Med J | year= 1947 | volume= 2 | issue= 4531 | pages= 745 | pmid=20271075 | doi=10.1136/bmj.2.4531.745 | pmc=2056045 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20271075 }}</ref> | |||
*1950: Hoquiam, Washington State (50 cases within one month and a morbidity rate of about 5 per 1,000 population)<ref name="pmid148947272">{{cite journal| author=LAZARUS AS, JOHNSTON EA, GALBRAITH JE| title=An outbreak of epidemic pleurodynia, with special reference to the laboratory diagnosis of Coxsackie virus infections. | journal=Am J Public Health Nations Health | year= 1952 | volume= 42 | issue= 1 | pages= 20-6 | pmid=14894727 | doi=10.2105/ajph.42.1.20 | pmc=1525806 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14894727 }}</ref> | *1950: Hoquiam, Washington State (50 cases within one month and a morbidity rate of about 5 per 1,000 population)<ref name="pmid148947272">{{cite journal| author=LAZARUS AS, JOHNSTON EA, GALBRAITH JE| title=An outbreak of epidemic pleurodynia, with special reference to the laboratory diagnosis of Coxsackie virus infections. | journal=Am J Public Health Nations Health | year= 1952 | volume= 42 | issue= 1 | pages= 20-6 | pmid=14894727 | doi=10.2105/ajph.42.1.20 | pmc=1525806 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14894727 }}</ref> | ||
*1951: Oxford (a total of 277 cases studied between the months of April and November; began abruptly)<ref name="pmid130422532">{{cite journal| author=WARIN JF, DAVIES JB, SANDERS FK, VIZOSO AD| title=Oxford epidemic of Bornholm disease, 1951. | journal=Br Med J | year= 1953 | volume= 1 | issue= 4824 | pages= 1345-51 | pmid=13042253 | doi=10.1136/bmj.1.4824.1345 | pmc=2016648 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13042253 }}</ref> | *1951: Oxford (a total of 277 cases studied between the months of April and November; began abruptly)<ref name="pmid130422532">{{cite journal| author=WARIN JF, DAVIES JB, SANDERS FK, VIZOSO AD| title=Oxford epidemic of Bornholm disease, 1951. | journal=Br Med J | year= 1953 | volume= 1 | issue= 4824 | pages= 1345-51 | pmid=13042253 | doi=10.1136/bmj.1.4824.1345 | pmc=2016648 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13042253 }}</ref> | ||
*1951: South-east Scotland<ref name="pmid13042254">{{cite journal| author=DISNEY ME, HOWARD EM, WOOD BS, FINDLAY GM| title=Bornholm disease in children. | journal=Br Med J | year= 1953 | volume= 1 | issue= 4824 | pages= 1351-4 | pmid=13042254 | doi=10.1136/bmj.1.4824.1351 | pmc=2016664 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13042254 }}</ref> | |||
*1958-1959: Toronto (strains of [[Coxsackie B5]] virus isolated)<ref name="pmid13662912">{{cite journal| author=RYDER DE, DOANE FW, ZBITNEW A, RHODES AJ| title=Report of an outbreak of Bornholm disease, with isolation of Coxsackie B5 virus: Toronto, 1958. | journal=Can J Public Health | year= 1959 | volume= 50 | issue= 7 | pages= 265-9 | pmid=13662912 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13662912 }} </ref><ref name="pmid20326199">{{cite journal| author=McLean DM, Walker SJ, McNaughton GA| title=Enterovirus Infections in Toronto, 1959. | journal=Can Med Assoc J | year= 1960 | volume= 82 | issue= 13 | pages= 661-5 | pmid=20326199 | doi= | pmc=1937957 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20326199 }} </ref> | *1958-1959: Toronto (strains of [[Coxsackie B5]] virus isolated)<ref name="pmid13662912">{{cite journal| author=RYDER DE, DOANE FW, ZBITNEW A, RHODES AJ| title=Report of an outbreak of Bornholm disease, with isolation of Coxsackie B5 virus: Toronto, 1958. | journal=Can J Public Health | year= 1959 | volume= 50 | issue= 7 | pages= 265-9 | pmid=13662912 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13662912 }} </ref><ref name="pmid20326199">{{cite journal| author=McLean DM, Walker SJ, McNaughton GA| title=Enterovirus Infections in Toronto, 1959. | journal=Can Med Assoc J | year= 1960 | volume= 82 | issue= 13 | pages= 661-5 | pmid=20326199 | doi= | pmc=1937957 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20326199 }} </ref> | ||
*1974: Singapore (patients were further studied in groups of "typical Bornholm disease" and "atypical Bornholm disease; the typical group included those with positive [[Coxsackie B3]] virus)<ref name="pmid1179480">{{cite journal| author=Chong AY, Lee LH, Wong HB| title=Epidemic pleurodynia (Bornholm disease) outbreak in Singapore. A clinical and virological study. | journal=Trop Geogr Med | year= 1975 | volume= 27 | issue= 2 | pages= 151-9 | pmid=1179480 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1179480 }} </ref> | *1974: Singapore (patients were further studied in groups of "typical Bornholm disease" and "atypical Bornholm disease"; the typical group included those with positive [[Coxsackie B3]] virus)<ref name="pmid1179480">{{cite journal| author=Chong AY, Lee LH, Wong HB| title=Epidemic pleurodynia (Bornholm disease) outbreak in Singapore. A clinical and virological study. | journal=Trop Geogr Med | year= 1975 | volume= 27 | issue= 2 | pages= 151-9 | pmid=1179480 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1179480 }} </ref> | ||
Southeast Asia has reported fewer cases of Bornholm disease comparatively but a retrospective study performed at the National Taiwan University Hospital in 2005 yielded informative material. This included statistics such as:<ref name="pmid21195979">{{cite journal| author=Huang WT, Lee PI, Chang LY, Kao CL, Huang LM, Lu CY | display-authors=etal| title=Epidemic pleurodynia caused by coxsackievirus B3 at a medical center in northern Taiwan. | journal=J Microbiol Immunol Infect | year= 2010 | volume= 43 | issue= 6 | pages= 515-8 | pmid=21195979 | doi=10.1016/S1684-1182(10)60079-5 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21195979 }} </ref> | Southeast Asia has reported fewer cases of Bornholm disease comparatively but a retrospective study performed at the National Taiwan University Hospital in 2005 yielded informative material. This included statistics such as:<ref name="pmid21195979">{{cite journal| author=Huang WT, Lee PI, Chang LY, Kao CL, Huang LM, Lu CY | display-authors=etal| title=Epidemic pleurodynia caused by coxsackievirus B3 at a medical center in northern Taiwan. | journal=J Microbiol Immunol Infect | year= 2010 | volume= 43 | issue= 6 | pages= 515-8 | pmid=21195979 | doi=10.1016/S1684-1182(10)60079-5 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21195979 }} </ref> | ||
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Various [[Pediatrics|paediatric]] studies done at the Chang Gung Memorial Hospital spanning from 2004-2012 found that of a total of 386 cases studied, 158 were due to the [[Coxsackie A4]] virus, 145 were attributable to the [[Coxsackie B3]] virus and only 83 were found to have been due to the [[Coxsackie B4 virus|Coxsackie B4]] virus. <ref name="pmid24504149">{{cite journal| author=Lee CJ, Huang YC, Yang S, Tsao KC, Chen CJ, Hsieh YC | display-authors=etal| title=Clinical features of coxsackievirus A4, B3 and B4 infections in children. | journal=PLoS One | year= 2014 | volume= 9 | issue= 2 | pages= e87391 | pmid=24504149 | doi=10.1371/journal.pone.0087391 | pmc=3913601 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24504149 }} </ref> | Various [[Pediatrics|paediatric]] studies done at the Chang Gung Memorial Hospital spanning from 2004-2012 found that of a total of 386 cases studied, 158 were due to the [[Coxsackie A4]] virus, 145 were attributable to the [[Coxsackie B3]] virus and only 83 were found to have been due to the [[Coxsackie B4 virus|Coxsackie B4]] virus. <ref name="pmid24504149">{{cite journal| author=Lee CJ, Huang YC, Yang S, Tsao KC, Chen CJ, Hsieh YC | display-authors=etal| title=Clinical features of coxsackievirus A4, B3 and B4 infections in children. | journal=PLoS One | year= 2014 | volume= 9 | issue= 2 | pages= e87391 | pmid=24504149 | doi=10.1371/journal.pone.0087391 | pmc=3913601 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24504149 }} </ref> | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
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[[Category:Mature chapter]] | [[Category:Mature chapter]] | ||
[[Category:Infectious diseases]] | [[Category:Infectious diseases]] | ||
[[Category: | [[Category:Up to date]] | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
Latest revision as of 16:55, 1 December 2022
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Bornholm disease Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Bornholm disease epidemiology and demographics On the Web |
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American Roentgen Ray Society Images of Bornholm disease epidemiology and demographics |
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Risk calculators and risk factors for Bornholm disease epidemiology and demographics |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Arooj Naz, M.B.B.S
Overview
Up to 90% of epidemics occur in the summer and early fall. The illness most commonly strikes people younger than age 30, although older people also may be affected.
Epidemiology and Demographics
According to the CDC, strains of the Coxsackie B4 virus were responsible for 1.9% of all enterovirus infections combined, which was equivalent to at least 54 cases in the United States alone. Bornholm disease is seemingly responsible for 20%-40% of all non-cardiac chest pain; these statistics have been found to be similar in various countries, including Germany, USA, China, and Australia.[1] Throughout history, there have been numerous epidemics of Bornholm disease, and it can be presumed that there were many other outbreaks that were not documented or remained unclassified as the cause of the disease was unknown till the 1950's. Several prominent outbreaks that were documented include:
- 1936: Cincinnati, Ohio[4]
- 1944: South-Pacific Islands[5]
- 1950: Hoquiam, Washington State (50 cases within one month and a morbidity rate of about 5 per 1,000 population)[6]
- 1951: Oxford (a total of 277 cases studied between the months of April and November; began abruptly)[7]
- 1951: South-east Scotland[8]
- 1958-1959: Toronto (strains of Coxsackie B5 virus isolated)[9][10]
- 1974: Singapore (patients were further studied in groups of "typical Bornholm disease" and "atypical Bornholm disease"; the typical group included those with positive Coxsackie B3 virus)[11]
Southeast Asia has reported fewer cases of Bornholm disease comparatively but a retrospective study performed at the National Taiwan University Hospital in 2005 yielded informative material. This included statistics such as:[12]
- Chest wall pain and tenderness present in 14% of the patients studied
- 75% cases experiencing pleuritic chest pain
- Radiological evidence in the form of pulmonary infiltrates or pleural effusions found in 45% of the cases
- Uncommon findings included tonsillar exudates and urinary tract infection
Various paediatric studies done at the Chang Gung Memorial Hospital spanning from 2004-2012 found that of a total of 386 cases studied, 158 were due to the Coxsackie A4 virus, 145 were attributable to the Coxsackie B3 virus and only 83 were found to have been due to the Coxsackie B4 virus. [13]
References
- ↑ Lal A, Akhtar J, Isaac S, Mishra AK, Khan MS, Noreldin M; et al. (2018). "Unusual cause of chest pain, Bornholm disease, a forgotten entity; case report and review of literature". Respir Med Case Rep. 25: 270–273. doi:10.1016/j.rmcr.2018.10.005. PMC 6197799. PMID 30364740.
- ↑ LAZARUS AS, JOHNSTON EA, GALBRAITH JE (1952). "An outbreak of epidemic pleurodynia, with special reference to the laboratory diagnosis of Coxsackie virus infections". Am J Public Health Nations Health. 42 (1): 20–6. doi:10.2105/ajph.42.1.20. PMC 1525806. PMID 14894727.
- ↑ LAZARUS AS, JOHNSTON EA, GALBRAITH JE (1952). "An outbreak of epidemic pleurodynia, with special reference to the laboratory diagnosis of Coxsackie virus infections". Am J Public Health Nations Health. 42 (1): 20–6. doi:10.2105/ajph.42.1.20. PMC 1525806. PMID 14894727.
- ↑ WARIN JF, DAVIES JB, SANDERS FK, VIZOSO AD (1953). "Oxford epidemic of Bornholm disease, 1951". Br Med J. 1 (4824): 1345–51. doi:10.1136/bmj.1.4824.1345. PMC 2016648. PMID 13042253.
- ↑ MATHESON F (1947). "Bornholm disease in the South Pacific". Br Med J. 2 (4531): 745. doi:10.1136/bmj.2.4531.745. PMC 2056045. PMID 20271075.
- ↑ LAZARUS AS, JOHNSTON EA, GALBRAITH JE (1952). "An outbreak of epidemic pleurodynia, with special reference to the laboratory diagnosis of Coxsackie virus infections". Am J Public Health Nations Health. 42 (1): 20–6. doi:10.2105/ajph.42.1.20. PMC 1525806. PMID 14894727.
- ↑ WARIN JF, DAVIES JB, SANDERS FK, VIZOSO AD (1953). "Oxford epidemic of Bornholm disease, 1951". Br Med J. 1 (4824): 1345–51. doi:10.1136/bmj.1.4824.1345. PMC 2016648. PMID 13042253.
- ↑ DISNEY ME, HOWARD EM, WOOD BS, FINDLAY GM (1953). "Bornholm disease in children". Br Med J. 1 (4824): 1351–4. doi:10.1136/bmj.1.4824.1351. PMC 2016664. PMID 13042254.
- ↑ RYDER DE, DOANE FW, ZBITNEW A, RHODES AJ (1959). "Report of an outbreak of Bornholm disease, with isolation of Coxsackie B5 virus: Toronto, 1958". Can J Public Health. 50 (7): 265–9. PMID 13662912.
- ↑ McLean DM, Walker SJ, McNaughton GA (1960). "Enterovirus Infections in Toronto, 1959". Can Med Assoc J. 82 (13): 661–5. PMC 1937957. PMID 20326199.
- ↑ Chong AY, Lee LH, Wong HB (1975). "Epidemic pleurodynia (Bornholm disease) outbreak in Singapore. A clinical and virological study". Trop Geogr Med. 27 (2): 151–9. PMID 1179480.
- ↑ Huang WT, Lee PI, Chang LY, Kao CL, Huang LM, Lu CY; et al. (2010). "Epidemic pleurodynia caused by coxsackievirus B3 at a medical center in northern Taiwan". J Microbiol Immunol Infect. 43 (6): 515–8. doi:10.1016/S1684-1182(10)60079-5. PMID 21195979.
- ↑ Lee CJ, Huang YC, Yang S, Tsao KC, Chen CJ, Hsieh YC; et al. (2014). "Clinical features of coxsackievirus A4, B3 and B4 infections in children". PLoS One. 9 (2): e87391. doi:10.1371/journal.pone.0087391. PMC 3913601. PMID 24504149.