An Outbreak of Epidemic Pleurodynia, with Special Reference to the Laboratory Diagnosis of Coxsackie Virus Infections

Abstract

The history of pleurodynia or Bornholm disease is briefly mentioned, together with the probable role of Coxsackie virus as the causative agent of the clinical entity. An outbreak of this disease, occurring in Hoquiam, Washington in the fall of 1950, with a known morbidity of at least 5 per 1000 population, is described. The illness was attributed to a Coxsackie virus, Group B, type 3, on the basis of virus isolation and identification from at least 4 cases, and possibly 9 cases out of 15 from whom suitable specimens were obtained. Patients showed a marked rise in neutralizing antibody titer to their own strain of virus or to other strains isolated during the outbreak. The function of the public health laboratory in the diagnosis of Coxsackie virus infections is discussed, and it is pointed out that a minimum of 2 serum specimens collected during the acute and the convalescent stages, together with a stool specimen or throat washing collected during the acute period, is required if the laboratory is to supply assistance. The need for demonstration of a rise in antibody titer to the patients own virus is discussed, and it is pointed out that the public health laboratory can assist in this problem only to the extent that the suitability of the specimens submitted will permit. Some of the numerous epidemiologic and physical similarities between Coxsackie and poliomyelitis viruses are mentioned, and it is suggested that adequate study of Coxsackie viruses may give information of value in the study of poliomyelitis.