Editing Bornholm disease (section)

==Epidemiology==
The most common cause of Bornholm disease, Coxsackie B virus, is shed in large amounts in the feces of infected persons and is spread primarily through the fecal-oral route.<ref name="pmid1179480">{{cite journal |vauthors=Chong AY, Lee LH, Wong HB |title=Epidemic pleurodynia (Bornholm disease) outbreak in Singapore. A clinical and virological study |journal=Trop Geogr Med |volume=27 |issue=2 |pages=151–9 |date=June 1975 |pmid=1179480 }}</ref> Respiratory secretions and oral-oral methods have also shown to be modes of transmission.<ref>{{cite journal |last1=Wikswo |first1=Mary |last2=Khetsuriani |first2=Nino |last3=Fowlkes |first3=Ashley |last4=Zheng |first4=Xiaotian |last5=Penaranda |first5=Silvia |last6=Verma |first6=Natasha |last7=Shulman |first7=Stanford |last8=Sircar |first8=Kanta |last9=Robinson |first9=Christine |last10=Schmidt |first10=Terry |last11=Schnurr |first11=David |last12=Oberste |first12=Steven |title=Increased activity of Coxsackievirus B1 strains associated with severe disease among young infants in the United States, 2007-2008 |journal=Clinical Infectious Diseases |date=Sep 1, 2009 |volume=49|issue=5 |doi=10.1086/605090 |pmid=19622041 |doi-access=|pages=e44–e51 }}</ref> In previous cases the disease has been spread by sharing drink containers,<ref name="pmid8411604">{{cite journal |vauthors=Ikeda RM, Kondracki SF, Drabkin PD, Birkhead GS, Morse DL |title=Pleurodynia among football players at a high school. An outbreak associated with coxsackievirus B1 |journal=JAMA |volume=270 |issue=18 |pages=2205–6 |date=November 1993 |pmid=8411604 |doi= 10.1001/jama.270.18.2205}}</ref> and has been contracted by laboratory personnel working with the virus.<ref name="pmid14774516"/>
The pharynx is typically the initial site for entering the body, however the virus will proliferate in lymphatic tissues and use the blood stream to reach the muscles and produce symptoms. Preventative measures to decrease transmission of the virus causing Bornholm disease emphasize hand hygiene. In previous studies of Bornholm disease the majority of the patients affected were children.<ref name="pmid13042253" />