Pathogenesis

The virus multiplies in the epithelium of the mouth or throat, and it destroys the cells. The blisters that form contain large numbers ofinfectious virions. Some epithelial cells fuse together, producing large, multinucleated giant cells. Nuclei of infected cells characteristically contain a deeply staining area called an intranuclear inclusion body (see figure 24.9), which is the site of earlier viral replication. Some virions are carried by lymph vessels to the nearby lymph nodes; an immune response develops and quickly limits the infection. Some of the virions enter the sensory nerves in the area. Viral DNA persists in these nerve cells in a noninfectious non-replicating form. This latent virus can from time to time become infectious, be carried by the nerves to skin or mucous membranes, and produce recurrent disease. Stresses that can precipitate recurrences include menstruation, sunburn, and any illness associated with fever.

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