By Alfred S. Evans (auth.), Alfred S. Evans (eds.)
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4. Genital The genital tract serves as a portal of infection for both partners during sexual activity and as a source of infection for the fetus as it passes down the birth canal. Herpes simplex type I and II viruses, CMV, and rubella virus have all been isolated from cervical secretions. (61) CMV has also been isolated from male semen. (66) Cervical or penile lesions may result from herpes infections. There is increasing epidemiological, virological, and serological evidence establishing an association between herpes type 2 (II) infections and cancer of the cervix.
Most respiratory viruses produce illness through the direct consequences of lpcal multiplication. Necrosis and lysis occur with desquamation of the res- 13 14 Chapter 1 • Epidemiological Concepts and Methods piratory epithelium. (21) Constitutional symptoms may then result from breakdown products of dying cells that are absorbed into the bloodstream; fever is produced by the liberation of endogenous pyrogen resulting from viral action on polymorphonuclear leukocytes. This sequence of events may be modified or altered by interferon production in infected cells, by the appearance or preexistence of secretory or local antibody, or by the presence of preexisting or produced humoral antibody.
Gastrointestinal Transmission by the oral-fecal route is probably the second most frequent means of spread of common viral infections, and the gastrointestinal tract is the second great portal of entry of infection. Viruses can directly infect susceptible cells of the oropharynx, but to induce intestinal infection, viruscontaining material must be swallowed, successfully resist the hydrochloric acid in the stomach and the bile acids in the duodenum, and progress to susceptible cells in the intestine.