“…Fundamentally, it involves a switch from viral quiescence to a replicative state within the neuron that may occur spontaneously or as a result of physical and emotional stress (reviewed in Roizman and Sears, 1996). In experimental animals and humans, reactivation is associated with axonal injury (Carton and Kilbourne, 1952;Walz et al, 1974;McLennan and Darby, 1980), traumatization of peripheral tissues (Hill et al, 1978;Valyi-Nagy et al, 1991), tooth extraction (Openshaw and Bennett, 1982), orofacial fracture (Kameyama et al, 1989), iontophoresis with epinephrine, timolol, and dexamethasone (Kwon et al, 1981;Gordon et al, 1986;Harwick et al, 1987;Hill et al, 1987), administration of prostaglandins, ultraviolet light radiation IUVRI (Wheeler, 1975;Blyth et al, 1976;Perna et al, 1987;Stanberry, 1989;Laycock et al, 1991), cadmium (Fawl and Roizman, 1993), transient hyperthermia (Sawtell and Thompson, 1992a;Moriya et a)., 1994), and immunosuppression with cyclophosphamide and prednisolone (Hurd and Robinson, 1977). Ex vivo, reactivation of HSV-1 occurs following explantation of latently infected human neurons (Baringer and Swoveland, 1973) and following superinfection of latently infected, explanted cultures with HSV-2 temperature-sensitive mutants (Lewis et al, 1984).…”