Understanding What Diseases Go Dormant and How Latency Works

September 24, 2025 •

4 min read

Over 90% of adults are believed to have been infected with the Epstein-Barr virus, which can lie dormant for a lifetime, yet only reactivate under certain conditions. Understanding what diseases go dormant is key to recognizing how your body's immune system battles infections long-term.

Quick Summary

Numerous pathogens, notably viruses in the herpes family like those causing chickenpox and cold sores, can reside silently in the body for many years. These dormant infections, including latent tuberculosis, can be reactivated by factors like stress or a weakened immune system, leading to a resurgence of symptoms.

Key Points

Viral Latency: Many viruses, including the herpes family (HSV, VZV, EBV, CMV), can remain dormant or 'latent' within the body's cells for years or even a lifetime.
Reactivation Triggers: Stress, a weakened immune system, aging, and other illnesses can all serve as triggers that cause a dormant virus to reactivate.
From Chickenpox to Shingles: The varicella-zoster virus (VZV) first causes chickenpox and then retreats into nerve cells, where it can re-emerge decades later as shingles.
Latent TB: Latent Tuberculosis Infection (LTBI) is a dormant bacterial condition where the immune system walls off the bacteria; it can reactivate into an active, contagious disease if immunity wanes.
Managing Your Risk: Understanding your medical history and maintaining a healthy immune system are key to managing the risk of reactivating a dormant disease.
Chronic Illness Connection: Reactivated latent viruses can contribute to chronic inflammation and symptoms, especially in individuals with compromised immune systems.

The Biological Mechanism of Latency

Viral latency is a survival strategy employed by certain pathogens, particularly viruses, to evade the host's immune system. Unlike an acute infection, where the virus actively replicates and is then cleared, a latent infection involves the viral genome hiding quietly within a host cell. During this dormant phase, the virus produces few or no proteins, making it virtually invisible to immune cells. The virus remains in this state until specific triggers, such as stress, hormonal changes, or immunosuppression, cause it to reactivate and begin replicating again.

Latent vs. Persistent Infections

While similar, it is important to distinguish latent from persistent viral infections. A persistent infection, such as Hepatitis C, involves the continuous, low-level replication of the virus, causing ongoing tissue damage and chronic disease. In contrast, a latent infection is marked by periods of absolute inactivity, followed by bursts of active replication during reactivation. This distinction is crucial for understanding disease progression and treatment strategies.

Common Viral Diseases That Go Dormant

The Herpesvirus Family

The family Herpesviridae is a prime example of viruses that establish lifelong latency. These viruses reside primarily in nerve cells or certain immune cells.

Herpes Simplex Virus (HSV-1 and HSV-2): Responsible for oral herpes (cold sores) and genital herpes, these viruses establish latency in sensory neurons. Reactivation often results in blisters at or near the original site of infection.
Varicella-Zoster Virus (VZV): The cause of chickenpox, VZV enters a latent phase in nerve ganglia near the spinal cord. Years or decades later, it can reactivate as the painful, blistering rash known as shingles, typically along a single nerve path.
Epstein-Barr Virus (EBV): The virus that causes infectious mononucleosis, EBV stays dormant in B-lymphocytes. While usually controlled by the immune system, it can reactivate without symptoms or, in immunocompromised individuals, contribute to serious conditions like certain lymphomas.
Cytomegalovirus (CMV): Another herpesvirus, CMV is carried dormantly by more than half of all adults. For most, it remains silent, but for those with weakened immune systems, it can cause severe disease.

Other Latent Pathogens

Human Immunodeficiency Virus (HIV): While managed with antiretroviral therapy, HIV can integrate its genetic material into the DNA of immune cells, where it remains dormant. This latent reservoir is a major obstacle to a cure, as the virus can reactivate if treatment is stopped.
Human Papillomavirus (HPV): Certain types of HPV, which cause warts, can go into a latent phase. The virus can persist within skin cells, with warts reappearing during periods of reactivation.

The Bacterial Example: Latent Tuberculosis

Not all dormant diseases are caused by viruses. The bacterium Mycobacterium tuberculosis can cause a latent infection known as Latent TB Infection (LTBI). In this state, the bacteria remain inactive in the body, walled off by the immune system. Individuals with LTBI do not feel sick and cannot spread the disease. However, if the immune system weakens, the bacteria can reactivate and cause active TB disease, which is contagious and potentially fatal if untreated. For more information, the Centers for Disease Control and Prevention offers comprehensive guidance on latent tuberculosis: CDC on Latent TB.

Triggers for Reactivation

The immune system plays a critical role in keeping dormant infections in check. Any factor that compromises this function can serve as a trigger for reactivation.

Stress: Both physical and psychological stress can release hormones that suppress the immune response, making it easier for a dormant virus to reactivate. Cortisol, a stress hormone, is a known immunosuppressant.
Weakened Immune System: Conditions like HIV/AIDS, chemotherapy, organ transplantation, and autoimmune disorders (requiring immunosuppressive drugs) significantly increase the risk of reactivation.
Aging: The immune system naturally declines with age, a process known as immunosenescence, which is why older adults are at a higher risk for conditions like shingles.
Other Illnesses: A co-infection, such as a cold or flu, can temporarily tax the immune system, providing an opportunity for a latent pathogen to emerge.

A Comparison of Infection Types


Feature	Acute Infection	Latent Infection	Persistent Infection
Viral Activity	Rapid replication	Dormant, then reactivated	Continuous, low-level replication
Immune System	Clears the pathogen	Keeps pathogen suppressed	Unable to completely clear
Clinical Course	Short duration, prominent symptoms	Intermittent symptoms	Chronic symptoms, long-term
Examples	Common Cold, Flu	Herpes, Shingles	Hepatitis B/C

Conclusion: Navigating a Lifelong Host-Pathogen Relationship

Many of us live with dormant diseases we may not even know about. The relationship between our immune system and these stealthy pathogens is a delicate lifelong dance. By understanding the common infections that go dormant and the triggers for their reactivation, we can take proactive steps to maintain our immune health and reduce the risk of future flare-ups. This includes managing stress, staying informed, and consulting healthcare providers, particularly if you have a known history of a latent infection or are facing immunosuppression. Recognizing the difference between acute, latent, and persistent infections empowers individuals to make informed decisions about their long-term health.

Frequently Asked Questions

A dormant (or latent) infection is marked by periods of inactivity where the pathogen is hidden from the immune system, followed by episodes of reactivation. A chronic infection, however, involves the pathogen continuously replicating at a low level, causing ongoing symptoms or damage.

Yes, a latent virus can be passed to others, but typically only during periods of reactivation. For example, during a cold sore outbreak (reactivated HSV), the virus can be transmitted through contact with the blister.

No, while viral latency is a common form of dormancy, certain bacteria, most notably Mycobacterium tuberculosis (the cause of latent TB), can also remain dormant in the body for long periods.

Many dormant infections like EBV or CMV are common and often asymptomatic, while others like latent TB can be detected with specific tests. A history of an initial illness like chickenpox, or recurrent symptoms like cold sores, is a strong indicator. For definitive diagnosis, a doctor can perform specific blood tests.

For most latent viral infections, there is no cure, and the virus remains in the body for life. However, antiviral medications can manage active outbreaks. For latent TB, a course of antibiotics can often prevent it from becoming active disease.

The risk of reactivation depends on the specific pathogen and individual health. Immunosuppression from medication, stress, aging, or other diseases significantly increases the risk. A healthy immune system is the best defense.

After a chickenpox infection, the varicella-zoster virus (VZV) lies dormant in nerve tissue. Its reactivation into shingles is often triggered by a weakening of the immune system, which can be due to aging, stress, or other illnesses. The virus then travels along nerve pathways to the skin, causing the painful rash.