Viremia

Primary versus secondary

Primary viremia refers to the initial spread of virus in the blood from the first site of infection. Secondary viremia occurs when primary viremia has resulted in infection of additional tissues via bloodstream, in which the virus has replicated and once more entered the circulation.

Usually secondary viremia results in higher viral shedding and viral loads within the bloodstream due to the possibility that the virus is able to reach its natural host cell from the bloodstream and replicate more efficiently than the initial site. An excellent example to profile this distinction is the rabies virus. Usually the virus will replicate briefly within the first site of infection, within the muscle tissues. Viral replication then leads to viremia and the virus spreads to its secondary site of infection, the central nervous system (CNS). Upon infection of the CNS, secondary viremia results and symptoms usually begin. Vaccination at this point is useless, as the spread to the brain is unstoppable. Vaccination must be done before secondary viremia takes place for the individual to avoid brain damage or death.