This section addresses the evidence from a primarily viral aspect -- the section on psychoneuroimmunology addresses the evidence from an immunological aspect.

There is substantial evidence that concurrent stress at the time of viral exposure leads to more severe disease; this is well‑established in the medical literature.

Stress is known to increase susceptibility to those diseases which are immunerelated, e.g.. infectious diseases, cancer and autoimmune disorders.

There is an enormous literature on the mechanisms whereby both viruses and stress affect the competence of the immune system.

For example, cortisol (which is greatly increased during acute stress) inhibits the synthesis of a protein (interferon) which can interfere with virus replication, i.e.. adrenocorticol hypersecretion brought about by acute stress is known to have an adverse effect on viral replication.

Physical trauma in man is expressly mentioned as a known route for this adverse mechanism.

NB. Most of the following papers in this section relate to animal (not human) models ‑‑­prospective studies in humans are limited, since it can never be ethical to subject human beings to severe stress and then deliberately introduce a viral agent purely for research purposes.

For the most part, extracts only are included in this section. The full papers are available if required.


Lethal Infection with Coxsackie Virus of Adult Mice Given Cortisone Edwin D.Kilbourne & Frank L.Horsfall. Proc Soc Exp Biol & Med 1951:77:135-138.


Cortisone and Roentgen Radiation in Combination as Synergistic Agents for Production of Lethal Infections Jerome T.Styverton et al. Proc Soc Exp Biol & Med 1952:80:123-128


Factors influencing host‑virus interactions William D.Boring et al. J Exp Med 1955:102:753-767

Alteration of experimental Poliomyelitis infection in the Syrian hampster with the aid of cortisone Gregory Shwartzman & Alice Fisher.Ann New York Acad Sci 1955:61:347-362


Susceptibility of adult mice to the pathogenic action of Coxsackie Virus following ionizing irradiation N.Cajal et al. Acta Virologica 1959:3:107-112


Inhibition by Cortisone of the Synthesis and Action of Interferon Edwin D Kilbourne et al 1961: 13th May:190:650-657


The influence of avoidance‑learning stress on resistance to Coxsackie B Virus in Mice T.Johnsson, J Lavender, E Hultin, AF Rasmussen. J Immunol 1963:91:569-575


The Evaluation and Management of Human Viral Infections In: Clinical Virology, ed:Robert Debre & Josette Celers, pub: WB Saunders, Philadelphia, London, Toronto 1970


Effects of immunosupression on Coxsackie B‑3 Virus infection in mice B.Rager‑Zisman & C.Allison J Gen Virol 1973:19:335-351


Viral Illness and Sports Performance JA Roberts. Sports Medicine 1986:3:296-303


Experimental influenza infection: influence of stress LK Chetverikova et al. Acta Virol 1987:31:424-433


Immunoparesis caused by Viral and Bacterial Infections HM Couvadia. In: Nutrition and Immunology 1988: ed: RK Chendra pub:Alan R Liss Inc.