Although the route of transmission is known to be perinatal in children, the transmission of adult-onset disease is unknown, he added. “My theory is that people with adult onset were probably were born with it,” he said. “It lives in the tissue of their larynx and with aging, the immune surveillance system isn’t as vigilant, and the papilloma starts growing.” He noted that this development can happen at any age. “I’ve seen it surface in 70-year-olds.”
People with adult-onset disease, then, may have had a perinatal transmission that has been dormant throughout their lives. “When you take the papilloma lesion off along with some normal adjacent tissue, you’ll find the virus in both the affected and the apparently healthy tissue,” Dr. Simpson said. “I think this phenomenon explains why the condition is milder in adults: they may have been living with it all their lives. There are a couple of theories about how adults get it, but perinatal transmission and subsequent dormancy is the only one that makes sense regarding how adults get the disease.”
Although the route of transmission is known to be perinatal in children, the transmission of adult-onset disease is unknown.