Norovirus

Norovirus (NoV) is a small non-enveloped, positive-sense RNA virus belonging to the Caliciviridae family of viruses. Six norovirus genogroups have been identified to date, which are further subdivided into genotypes. NoVs have a high mutation rate and numerous genotypes have been identified. NoVs responsible for human disease are found within genogroups G11, G1 and GIV. The variant GII.4 has been identified as the most common cause of Norovirus outbreaks since 2002. (Karst, S.M.)

Previously known as Norwalk virus, NoV is a major cause of non-bacterial outbreaks of acute gastroenteritis worldwide. Norovirus can infect individuals of all ages and can be a major cause of gastroenteritis in schools, care-homes, hospitals and cruise ships. Symptoms of NoV infection develop rapidly and include vomiting, nausea, abdominal cramps and diarrhoea (Robilotti, E. et al). In most cases, Nov infection is a self-limiting disease that may last 1- 3 days but can cause complications in very young, elderly and immunocompromised individuals. In some severe cases, NoV infection can result in dehydration, hospitalisation and death. (CDC)

NoV is highly contagious. It can persistent in the environment and is resistant to most household disinfectants. Transmission of NoV primarily occurs through the faecal oral route and through contact with infected individuals, contaminated clothing, surfaces, food and water. In the USA, NoV is the major cause of food related illness. (CDC)

Diagnosis of NoV infection is commonly performed using real-time reverse transcriptase polymerase chain reaction (RT-qPCR) assays. Enzyme-linked immunoassays are also employed to detect NoV in stool samples, but these assays are reported to lack sensitivity. Currently, no licensed vaccine is available for the prevention of NoV infection. However, recent reports suggest that significant progress is being made to develop a vaccine that may provide short term immunity against GI.1 and GII.4 genotypes. (Takeda)

References
1. Karst SM. (2010). Pathogenesis of noroviruses, emerging RNA viruses. Viruses.Mar;2(3):748-81. PMID: 21994656
2. Robilotti E, Deresinski S, Pinsky BA. (2015). Norovirus. Clin Microbiol Rev.Jan;28(1):134-64. PMID: 25567225
3. Centers for disease control and prevention: Norovirus, Clinical overview
4. Centers for disease control and prevention: Norovirus, Burden of norovirus illness and outbreaks
5. Takeda press release: Takeda initiates world’s first norovirus vaccine field trial

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