Infectious Norovirus Is Chronically Shed by Immunocompromised Pediatric Hosts.

Amy Davis,Randall T Hayden,Melissa K Jones,Marco Grodzki,Valerie Cortez,Li Tang,Jose Ferrolino,Adam Huys,Ronald Dallas,Hana Hakim,Abimbola O Kolawole,Stacey Schultz-Cherry,Christiane E Wobus,Pamela Freiden,Stephanie M Karst,Gabriela Maron

doi:10.3390/v12060619

Abstract

Noroviruses are a leading cause of gastroenteritis worldwide. Although infections in healthy individuals are self-resolving, immunocompromised individuals are at risk for chronic disease and severe complications. Chronic norovirus infections in immunocompromised hosts are often characterized by long-term virus shedding, but it is unclear whether this shed virus remains infectious. We investigated the prevalence, genetic heterogeneity, and temporal aspects of norovirus infections in 1140 patients treated during a 6-year period at a pediatric research hospital. Additionally, we identified 20 patients with chronic infections lasting 37 to >418 days. Using a new human norovirus in vitro assay, we confirmed the continuous shedding of infectious virus for the first time. Shedding lasted longer in male patients and those with diarrheal symptoms. Prolonged shedding of infectious norovirus in immunocompromised hosts can potentially increase the likelihood of transmission, highlighting the importance of isolation precautions to prevent nosocomial infections.

Highlights

Noroviruses are highly infectious gastrointestinal viruses that are transmitted via multiple routes, including ingestion of food or water with fecal contamination and inhalation of infectious aerosols produced during episodes of emesis [1,2]
Based on our results obtained using a novel human norovirus propagation system, we report that both asymptomatic and symptomatic chronic infections are associated with the shedding of infectious virus
Noroviruses are a leading cause of acute diarrhea worldwide, with immunocompromised patients being at risk for chronic infections [17,18,40,41]

Summary

Introduction

Noroviruses are highly infectious gastrointestinal viruses that are transmitted via multiple routes, including ingestion of food or water with fecal contamination and inhalation of infectious aerosols produced during episodes of emesis [1,2]. Viruses 2020, 12, 619 is attributed to a norovirus [4,5], making these viruses a leading cause of childhood diarrhea and foodborne outbreaks of disease worldwide [4,5,6]. Noroviruses are small, nonenveloped viruses belonging to the family Caliciviridae. They have a single-stranded RNA genome and are segregated into. 10 genogroups, designated GI to GX, with GI-, GII-, and GIV-containing strains associated with human gastroenteritis [3,7,8]. These genogroups are further subdivided into genotypes (e.g., a genogroup I, genotype 1 virus would be referred to as GI.).

Methods

Results

Conclusion