2024-05-29 | Katherine B. Carlson, Anne Dilley, Thomas O'Grady, Jordan A. Johnson, Ben Lopman, Emma Viscidi
Norovirus is a leading cause of acute gastroenteritis (AGE) globally, causing significant morbidity and mortality, particularly among young children and older adults. The virus is genetically diverse, with multiple genogroups and genotypes circulating worldwide. Variants of the GII.4 genotype are the most common, while other genotypes cause varying amounts of disease year-to-year. Noroviruses are primarily transmitted via the fecal-oral route, and outbreaks are difficult to control due to the low infectious dose required for infection. Settings like long-term care facilities, daycares, and hospitals are at high risk of outbreaks, leading to substantial costs and disease burden. Severe cases of norovirus AGE are most common in vulnerable populations, and available treatments are limited to rehydration therapies and supportive care. Despite the substantial human and economic burden, there are currently no FDA-approved norovirus vaccines, although several candidates are in development. The lack of a robust cell culture system and incomplete understanding of natural immunity make vaccine development challenging. Given the high transmissibility and short incubation period of norovirus, a vaccine could significantly impact global public health.Norovirus is a leading cause of acute gastroenteritis (AGE) globally, causing significant morbidity and mortality, particularly among young children and older adults. The virus is genetically diverse, with multiple genogroups and genotypes circulating worldwide. Variants of the GII.4 genotype are the most common, while other genotypes cause varying amounts of disease year-to-year. Noroviruses are primarily transmitted via the fecal-oral route, and outbreaks are difficult to control due to the low infectious dose required for infection. Settings like long-term care facilities, daycares, and hospitals are at high risk of outbreaks, leading to substantial costs and disease burden. Severe cases of norovirus AGE are most common in vulnerable populations, and available treatments are limited to rehydration therapies and supportive care. Despite the substantial human and economic burden, there are currently no FDA-approved norovirus vaccines, although several candidates are in development. The lack of a robust cell culture system and incomplete understanding of natural immunity make vaccine development challenging. Given the high transmissibility and short incubation period of norovirus, a vaccine could significantly impact global public health.