Recent advances in norovirus infection

ABSTRACT

Norovirus (NoV) infections are an important cause of epidemic and sporadic viral gastroenteritis and a major cause of foodborne and waterborne outbreaks. NoV is characterized by genetic diversity, frequent mutations, and stability in a wide range of external environmental conditions. In recent years, a number of major advances that could overcome technical barriers have been made. The complex mechanisms of NoV pathogenesis and persistent infection involving interactions between the virus and the host immune system are being delineated. Human histo-blood group antigens, receptors for NoV attachment, play an important role in infection, which makes this interaction a critical target for the development of anti-NoV drugs. A number of vaccine candidates, chiefly based on virus-like particles, have entered phase 2 clinical development, and increasing efforts are being made to develop antiviral drugs. This review presents the current understanding of NoV immunology, epidemiology, therapeutic options, and vaccine development.