Excess mortality following community-onset norovirus enteritis in the elderly

Gustavsson, Lars; Andersson, Lars‐Magnus; Lindh, Magnus; Westin, Johan

doi:10.1016/j.jhin.2011.05.018

Cited by 35 publications

(25 citation statements)

References 26 publications

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“…Although it often causes a brief and self-limited illness, among vulnerable populations, such as elderly people or individuals who are immunosuppressed, NoV illness can be more protracted and have severe outcomes [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Norovirus in symptomatic and asymptomatic individuals: cytokines and viral shedding

Newman

Moe

Kirby

et al. 2016

Clinical and Experimental Immunology

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Summary Noroviruses (NoV) are the most common cause of epidemic gastroenteritis world-wide. NoV infections are often asymptomatic, although individuals still shed large amounts of NoV in their stool. Understanding the differences between asymptomatic and symptomatic individuals would help in elucidating mechanisms of NoV pathogenesis. Our goal was to compare the serum cytokine responses and faecal viral RNA titres of asymptomatic and symptomatic NoV-infected individuals. We tested serum samples from infected subjects (n = 26; 19 symptomatic, seven asymptomatic) from two human challenge studies of GI.1 NoV for 16 cytokines. Samples from prechallenge and days 1-4 post-challenge were tested for these cytokines. Cytokine levels were compared to stool NoV RNA titres quantified previously by reverse transcription–polymerase chain reaction (RT–qPCR). While both symptomatic and asymptomatic groups had similar patterns of cytokine responses, the symptomatic group generally exhibited a greater elevation of T helper type 1 (Th1) and Th2 cytokines and IL-8 post-challenge compared to the asymptomatic group (all P < 0·01). Daily viral RNA titre was associated positively with daily IL-6 concentration and negatively with daily IL-12p40 concentration (all P < 0·05). Symptoms were not associated significantly with daily viral RNA titre, duration of viral shedding or cumulative shedding. Symptomatic individuals, compared to asymptomatic, have greater immune system activation, as measured by serum cytokines, but they do not have greater viral burden, as measured by titre and shedding, suggesting that symptoms may be immune-mediated in NoV infection.

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Section: Introductionmentioning

confidence: 99%

Norovirus in symptomatic and asymptomatic individuals: cytokines and viral shedding

Newman

Moe

Kirby

et al. 2016

Clinical and Experimental Immunology

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“…Infection with HuNoVs can be asymptomatic or can cause clinical symptoms, including malaise, nausea, vomiting, and watery diarrhea (1,2,20,47). Although human norovirus (HuNoV) infection is typically self-limiting, severe and long-term infection can occur in elderly or immunocompromised individuals (22,44,50,60,62). More recently, HuNoV infection has also been associated with necrotizing enterocolitis in infants and postinfectious irritable bowel syndrome in adults, as well as extraintestinal symptoms, such as benign infantile seizures and encephalopathy (12,37,40,45,54,59).…”

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confidence: 99%

Protruding Domain of Capsid Protein Is Necessary and Sufficient To Determine Murine Norovirus Replication and Pathogenesis In Vivo

Strong

Thackray

Smith

et al. 2012

J Virol

155

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bHuman noroviruses (HuNoVs) are the major cause of epidemic, nonbacterial gastroenteritis worldwide. Due to the lack of a tractable model system and the inability to grow HuNoVs in cell culture, factors required for the norovirus (NoV) life cycle and pathogenesis in the host remain largely unknown. The discovery of murine norovirus (MNV) and the development of reversegenetics systems for this virus provide an opportunity to study these aspects of NoV infection in vitro and in vivo. Previous studies identified a single amino acid at residue 296 in the protruding (P) domain of the capsid protein that is responsible for determining the virulence of the MNV clone MNV1.CW1 in 12956/SvEv background STAT1-deficient (STAT1 ؊/؊ ) mice. In this report, we identified and characterized another determinant of lethality in the P domain that is necessary and sufficient to determine the replication and pathogenesis of the MNV clones MNV1.CW3 and CR6.STL1 in C57BL/6 background STAT1 ؊/؊ mice. Furthermore, we describe how the role of residue 296 in MNV virulence differs between STAT1 ؊/؊ mouse strains. We also describe potential interactions between subdomains of the P domain, as well as between other virus elements, which facilitate recovery of MNV using a reverse-genetics system.

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“…In Brazil, there was an outbreak of NoV infection in a long-term care facility in 2010, with an incidence of 41.3% and 16.25% among patients and employees, respectively [8]. Given its high frequency, gastroenteritis in the elderly can be viewed with contempt and can lead to more serious consequences, as reported in Gothenburg, Sweden, during 2008 and 2009, when death cases increased among NoV-infected elderly outpatients compared to inpatients [6].…”

Section: Discussionmentioning

confidence: 99%

“…Most studies are limited to events in childhood or outbreaks in nursing homes [6][7][8]. In the world population, viral diarrhea accounts for over half of the outbreaks recorded at healthcare centers and involves mainly two viruses: rotavirus (RV) and norovirus (NoV) [9].…”

Section: Introductionmentioning

confidence: 99%

Detecção de rotavírus e norovírus na população idosa na cidade de Caxias do Sul, Rio Grande do Sul, Brasil, de 2010 a 2012

Paesi

Modena

Roesch‐Ely

2015

Sci Med

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Aims: Rotavirus (RV) and norovirus (NoV) are the most common causes of diarrhea in children aged less than five years throughout the world. However, RV and NoV have frequently been overlooked as pathogens in elderly individuals. This study examined the frequency of RV and NoV among elderly patients with complaints of diarrhea in the city of Caxias do Sul, southern Brazil. Methods: Between 2010 and 2012, stool samples from patients aged 60 years or older with acute gastroenteritis treated at a private healthcare center were analyzed, seeking to identify RV and NoV. RV detection was performed by latex agglutination (LA) methods and polyacrylamide gel electrophoresis (PAGE). One third of the samples were further tested for NoV by reverse transcription polymerase chain reaction (RT-PCR). Results: A total of 145 stool samples from patients aged 60 to 105 years were analyzed. RV was detected in 6/145 (4.14%) and 5/125 (4.00%) of the samples by LA and PAGE, respectively. NoV was detected in 6/51 (11.76%). Mixed infection (RV and NoV) was detected in a single sample: 1/51 (1.96%). Conclusions: This study adds further evidence that viral agents are involved in the etiology of gastroenteritis in the elderly, contributing significantly to the understanding of RV and NoV infections in the mature population.

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Excess mortality following community-onset norovirus enteritis in the elderly

Cited by 35 publications

References 26 publications

Norovirus in symptomatic and asymptomatic individuals: cytokines and viral shedding

Norovirus in symptomatic and asymptomatic individuals: cytokines and viral shedding

Protruding Domain of Capsid Protein Is Necessary and Sufficient To Determine Murine Norovirus Replication and Pathogenesis In Vivo

Detecção de rotavírus e norovírus na população idosa na cidade de Caxias do Sul, Rio Grande do Sul, Brasil, de 2010 a 2012

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