Norovirus Infectivity in Humans and Persistence in Water

Seitz, Scot R.; León, Juan S.; Schwab, Kellogg J.; Lyon, G. Marshall; Dowd, Melissa; McDaniels, Marisa; Abdulhafid, Gwen; Fernández, M; Lindesmith, Lisa C.; Baric, Ralph S.; Moe, Christine L.

doi:10.1128/aem.05806-11

Cited by 251 publications

(197 citation statements)

References 38 publications

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“…The study population was comprised of individuals from two separate NoV challenge studies, described in [14,15]. Overall serum cytokine responses for this population are reported in [12].…”

Section: Population and Samplesmentioning

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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“…The study population was comprised of individuals from two separate NoV challenge studies, described in [14,15]. Overall serum cytokine responses for this population are reported in [12].…”

Section: Population and Samplesmentioning

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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“…They can survive chlorination in concentrations up to 10 ppm and temperatures ranging from below 0 °C to 60 °C and higher. The NoV genome may persist for 1-3 months in different types of water (mineral, tap water and river) [31]; GI NoV stored in groundwater was still infectious in human volunteers after 2 months, and GI NoV RNA stored in groundwater was still detectable by RT-PCR after 588 days [32,33]. Several reviews on waterborne NoV outbreaks have been published [10,20,34].…”

Section: Viral Pathogens Transmitted Through Water Norovirusmentioning

confidence: 99%

Emerging and potentially emerging viruses in water environments

Rosa

Fratini

Libera

et al. 2012

Annali Dell'Istituto Superiore Di Sanità

105

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Abstract. Among microorganisms, viruses are best fit to become emerging pathogens since they are able to adapt not only by mutation but also through recombination and reassortment and can thus become able to infect new hosts and to adjust to new environments. Enteric viruses are among the commonest and most hazardous waterborne pathogens, causing both sporadic and outbreak-related illness. The main health effect associated with enteric viruses is gastrointestinal illness, but they can also cause respiratory symptoms, conjunctivitis, hepatitis, central nervous system infections, and chronic diseases. Non-enteric viruses, such as respiratory and epitheliotrophic viruses are not considered waterborne, as they are not readily transmitted to water sources from infected individuals. The present review will focus on viral pathogens shown to be transmitted through water. It will also provide an overview of viruses that had not been a concern for waterborne transmission in the past, but that may represent potentially emerging waterborne pathogens due to their occurrence and persistence in water environments.Key words: viruses, waterborne, emerging, drinking water, recreational water. Riassunto (Infezioni emergenti e potenzialmente emergenti in ambienti acquatici).I virus sono tra i principali agenti di infezioni emergenti, in quanto sono in grado di acquisire nuove caratteristiche biologiche attraverso fenomeni di mutazione, ricombinazione e riassortimento genico, adattandosi così a nuovi ospiti e nuove nicchie ecologiche. I virus enterici sono tra le principali cause di malattie infettive di origine idrica, che possono manifestarsi come casi sporadici o cluster epidemici. Le manifestazioni cliniche più comuni sono le gastroenteriti; tuttavia i virus enterici sono in grado di causare anche sintomi respiratori, congiuntiviti, epatiti, infezioni del sistema nervoso centrale e malattie croniche. La presente rassegna fornisce una panoramica dei virus enterici tradizionalmente associati alle malattie idrotrasmesse; mostra inoltre dati epidemiologici su alcuni gruppi di virus che non sono stati associati a malattie idrodiffuse in passato (inclusi virus respiratori ed epiteliotropici), ma che possono rappresentare nuovi patogeni emergenti a causa della loro presenza e persistenza in ambienti acquatici.Parole chiave: virus, malattie idrotrasmesse, patogeni emergenti, acque potabili, acque ricreative.

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“…Norovirus was chosen because it is the pathogen most likely to cause infection after intrusion into the proposed water systems, because of its potential presence in well-protected groundwater (Borchardt et al, 2012), its relatively long lifespan in groundwater (Seitz et al, 2011), low sand filtration efficiency in the absence of coagulation (Shirasaki et al, 2010), high concentration in the faeces of infected individuals (Tu et al, 2008), and high contagion rate (Teunis et al, 2008). A reverse quantitative microbial risk assessment (QMRA) was carried out assuming that the water is used for toilet flushing and laundry.…”

Section: Risk Of Infectionmentioning

confidence: 99%