Infectious Norovirus Is Chronically Shed by Immunocompromised Pediatric Hosts

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...

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Bibliographic Details
Published in:Viruses 2020-06, Vol.12 (6), p.619
Main Authors: Davis, Amy, Cortez, Valerie, Grodzki, Marco, Dallas, Ronald, Ferrolino, Jose, Freiden, Pamela, Maron, Gabriela, Hakim, Hana, Hayden, Randall T, Tang, Li, Huys, Adam, Kolawole, Abimbola O, Wobus, Christiane E, Jones, Melissa K, Karst, Stephanie M, Schultz-Cherry, Stacey
Format: Article
Language:English
Subjects:
Adolescent
Adult
asymptomatic
Caliciviridae Infections - immunology
Caliciviridae Infections - transmission
Caliciviridae Infections - virology
Carrier State - transmission
Carrier State - virology
Child
Child, Preschool
Cross Infection - transmission
Cross Infection - virology
diarrhea
Feces - virology
Female
Gastroenteritis - virology
genotype
Humans
Immunocompromised Host
Infant
infectious virus shedding
Male
norovirus
Norovirus - genetics
Norovirus - physiology
Pediatrics - statistics & numerical data
Prospective Studies
Seasons
Virus Shedding
Young Adult
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Summary: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.
ISSN:1999-4915
1999-4915
DOI:10.3390/v12060619