Norovirus Gastroenteritis and the Development of Norovirus Vaccines
Analysis
DOI:
https://doi.org/10.55175/cdk.v52i9.1614Keywords:
Gastroenteritis, norovirus, vaccineAbstract
Viral gastroenteritis is responsible for millions of diarrhoea cases annually. Norovirus is currently reported to be the second leading cause of acute diarrhoea worldwide, after rotavirus, in all paediatric age groups in both developed and developing countries. Norovirus is a single-stranded RNA virus belonging to the Caliciviridae family. The largest human strain belongs to genogroup II, genotype 4 (II.4). Transmission is primarily faecal-oral with humans as the principal host; the virus itself has a very low infectious dose, persists across diverse temperatures and surfaces, and can be shed pre-symptomatically, enabling rapid spread. Clinical features include nausea, vomiting, abdominal cramps, and diarrhea, with heightened dehydration risk among young children, older adults, and immunocompromised individuals. To date, norovirus vaccine development still encountered difculties, including the complex nature of norovirus, human immune response, virus culture, and limited animal models for vaccine testing. Currently, several vaccines are still in the pre-clinical stage. Vaccine development needs to be accelerated while maximizing prevention of norovirus infection.
Downloads
References
Hartman S, Brown, Loomis E, Russell HA. Gastroenteritis in children. Am Fam Physician. 2019;99(3):159-65. PMID: 30702253.
National Digestive Diseases Information. Viral gastroenteritis [Internet]. 2011. Available from: www.digestive.niddk.nih.gov.
Leung AKC, Hon KL. Pediatrics: how to manage functional constipation. Drugs Context. 2021;10:2020-11-2. doi: 10.7573/dic.2020-11-2.
Nirwati H, Donato CM, Mawarti Y, Mulyani NS, Ikram A, Aman AT, et al. Norovirus and rotavirus infections in children less than five years of age hospitalized with acute gastroenteritis in Indonesia. Arch Virol. 2019;164(6):1515–25. doi: 10.1007/s00705-019-04215-y.
Athiyyah AF, Shigemura K, Kitagawa K, Agustina N, Darma A, Ranuh R, et al. Clinical manifestation of norovirus infection in children aged less than five years old admitted with acute diarrhea in Surabaya, Indonesia: a cross-sectional study. F1000Res. 2019;8:2130. doi: 10.12688/f1000research.21069.3.
Stuempfig ND, Tobin EH, Seroy J. Viral gastroenteritis [Internet]. Treasure Island (FL): StatPearls Publishing; 2025. Available from: https://pubmed.ncbi.nlm.nih.gov/30085537/.
MacCannell T, Umscheid CA, Agarwal RK, Lee I, Kuntz G, Stevenson KB, et al. Guideline for the prevention and control of norovirus gastroenteritis outbreaks in healthcare settings. Infect Control Hosp Epidemiol. 2011;32(10):939-69. doi: 10.1086/662025.
Esposito S, Principi N. Norovirus vaccine: priorities for future research and development. Front Immunol. 2020:11:1383. doi: 10.3389/fimmu.2020.01383.
Tan, M. Norovirus vaccines: current clinical development and challenges. Pathogens 2021;10(12):1641. doi: 10.3390/pathogens10121641.
Glass RI, Parashar UD, Estes MK. Norovirus gastroenteritis. N Engl J Med. 2009; 361(18):1776-85. doi: 10.1056/NEJMra0804575.
Farahmand M, Moghoofei M, Dorost A, Shoja Z, Ghorbani S, Kiani SJ, et al. Global prevalence and genotype distribution of norovirus infection in children with gastroenteritis: a meta-analysis on 6 years of research from 2015 to 2020. Rev Med Virol. 2022; 32(1):e2237. https://doi.org/10.1002/rmv.2237.
Lopman B, Centers for Disease Control and Prevention. Global burden of norovirus and prospects for vaccine development [Internet]. Washington: CDC; 2015. Available from: https://www.cdc.gov/norovirus/downloads/global-burden-report.pdf.
Elizafanti AJS, Lusida MI, Miftahussurur M, Athiyyah AF. Human norovirus molecular analysis and development of norovirus vaccine. Indon J Trop Infect Dis. 2022;10(1):8–17. https://doi.org/10.20473/ijtid.v10i1.32699.
Phattanawiboon B, Nonthabenjawan N, Boonyos P, Jetsukontorn C, Towayunanta W, Chuntrakool K, et al. Norovirus transmission mediated by asymptomatic family members in households. PLoS One 2020;15(7):e0236502. doi: 10.1371/journal.pone.0236502.
Graaf M, van Beek J, Koopmans MP. Human norovirus transmission and evolution in a changing world. Nat Rev Microbiol. 2016;14(7):421-33. doi: 10.1038/nrmicro.2016.48.
Steele MK, Wikswo ME, Hall AJ, Koelle K, Handel A, Levy K, et al. Characterizing norovirus transmission from outbreak data, United States. Emerg Infect Dis. 2020; 26(8):1818-25. doi: 10.3201/eid2608.191537.
Winder N, Gohar S, Muthana M. Norovirus: an overview of virology and preventative measures. Viruses 2022;14(12):2811. doi: 10.3390/v14122811.
Parashar UD, Glass RI. Viral gastroenteritis. In: Jameson J, Fauci AS, Kasper DL, Hauser SL, Longo DL, Loscalzo J, editors. Harrison's principles of internal medicine, 20th ed. United States: McGraw-Hill Education; 2018.
National Health Service UK. Diarrhoea and vomiting [Internet]. 2023. Available from: https://www.nhs.uk/symptoms/diarrhoea-and-vomiting/.
Armah G, Lopman BA, Vinje J, O’Ryan M, Lanata CF, Groome M, et al. Vaccine value profile for norovirus. Vaccine 2023;41(Suppl 2):S134-52. doi: 10.1016/j.vaccine.2023.03.034.
Riddle MS, Chen WH, Kirkwood CD, MacLennan. Update on vaccines for enteric pathogens. Clin Microbiol Infect. 2018;24(10):1039–45. doi: 10.1016/j.cmi.2018.06.023.
Cates JE, Vinje J, Parashar U, Hall AJ. Recent advances in human norovirus research and implications for candidate vaccines. Expert Rev Vaccines 2020;19(6):539–48. doi: 10.1080/14760584.2020.1777860.
Zhang M, Fu M, Hu Q. Advances in human norovirus vaccine research. Vaccines 2021;9(7):732. doi: 10.3390/vaccines9070732.
Hallowell BD, Parashar UD, Hall AJ. Epidemiologic challenges in norovirus vaccine development. Hum Vaccin Immunother. 2019;15(6):1279-83 doi: 10.1080/21645515.2018.1553594.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Aribowo I Kadek, Ade Sithanaya Miyardi
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
