article · Vaccines
Noroviruses are a major cause of sporadic and epidemic gastroenteritis worldwide, disproportionately affecting young children, older adults, and immunocompromised patients. Viral transmission across diverse socioeconomic environments is facilitated by a very low infectious dose, prolonged shedding in faeces, and high persistence in the environment. Disease management remains difficult, leading to a substantial healthcare and community burden. The review covers current understanding of norovirus biology, molecular diversity, pathogenesis, immunity, and the mechanisms driving evolutionary trends. It also addresses reservoir hosts, intra- and inter-host dynamics, and their eco-evolutionary implications. Finally, the synthesis assesses candidates in the vaccine development pipeline alongside the complex host and pathogen factors that impede successful vaccine development.
Gastroenteritis caused by noroviruses generates a considerable burden in both community settings and hospitals globally. Because the virus spreads easily and persists on surfaces, containment is exceptionally difficult. Mapping the current state of viral evolution, disease mechanisms, and the vaccine development pipeline provides crucial insight needed to guide interventions that protect vulnerable populations such as infants and older adults.
The findings primarily apply to vaccine developers, biotechnology firms, and pharmaceutical researchers tracking norovirus candidates in the development pipeline. The abstract points to early-stage to clinical pipeline research, noting that significant biological and host-pathogen obstacles must still be resolved before viable, market-ready vaccines can be realised.
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Noroviruses constitute a significant aetiology of sporadic and epidemic gastroenteritis in human hosts worldwide, especially among young children, the elderly, and immunocompromised patients. The low infectious dose of the virus, protracted shedding in faeces, and the ability to persist in the environment promote viral transmission in different socioeconomic settings. Considering the substantial disease burden across healthcare and community settings and the difficulty in controlling the disease, we review aspects related to current knowledge about norovirus biology, mechanisms driving the evolutionary trends, epidemiology and molecular diversity, pathogenic mechanism, and immunity to viral infection. Additionally, we discuss the reservoir hosts, intra-inter host dynamics, and potential eco-evolutionary significance. Finally, we review norovirus vaccines in the development pipeline and further discuss the various host and pathogen factors that may complicate vaccine development.
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DOI: 10.3390/vaccines12060590
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