How long does norovirus last in adults
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Duration of Norovirus in Adults
Acute Norovirus Infection Duration
Norovirus is a leading cause of acute gastroenteritis, typically presenting with symptoms such as vomiting, diarrhea, and stomach pain. In otherwise healthy adults, the duration of acute norovirus infection is generally short. Most individuals experience symptoms for about 2 to 3 days, with a complete recovery within 3 to 5 days4 6. This rapid resolution is characteristic of the self-limiting nature of the virus in healthy populations.
Prolonged Norovirus Shedding in Elderly and Immunocompromised Individuals
In contrast to the brief duration of symptoms in healthy adults, elderly individuals and those with compromised immune systems can experience prolonged viral shedding. Studies have shown that elderly patients can excrete the virus for an average of 14.3 days, with some cases extending up to 32 days5. This extended period of viral shedding poses a significant risk for transmission, especially in semiclosed environments like aged-care facilities5.
Chronic Norovirus Infection in Immunocompromised Hosts
Immunocompromised individuals, such as those who have undergone organ transplants or are receiving immunosuppressive therapy, can suffer from chronic norovirus infections. These infections can persist for weeks, months, or even years, making clinical management challenging. For instance, kidney transplant recipients have been documented to shed the virus for durations ranging from 97 to 898 days1. Similarly, allogeneic hematopoietic stem cell transplant recipients have experienced diarrhea lasting a median of 3 months, with some cases extending up to 14 months8. The persistence of the virus in these patients is often accompanied by continuous viral evolution, complicating treatment efforts1.
Implications for Public Health and Clinical Management
The prolonged duration of norovirus infection and shedding in vulnerable populations underscores the need for stringent infection control measures, particularly in healthcare and aged-care settings. Monitoring viral loads and implementing isolation protocols can help mitigate the spread of the virus. Additionally, the development of effective vaccines and antiviral therapies remains a priority to protect these high-risk groups7.
Conclusion
While norovirus typically causes a short-lived illness in healthy adults, the duration of infection can be significantly extended in elderly and immunocompromised individuals. Understanding these variations is crucial for effective public health strategies and clinical management to prevent widespread outbreaks and protect vulnerable populations.
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Most relevant research papers on this topic
Chronic norovirus infection after kidney transplantation: molecular evidence for immune-driven viral evolution.
Chronic norovirus infection may persist in adult kidney transplant recipients, with molecular analysis suggesting continuous viral evolution in immunocompromised patients unable to clear the infection.
Case Report
Highly CitedRapid Responses to 2 Virus-Like Particle Norovirus Vaccine Candidate Formulations in Healthy Adults: A Randomized Controlled Trial.
The 15/50 formulation showed the best balance of tolerability and immunogenicity in healthy adults aged 18-49 years, with both candidate VLP vaccines well tolerated and eliciting robust immune responses by 7-10 days.
RCT
Large Human TrialDuration of Immunity to Norovirus Gastroenteritis
The duration of immunity to norovirus gastroenteritis is estimated at 4.1 to 8.7 years, with children under 5 years old being more infectious than older children and adults.
Highly CitedNorovirus infection in immunocompromised hosts.
Chronic norovirus infection in immunocompromised individuals can last weeks to years, making clinical management difficult.
Highly CitedDuration of norovirus excretion and the longitudinal course of viral load in norovirus-infected elderly patients.
Norovirus excretion in elderly patients can last up to 32 days, and measuring viral load in stools around 16 days after onset may help follow the course of viral shedding.
Observational StudyHighly CitedClinical manifestation of norovirus gastroenteritis in health care settings.
Hospitalized patients experience a longer duration of norovirus gastroenteritis compared to nursing home staff and residents, highlighting the need for increased prevention measures in healthcare settings.
Observational StudyHighly CitedViral shape-shifting: norovirus evasion of the human immune system
Noroviruses persist in human populations due to molecular and structural mechanisms that enable their evasion of the immune system, highlighting the need for effective vaccines and antiviral therapies.
Highly CitedAllogeneic hematopoietic stem cell transplantation and norovirus gastroenteritis: a previously unrecognized cause of morbidity.
Norovirus gastroenteritis is a previously unrecognized cause of prolonged morbidity and mortality in adults after allogeneic hematopoietic stem cell transplantation.
Rigorous JournalHighly CitedNorovirus Excretion in an Aged-Care Setting
Norovirus genogroup II excretion in an aged-care facility peaked in the acute stage of illness and continued for an average of 28.7 days, with a viral half-life of 2.5 days.
Observational StudyHighly CitedA novel intramuscular bivalent norovirus virus-like particle vaccine candidate--reactogenicity, safety, and immunogenicity in a phase 1 trial in healthy adults.
The bivalent intramuscular norovirus vaccine was well-tolerated and immunogenic, with rapid immune response to a single dose potentially useful for military personnel, travelers, and outbreak control.
RCTRigorous JournalHighly Cited