title: Community acquired respiratory and gastrointestinal viral infections:  challenges in the immunocompromised host.
abstract: OBJECTIVE
  Newer molecular diagnostic techniques have advanced the field of clinical microbiology and infectious diseases, particularly with respect to characterizing the role that community acquired viruses play in the clinical course and outcomes of the immunocompromised host. This review will examine recent studies describing the impact of adenovirus, rhinovirus, hepatitis E and norovirus in the course of solid organ and stem cell transplant recipients, as well as their epidemiology and implications for infection prevention and control.
  
  
  RESULTS
  Adenovirus transmission is poorly understood; recent studies increasingly point to reactivation of latent infection in the immunocompromised host. Rhinovirus shedding can persist for weeks after acute viral infection, complicating hospital infection control policies. Hepatitis E is increasingly recognized as a potential pathogen in the stem cell and solid organ transplant population, and should be considered in the work-up for unexplained liver function test abnormalities. Similar to rhinovirus, norovirus shedding from the gastrointestinal tract may persist for months in the immunocompromised host; infected patients are at a higher risk for transmitting norovirus compared with infected healthcare workers.
  
  
  CONCLUSIONS
  Additional studies are needed, particularly with respect to transmission, for these community acquired viral infections, which often have devastating consequences in the immunocompromised patient population.
authors: Infectious Diseases Service, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA. kaltsasa@mskcc.org
authors: Anna
authors: A
authors: Kaltsas
authors: Kent
authors: K
authors: Sepkowitz
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D017714:Community-Acquired Infections / Q000517:prevention & control / Q000821:virology; D005767:Gastrointestinal Diseases / Q000517:prevention & control / Q000821:virology*; D006801:Humans; D016867:Immunocompromised Host; D007165:Immunosuppression Therapy / Q000009:adverse effects; D016377:Organ Transplantation / Q000009:adverse effects; D012141:Respiratory Tract Infections / Q000517:prevention & control / Q000821:virology*; D033581:Stem Cell Transplantation / Q000009:adverse effects; D014777:Virus Diseases / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control
chemical_list: D000998:Antiviral Agents