title: No! When the immunologist becomes a virologist: Norovirus - an emerging infection in immune deficiency diseases.
abstract: Norovirus infection is an emerging chronic infection in immunocompromised hosts. The aim of this review is to discuss the pathophysiology of Norovirus infection and explore mechanistic models for chronic infection/shedder state, especially in patients with immune deficiency diseases.
  
  
  
  Chronic Norovirus infection is increasingly associated with enteropathy associated with both primary and secondary immune deficiency diseases. There is an ongoing debate in the immune deficiency community whether it is truly a causative agent for the enteropathy or it is an innocent bystander.We describe the historic aspects of Norovirus infection, its immunology and viral structure and the basis for preventive and vaccination strategies.We also postulate in this review a disease model in immune deficiency subjects which creates a milieu for it to become a chronic and explore newer frontiers for disease modification and prevention.
  
  
  
  Norovirus is the most common cause of acute gastroenteritis in general population but the factors that lead to its persistence in patients with immune deficiency need further holistic studies. This should include host assessment, microbiome signatures, and viral pathogenic factors assessment.
authors.affiliation: aMayo Medical School bMayo Undergraduate Research Trainee cDivision of Allergy and Immunology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Stella
authors.initials: S
authors.lastname: Hartono
authors.forename: Amrita
authors.initials: A
authors.lastname: Bhagia
authors.forename: Avni Y
authors.initials: AY
authors.lastname: Joshi
mesh_terms: D000818:Animals; D017250:Caliciviridae Infections / Q000276:immunology*; D002908:Chronic Disease; D005759:Gastroenteritis / Q000276:immunology*; D000069196:Gastrointestinal Microbiome; D006801:Humans; D016867:Immunocompromised Host; D007153:Immunologic Deficiency Syndromes / Q000276:immunology*; D029322:Norovirus / Q000502:physiology*; D014765:Viral Vaccines / Q000276:immunology*; D014774:Virulence
chemical_list: D014765:Viral Vaccines