title: Chronic norovirus infection among solid organ recipients in a tertiary care hospital, the Netherlands, 2006-2014.
abstract: OBJECTIVE
  Immunocompromised patients can suffer prolonged norovirus symptoms and virus shedding for many years. Little is known about the prevalence of chronic norovirus infection among solid organ transplant (SOT) recipients. In this study, 2182 SOT recipients were retrospectively tested for chronic norovirus infection.
  
  
  METHODS
  The first and last norovirus positive faecal samples of SOT recipients were sequenced to distinguish between persisting infection and re-infection. Patient charts were reviewed to obtain data on health status and treatments.
  
  
  RESULTS
  In all, 101 of 2182 (4.6%) recipients were norovirus infected and 23 (22.8%) of these developed chronic norovirus infection. Chronic norovirus infection was found among allogeneic heart, kidney and lung transplant recipients. The median shedding period at the end of the study period was 218 days (range 32-1164 days).
  
  
  CONCLUSIONS
  This study shows that chronic norovirus infection is not a rare phenomenon among SOT recipients in a tertiary-care hospital. Further research is needed to study the risk of norovirus transmission to other immunocompromised patients in the hospital and to the general population.
authors.affiliation: Erasmus Medical Center, Rotterdam, The Netherlands; National Institute of Public Health and the Environment, Bilthoven, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: van Beek
authors.affiliation: Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: A A
authors.initials: AA
authors.lastname: van der Eijk
authors.affiliation: Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: P L A
authors.initials: PL
authors.lastname: Fraaij
authors.affiliation: Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: K
authors.initials: K
authors.lastname: Caliskan
authors.affiliation: Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: K
authors.initials: K
authors.lastname: Cransberg
authors.affiliation: Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Dalinghaus
authors.affiliation: Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: R A S
authors.initials: RA
authors.lastname: Hoek
authors.affiliation: Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: H J
authors.initials: HJ
authors.lastname: Metselaar
authors.affiliation: Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Roodnat
authors.affiliation: National Institute of Public Health and the Environment, Bilthoven, The Netherlands.
authors.forename: H
authors.initials: H
authors.lastname: Vennema
authors.affiliation: Erasmus Medical Center, Rotterdam, The Netherlands; National Institute of Public Health and the Environment, Bilthoven, The Netherlands. Electronic address: m.koopmans@erasmusmc.nl.
authors.forename: M P G
authors.initials: MP
authors.lastname: Koopmans
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017250:Caliciviridae Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D005814:Genes, Viral; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D029322:Norovirus / Q000235:genetics / Q000302:isolation & purification; D016377:Organ Transplantation / Q000009:adverse effects; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D066027:Transplant Recipients; D017201:Virus Shedding; D055815:Young Adult
keywords: Chronic; Infection; Norovirus; Prevalence; Solid organ transplantation