Journal of Clinical Virology 44 (2009) 1–8 Contents lists available at ScienceDirect Journal of Clinical Virology journal homepage: www.elsevier.com/locate/jcv Review Noroviruses: A comprehensive review  Manish M. Patel a,∗ , Aron J. Hall a , Jan Vinjé b , Umesh D. Parashar a a Epidemiology Branch, Division of Viral Diseases, National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States b Gastroenteritis and Respiratory Virus Laboratory Branch, Division of Viral Diseases, National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States article info Article history: Received 28 August 2008 Received in revised form 10 October 2008 Accepted 14 October 2008 Keywords: Norovirus NoV Calicivirus Review Diarrhea Gastroenteritis Contents 1. Introduction ............................................................................................................................................ 1 2. History ................................................................................................................................................. 2 3. Clinical and epidemiologic features ................................................................................................................... 2 4. Transmission ........................................................................................................................................... 3 5. Host susceptibility, immunology, and pathogenesis .................................................................................................. 3 6. Detection methods ..................................................................................................................................... 3 7. Role of NoVs in infection and illness among humans ................................................................................................. 4 7.1. Antibody prevalence ............................................................................................................................ 4 7.2. Sporadic gastroenteritis ........................................................................................................................ 4 7.3. Epidemic gastroenteritis ....................................................................................................................... 4 7.4. Clinical management ........................................................................................................................... 5 8. Prevention and control ................................................................................................................................ 5 8.1. Outbreaks ....................................................................................................................................... 5 8.2. Endemic disease ................................................................................................................................ 6 References ............................................................................................................................................. 6  Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention. ∗ Corresponding author at: MS-A47, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Atlanta, GA 30333, United States. Tel.: +1 404 639 2343; fax: +1 404 639 3607. E-mail address: Aul3@CDC.GOV (M.M. Patel). 1. Introduction Gastroenteritis, both epidemic and sporadic, is a common cause of morbidity and mortality among persons of all ages, account- ing for over 1.8 million deaths in children under 5 years of age worldwide. 1 The causes of gastroenteritis include a large variety of bacteria, parasites and viruses, yet in many settings the relative contribution of these agents is unknown. Studies of gastrointestinal disease rarely test for all etiologies comprehensively, and even in those that do, 40–50% of gastroenteritis cases remain of unknown 1386-6532/$ – see front matter. Published by Elsevier B.V. doi:10.1016/j.jcv.2008.10.009