Norovirus infections in immunosupressed patients – pro
Immunosupressed patients, such as transplant receipients, can be infected by organisms that usually don’t cause disease. Noroviruses are the leading cause of foodborne disease outbreaks worldwide, and may soon eclipse rotaviruses as the most common cause of severe pediatric gastroenteritis, as the use of rotavirus vaccines becomes more widespread. It is not as common in developed countries, but is a particular problem in the very young and the very old. Norovirus infection, a major cause of acute epidemic diarrhea, has been described as a cause of chronic diarrhea in patients who are immunosuppressed, including transplant recipients and the very young.
Unfortunately what is known about this rare infection, is based on case reports. Some of these reports suggest that intravenous gammaglobulin is effective.
Todd Capizz et al, Chronic diarrhea associated with persistent norovirus excretion in patients with chronic lymphocytic leukemia: report of two cases, BMC Infect Dis. 2011; 11: 131.
Bok K, Green KY, Norovirus gastroenteritis in immunocompromised patients.N Engl J Med. 2012 Nov 29;367(22):2126-32.
Chagla Z, Quirt J, Woodward K, Neary J, Rutherford C. Chronic norovirus infection in a transplant patient successfully treated with enterally administered immune globulin.J Clin Virol. 2013 Sep;58(1):306-8.
Koo HL, Ajami N, Atmar RL, DuPont HL.Noroviruses: The leading cause of gastroenteritis worldwide.Discov Med. 2010 Jul;10(50):61-70.