Centers for Disease Control and Prevention Foundation, Atlanta, Georgia.
Rollins School of Public Health, Emory University, Atlanta, Georgia.
Clin Infect Dis. 2019 Jul 2;69(2):357-365. doi: 10.1093/cid/ciy985.
Globally, noroviruses are among the foremost causes of acute diarrheal disease, yet there are many unanswered questions on norovirus immunity, particularly following natural infection in young children during the first 2 years of life when the disease burden is highest. We conducted a literature review on birth cohort studies assessing norovirus infections in children from birth to early childhood. Data on infection, immunity, and risk factors are summarized from 10 community-based birth cohort studies conducted in low- and middle-income countries. Up to 90% of children experienced atleast one norovirus infection and up to 70% experienced norovirus-associated diarrhea, most often affecting children 6 months of age and older. Data from these studies help to fill critical knowledge gaps for vaccine development, yet study design and methodological differences limit comparison between studies, particularly for immunity and risk factors for disease. Considerations for conducting future birth cohort studies on norovirus are discussed.
全球范围内,诺如病毒是引发急性腹泻病的首要病原体之一,但人们对于诺如病毒免疫仍存在诸多未解问题,尤其是在婴幼儿生命早期(2 岁以内),此时疾病负担最高,而自然感染诺如病毒的情况更是如此。我们对评估儿童从出生到幼儿期诺如病毒感染的队列研究进行了文献回顾。从在低收入和中等收入国家开展的 10 项基于社区的队列研究中总结了有关感染、免疫和危险因素的数据。高达 90%的儿童至少经历过一次诺如病毒感染,高达 70%的儿童经历过诺如病毒相关腹泻,最常见于 6 月龄及以上儿童。这些研究的数据有助于填补疫苗开发的关键知识空白,但研究设计和方法学差异限制了研究之间的比较,尤其是在免疫和疾病危险因素方面。文中还讨论了开展诺如病毒未来队列研究时需要考虑的问题。