NOROVIRUS

1. Andritta Febriana (NIM : 011728226305)

2. Rizky Hurriah (NIM : 011828226305)
History of Norovirus
• The Norovirus → Norwalk agent after Norwalk,OHIO,USA
(Outbreak of acute gastroenteritis) in 1968.
• The name was shortened to Norovirus after being
identified in a number of outbreaks on cruise ships and
receiving attention throughout the USA.
• In 1972, electron microscopy on stored human stool
samples identified a virus, which was given the name
Norwalk virus
MORPHOLOGY
• Family : Calciviridae
• Non-enveloped small round structured viruses (27-32 nm
diameter)
• Genome : positive ssRNA ≈7.5kb
• According to the International Committe on Taxonomy
of Virus, the genus Norovirus has one species, which
is called “Norwalk virus'' and assigned the
abbreviation 'NV'.
CHARACTERISTIC
• Highly contagious
• Causes of 50% of all foodborne outbreaks of gastroenteritis
• Predominantly epidemic
• Multiple modes of transmission
• Stable in the environtment (able to survive freezing and high
temperatures)
• Resistant to routine disinfection methods
• Carriers may not be symptomatic
TRANSMISSION
• Oral-fecal route
• Food (39%)
• Hands, person to person (12%)
• water ( 3%)
• also enviromental surfaaces : carpets, toilets, etc
 Modes Oof Transmission by Food
• Food sources ( i.e.,food arrives contaminates
• Preparation
• Food handlers
• Customers
• Most at risk : ready-to-eat foods that require
handling but no subsequent cooking (2.g.,salads)
 CLASSIFICATION
• Noroviruses (NoV) are a genetically diverse group of single-
stranded positive-sense RNA, non-enveloped viruses belonging to
the family Caliciviridae
• According to the International Committee on Taxonomy of Viruses,
the genus Norovirus has one species, which is called Norwalk virus.
• Noroviruses can genetically be classified into at least seven different
genogroups (GI, GII, GIII, GIV, GV, GVI, and GVII), which can be
further divided into different genetic clusters or genotypes
• Most noroviruses that infect humans belong to genogroups GI and
GII.
 STRUCTURE
• Viruses in Norovirus are non-envelopedwith
• Icosahedral geometries
• Capsid diameters vary widely, from 23–40 nm in diameter. The
larger capsids (38–40 nm) exhibit T=3 symmetry and are composed
of 180 VP1 proteins
• Small capsids (23 nm) show T=1 symmetry, and are composed of
60 VP1 proteins
• The virus particles demonstrate an amorphous surface structure
when visualized using electron microscopy
VIRION
GENOME
 REPLICATION
1. Viral replication is cytoplasmic
2. Attachement to host receptors mediates clathrin- and caveolin-
independent endocytosis of the virus.
3. Uncoating, and release of the viral genomic RNA into the cytoplasm.
4. VPg is removed from the viral RNA, which is then translated into a
processed ORF1 polyprotein to yield the replication proteins.
5. Replication occurs in viral factories. A dsRNA genome is synthesized
from the genomic ssRNA(+).
6. The dsRNA genome is transcribed/replicated thereby providing viral
mRNAs/new ssRNA(+) genomes.
7. Subgenomic RNA translation gives rise to the capsid protein and VP2.
8. Assembly of new virus particles and release by cell lysis.
 PATHOPHYSIOLOGY
• When a person becomes infected with norovirus, the virus is replicated within
the small intestine.
• After approximately one to two days, norovirus infection symptoms can appear.
• The principal symptom is acute gastroenteritis that develops between 12 and 48
hours after exposure, and lasts for 24–72 hours.
• The disease is usually self-limiting, and characterized by nausea, forceful
vomiting, watery diarrhea, and abdominal pain, and in some cases, loss of taste.
General lethargy, weakness, muscle aches, headache, coughs, and low-grade
fever may occur.
• Severe ilness is rare; although people are frequently treated at the emergency
ward
• Symptoms may become life-threaning in theese group of dehydration or
electrolye imbalance is ignorant or not treated
SYMPTOMS
• Signs and symptoms include:
– Acute gastroenteritis (inflammation of the stomach and intestines)
• diarrhea, vomiting, nausea, stomach pain
• Fever, body aches, fatigue
– Dehydration (because of having diarrhea and vomiting many times per day)
• Less urination
• Dry mouth or throat
• Dizziness

• When someone gets infected with norovirus, they may say they have ‘food
poisoning’ or ‘stomach flu’.
– Food poisoning can be caused by noroviruses, but other germs and chemicals
can also cause food poisoning.
DIAGNOSIS

Detection of virus in stool samples :

• (immune) transmission electron microscopy (TEM)
• ELISA
• PCR
→ All three methods tested are useful for epidemiological
investigations in gastroenteritis outbreaks; however to
maximize diagnostic validity for individual cases, at least
two of the methods should be combined.
THERAPY

• There is no vaccine to prevent Norovirus infection

• There is no specific drug
• Rehydration is important for infected people
PREVENTION

• Proper hand hygiene

• Carefully wash fruits and vegetables and cook oysters
and other shellfish throughly before eating them
• Do not prepare food while infected
• Clean and disinfect contaminated surfaces
• Wash laundry throughly
 Why are noroviruses a big issue?

• Noroviruses are a public health problem.

– They are highly contagious.
– They spread easily and quickly, especially in closed places
like daycare settings, nursing homes, schools, and cruise
ships.
– They are hard to get rid of because they:
• stay on objects and surfaces and still infect people after days or
weeks
• survive both freezing and heating (although not thorough cooking)
and even some disinfectants
 How can future norovirus outbreaks be
prevented in the food industry?

• First, focus on food handler.

– We found that infected food handlers were the source of 53% of foodborne
norovirus outbreaks.
– They possibly contributed to 82% of outbreaks.
– Most outbreaks were caused by food in restaurants contaminated during
preparation.
– Food handlers should:
• always practice good hand hygiene
• avoid touching foods with bare hands
• stay out of the kitchen and not handle or prepare food when they are sick
 How can future norovirus outbreaks be
prevented in the food industry?

• Second, consider protecting food before it reaches

the kitchen.
– Some outbreaks caused by shellfish and produce
were likely contaminated during production.
– Using safe water for growing and irrigation can
help prevent food from getting contaminated at
the source.
 Is there a vaccine for norovirus?

• Currently, no vaccine is available to protect against

norovirus, but research is being done in this area.
What should people do to avoid getting foodborne norovirus?

 First, always wash your hands carefully with soap and water after using
toilet and changing diapers and before eating, preparing, or handling
food.
 Second, wash your fruits and vegetables thoroughly, and cook oysters and
other shellfish thoroughly before eating them.
 Third, do not handle or prepare food for others when you are sick.
 Fourth, clean and disinfect contaminated surfaces after throwing up or
having diarrhea.
 Finally, wash any soiled laundry thoroughly after throwing up or having
diarrhea.
 More information, visit CDC’s norovirus website at
www.cdc.gov/norovirus.