Norovirus: Clinical Findings and Pharmaceutical Developments

Norovirus (NoV) is one of the most ubiquitous factors contributing to acute gastroenteritis that causes widespread outbreaks in travel industry, military, or healthcare facilities. NoV could lead to serious symptoms and result in severe societal costs worldwide. Surprisingly, there has been no available licensed vaccines, albeit there are ongoing pre-clinical or clinical trials of several candidate vaccines. Development of effective universal vaccines has been found difficult clinically due to the frequent point mutations and a lack of robust animal model and cell culture system. Preclinical studies showed that vaccines with virus-like particles (VLPs) have high immunogenicity and efficacies and were demonstrated to be protective and safe. Recent in vitro research also suggests that human intestinal enteroids can enhance our understanding of protection mechanism and give guidance for vaccine development. Overall, this chapter will give a comprehensive review of the current challenge and progress of clinical findings, efficacy/safety of the developing vaccines, and antiviral drug developments for NoV in clinical trials or preclinical investigations.