Nature Reviews Microbiology 8, 231-241 (March 2010) | doi:10.1038/nrmicro2296

Viral shape-shifting: norovirus evasion of the human immune system

Eric F. Donaldson1, Lisa C. Lindesmith1, Anna D. LoBue1 & Ralph S. Baric1  About the authors


Noroviruses are the most common cause of food-borne gastroenteritis worldwide, and explosive outbreaks frequently occur in community settings, where the virus can immobilize large numbers of infected individuals for 24–48 hours, making the development of effective vaccines and antiviral therapies a priority. However, several challenges have hampered therapeutic design, including: the limitations of cell culture and small-animal model systems; the complex effects of host pre-exposure histories; differential host susceptibility, which is correlated with blood group and secretor status; and the evolution of novel immune escape variants. In this Review, we discuss the molecular and structural mechanisms that facilitate the persistence of noroviruses in human populations.

Author affiliations

  1. University of North Carolina, Department of Epidemiology and Department of Microbiology and Immunology, Chapel Hill, North Carolina 27599, USA.

Correspondence to: Ralph S. Baric1 Email:

Published online 2 February 2010


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