ABSTRACT Noroviruses are important human pathogens and the major cause of epidemic gastroenteritis worldwide. Immunity to norovirus infection has remained largely undefined since their discovery in 1972 due to the lack of in vivo models with which to characterize immune responses. Human challenge and outbreak studies into norovirus immunity are confounded by differential pre-exposure histories of individuals; however, identification of murine-specific norovirus strains and improvement of recombinant immunization techniques have allowed researchers to study norovirus immunity in greater detail than ever before. Innate and adaptive as well as cellular and humoral immune responses have been implicated in the clearance of norovirus infection in both complementary and supplementary capacities. While short-term adaptive immunity has been documented, long-term memory responses are unclear. Furthermore, the extreme heterogeneity of the virus family limits recognition of divergent strains by immunological memory responses following previous exposures. Recombinant vaccines have been developed to address the immunogenicity of norovirus proteins, routes of immunization, and efficacy of single versus multiple strain delivery. Safe and effective vaccines are urgently needed for personnel and patrons of settings such as hospitals, nursing homes, and day-care centers, where high-risk individuals are present and outbreaks frequently occur. The molecular biology, structure, and pathogenesis of human norovirus infection will be reviewed, and the current status of norovirus vaccine development will be discussed.
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