НОРОВИРУСНАЯ ИНФЕКЦИЯ (ОБЗОР ЛИТЕРАТУРЫ)

The share of norovirus infection is 17–20% of all cases of acute gastroenteritis in the world. The dominant II genogroup of noroviruses is characterized by rapid variability. The new recombinant norovirus GII.P16-GII.2 caused a sharp increase in the incidence of gastroenteritis in Asian and European countries during the winter season 2016–2017. The epidemiological features of norovirus infection are long-term excretion of the pathogen from the body of patients and carriers of viruses, especially in persons with immunosuppression; the implementation of various transmission routes (food, water, contact, aerosol), high contagiosity, winter seasonality in the countries of the northern hemisphere. In recent years, two human systems for the cultivation of noroviruses in vitro have been created, a double tropism of noroviruses has been established for immune cells and epithelial cells of the intestine, and the life cycle of noroviruses has been studied. The microbiota and its members can be either protective or stimulating for norovirus infection. Lactobacillus may play a protective role against norovirus infection. The existence of chronic norovirus infection lasting from several months to several years is proved, especially in patients with immunodeficiency. Severe form of norovirus infection and deaths are more often recorded in young children, the elderly, patients with comorbidity and immunocompromised individuals. The clinical picture of norovirus gastroenteritis is similar in many respects to other viral gastroenteritis, which determines the need for laboratory verification of the diagnosis. The polymerase chain reaction method with reverse transcription is the most widely used in the world for diagnosing infection in patients and for detecting the virus in food and environmental objects. There are still no approved vaccines and antiviral drugs against this infection. Recommended therapeutic interventions include, along with rehydration with hypoosmolar solutions, the administration of specific probiotics such as Lactobacillus GG or Saccharomyces boulardii, diosmectit and racecadotril.Доля норовирусной инфекции составляет 17–20% всех случаев острого гастроэнтерита в мире. Доминирующая II геногруппа норовирусов характеризуется быстрой изменчивостью. Новый рекомбинантный норовирус GII.P16-GII.2 вызвал резкий рост случаев гастроэнтерита в странах Азии и Европы в зимний сезон 2016–2017 гг. Эпидемиологическими особенностями норовирусной инфекции являются длительное выделение возбудителя из организма больных и вирусовыделителей, особенно у лиц с иммуносупрессией, реализация различных путей передачи (пищевого, водного, контактно-бытового, аэрозольного), высокая контагиозность, зимняя сезонность в странах северного полушария. В последние годы созданы две человеческие системы для культивирования норовирусов in vitro, установлен двойной тропизм норовирусов к иммунным клеткам и эпителиальным клеткам кишечника, изучается жизненный цикл норовирусов. Микробиота и ее члены могут быть либо протективными, либо стимулирующими для норовирусной инфекции. Lactobacillus могут играть защитную роль против норовирусной инфекции. Доказано существование хронической норовирусной инфекции длительностью от нескольких месяцев до нескольких лет, особенно у пациентов с иммунодефицитом. Тяжелая форма норовирусной инфекции и летальные исходы чаще регистрируются у детей младшего возраста, пожилых, пациентов с коморбидностью и иммунокомпроментированных лиц. Клиническая картина норовирусного гастроэнтерита во многом сходна с другими вирусными гастроэнтеритами, что определяет необходимость лабораторной верификации диагноза. Метод полимеразной цепной реакции с обратной транскрипцией получил наибольшее распространение в мире для диагностики инфекции у пациентов и для обнаружения вируса в пищевых продуктах и объектах окружающей среды. До сих пор нет одобренных вакцин и антивирусных препаратов против этой инфекции. Рекомендуемые терапевтические вмешательства, наряду с регидратацией гипоосмолярными растворами, включают назначение специфических пробиотиков, таких как Lactobacillus GG или Saccharomyces boulardii, диосмектит и рацекадотрил.

NOROVIRUS INFECTION (SYSTEMATIC REVIEW)

The share of norovirus infection is 17–20% of all cases of acute gastroenteritis in the world. The dominant II genogroup of noroviruses is characterized by rapid variability. The new recombinant norovirus GII.P16-GII.2 caused a sharp increase in the incidence of gastroenteritis in Asian and European countries during the winter season 2016–2017. The epidemiological features of norovirus infection are long-term excretion of the pathogen from the body of patients and carriers of viruses, especially in persons with immunosuppression; the implementation of various transmission routes (food, water, contact, aerosol), high contagiosity, winter seasonality in the countries of the northern hemisphere. In recent years, two human systems for the cultivation of noroviruses in vitro have been created, a double tropism of noroviruses has been established for immune cells and epithelial cells of the intestine, and the life cycle of noroviruses has been studied. The microbiota and its members can be either protective or stimulating for norovirus infection. Lactobacillus may play a protective role against norovirus infection. The existence of chronic norovirus infection lasting from several months to several years is proved, especially in patients with immunodeficiency. Severe form of norovirus infection and deaths are more often recorded in young children, the elderly, patients with comorbidity and immunocompromised individuals. The clinical picture of norovirus gastroenteritis is similar in many respects to other viral gastroenteritis, which determines the need for laboratory verification of the diagnosis. The polymerase chain reaction method with reverse transcription is the most widely used in the world for diagnosing infection in patients and for detecting the virus in food and environmental objects. There are still no approved vaccines and antiviral drugs against this infection. Recommended therapeutic interventions include, along with rehydration with hypoosmolar solutions, the administration of specific probiotics such as Lactobacillus GG or Saccharomyces boulardii, diosmectit and racecadotril