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Volume 14, Number 10—October 2008

Research

Norwalk Virus Shedding after Experimental Human Infection

Robert L. AtmarComments to Author , Antone R. Opekun, Mark A. Gilger, Mary K. Estes, Sue E. Crawford, Frederick H. Neill, and David Y. Graham
Author affiliations: Baylor College of Medicine, Houston, Texas, USA;

Main Article

Table

Fecal virus shedding among 16 participants inoculated with Norwalk virus*

Participant no. Estimated Norwalk virus inoculum dose (RT-PCR units) First–last study days† postinoculation when symptoms present First–last study days IMC 
RT-PCR positive Day peak virus titer (character of feces) Peak qRT-PCR virus titer (log10/g) First–last study days postinoculation when antigen positive
Met clinical definition of gastroenteritis
Had diarrhea and vomiting
706 4,800 2 2–28‡ 2 (liquid) 11.1 2–9
707 4,800 2–4 1–30‡ 2 (liquid) 9.5 4–8
710 4,800 1–2 2–30‡ 5 (solid) 10.9 2–7
722 48 2 2–48 4 (solid) 11.7 2–8
724 4.8 2–3 2–56 3 (solid) 11.4 2–6
Had vomiting only
701 4,800 1–2 1–29‡ 4 (solid) 10.8 3–10
720§ 48 2 2–56 4 (solid) 11.5 2–9
721 48 1–3 2–21 4 (solid) 11.7 2–10
723 48 2 1–50 4 (solid) 12.2 2–6
731 4.8 2–3 5–10 5 (solid) 10.0 None
732 4.8 2–3 2–15 3 (solid) 11.9 2–6
Median

2
2–30‡
4 (solid)
11.4
2–8
Did not meet clinical definition of gastroenteritis
703 4,800 2–3 1–32‡ 2 (solid) 10.7 2–9
704 4,800 2–3 4–21‡ 5 (solid) 9.2 5–7
715§ 48 2–3 1–28 3 (solid) 11.7 2–5
716§ 48 2–3 1–20 4 (unformed) 10.1 3–7
717 48 3 4–13 4 (solid) 9.3 None
Median 2–3 1–21‡ 4 (solid) 10.1 2–7

*RT–PCR, reverse transcription–PCR; IMC, immunomagnetic capture; qRT-PCR, quantitative PCR.
†Study days are reported as calendar days; study day 1 began ≈5–6 h postinoculation.
‡Fecal samples only collected for 30 d postinoculation.
§Watery feces with mass <200 g.

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