Norovirus is the number one cause of diarrheal disease globally, including in the critical first year of life. With the control of rotavirus through vaccination, norovirus is now the most common cause of severe diarrheal disease in children in many countries. Vaccines for norovirus are promising and multiple products are moving rapidly through the development pipeline. But, development of effective vaccines for norovirus will face multiple challenges. Noroviruses are highly genetically diverse and rapidly evolving. Immunity is limited in breadth and duration. And, the whole age range -- from babies to the elderly in nursing homes -- is affected. In this project, we are developing a norovirus transmission and vaccination simulator. We are conducting analyses across biological scales of the within-host, epidemiological and evolutionary dynamics of norovirus to inform the data-driven model of norovirus vaccination. Our aim to guide vaccine design and, ultimately, implementation.

Long-term care facilities, home to nearly 2.5 million people in the US, are the most common setting for norovirus outbreaks. Vomiting is a classic symptom of norovirus gastroenteritis, and is also a strong risk factor for norovirus transmission. Filling knowledge gaps that impede the development of evidence-based, detailed vomitus clean-up will allow us to move towards the goal of preventing norovirus-associated disease and deaths resulting from improper environmental sanitation.