Viral shedding and fecal IgA response after Norwalk virus infection.

Protection is not conferred by preexposure to Norwalk virus (NV). By use of an ELISA with baculovirus-expressed recombinant NV (rNV) capsid protein, the pattern of NV fecal shedding and the protective effect of rNV-specific fecal IgA (flgA) were investigated in volunteers who were repeatedly challenged with NV. After the first challenge, ill volunteers were significantly more likely than well volunteers to have NV antigen in their stool (P < .05). After challenge, antigen shedding was detected on days 1-13; ill volunteers shed the antigen longer (P = .02). A higher prechallenge rNV-specific flgA geometric mean titer was found in ill compared with well volunteers (P < .05) and in infected versus noninfected volunteers (P < .05). NV shedding was common after infection and was present up to 2 weeks after challenge. Preexisting rNV-specific flgA, like serum IgG, is not protective and may be a marker for symptomatic disease.