Norovirus and other GI Viruses Can Be Spread Through Saliva Interview with:

Nihal Altan-Bonnet, Ph.D. Chief of the Laboratory of Host-Pathogen Dynamics NHLBI

Dr. Altan-Bonnet

Nihal Altan-Bonnet, Ph.D.
Chief of the Laboratory of Host-Pathogen Dynamics
NHLBI  What is the background for this study?  What are the main findings?

Response: Enteric viruses such as norovirus, rotavirus and astrovirus are responsible for nearly 1.5 billion global infections per year resulting in gastrointestinal illnesses and sometimes leading to death in the very young, in the elderly and in the immunocompromised. These viruses have been thought to traditionally infect and replicate only in the intestines, then shed into feces and transmit to others via the oral-fecal route (e.g. through ingestion of fecal contaminated food items).

Our findings reported in Nature, using animal models of norovirus, rotavirus and astrovirus infection, challenge this traditional view and reveal that these viruses can also replicate robustly in salivary glands, be shed into saliva in large quantities and transmit through saliva to other animals.

In particular we also show infected infants can transmit these viruses to their mothers mammary glands via suckling and this leads to both an infection in their mothers mammary glands but also a rapid immune response by the mother resulting in a surge in her milk antibodies. These milk antibodies may play a role in fighting the infection in their infants . Is Norovirus killed by common hand sanitizers, with or without alcohol?

Response: Hand sanitizers are not very effective against norovirus. What should readers take away from your report?

Response: There have been many reports in literature of norovirus or rotavirus presence in human saliva but they have all been assumed to be contaminants from the gut (via vomiting for example). If our findings hold true for humans, in that human salivary glands replicate enteric viruses, then it would indicate that talking, sneezing, coughing, kissing could all be ways in which these viruses can spread to others and that we will need to revise our sanitation practices and include preventive measures such as wearing masks during these enteric virus outbreaks. 

No disclosures.


Ghosh, M. Kumar, M. Santiana, A. Mishra, M. Zhang, H. Labayo, A. M. Chibly, H. Nakamura, T. Tanaka, W. Henderson, E. Lewis, O. Voss, Y. Su, Y. Belkaid, J. A. Chiorini, M. P. Hoffman, N. Altan-Bonnet. Enteric viruses replicate in salivary glands and infect through saliva. Nature, 2022; DOI:

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Last Updated on June 30, 2022 by Marie Benz MD FAAD