BBC 2024-03-07 16:01:49

Hamas delegation leaves Gaza truce talks in Cairo without deal

A Hamas delegation has left talks in Cairo without a deal for a ceasefire in Gaza, but the armed group says indirect negotiations with Israel are not over.

It had been hoped that a 40-day truce could be in place for the start of the Islamic month of Ramadan next week.

With more signs of a famine looming, international pressure has only grown.

But Egyptian and Qatari mediators have struggled to seal a deal that would see Hamas free Israeli hostages in exchange for Palestinians held in Israeli jails.

Israel did not send a delegation to Cairo, saying it first wanted a list of the surviving hostages who could be released under the agreement.

Hamas said Israel did not accept its demands for displaced Palestinians to be able to return to their homes nor a complete withdrawal of Israeli forces from Gazan cities.

The war in Gaza began when Hamas fighters stormed into southern Israel on 7 October, killing about 1,200 people and seizing 253 hostages, according to Israeli tallies.

More than 30,800 people have been killed in Gaza since then, the Hamas-run health ministry says.

A Hamas statement said its delegation left Cairo on Thursday morning “for consultation with the leadership of the movement, with negotiations and efforts continuing to stop the aggression, return the displaced and bring in relief aid to our people”.

Egyptian state-affiliated TV channel al-Qahera meanwhile cited a senior source as saying that the negotiations would resume next week.

There was no immediate comment from Israel’s government.

On Wednesday, the US state department said it believed the obstacles raised were “not insurmountable and a deal can be reached”.

The proposed agreement would reportedly see 40 Israeli hostages released in exchange for about 10 times as many Palestinian prisoners being freed from Israeli jails.

More than 130 hostages are still believed to be held by Hamas. Israeli officials have said that at least 30 of them are dead.

Over the course of a proposed 40-day truce, there would be a surge in desperately needed aid entering into Gaza.

During a week-long ceasefire in late November, 105 hostages – most of them women and children – were freed in return for some 240 Palestinian prisoners in Israeli jails.

Without a new deal, there is a higher threat of a further spread of tensions during Ramadan, which this year is due to begin on Sunday or Monday, depending on the lunar calendar.

Meanwhile, amid reports of further deaths in Gaza from starvation, the UK and the US are pressing Israel to increase the flow of aid. Israel is blaming the UN for aid distribution problems.

Ukraine war: Eastern residents brace for Russian advance

In eastern Ukraine, the tide of this war hasn’t just changed – it’s coming in fast.

“We know what’s coming,” says Mariya as she packs up the TV in her flat in Kostyantynivka. She’s having it delivered to Kyiv before making the journey there with her son.

“We’re tired all day [and suffer] moods and panic attacks. It’s constantly depressing, and we’re scared.”

In February, Russia captured the strategic town of Avdiivka. Since then, the invaders have advanced further west, and taken several villages.

Ukraine says its forces are “holding on”. But Russian troops are now attacking in five areas along the 1,100km (700 mile) front line.

Over 1.2 million people – or two thirds of the population – have left the Ukrainian-controlled Donetsk region since Russia’s full scale invasion two years ago.

And it’s here in the eastern Donetsk region that Ukraine’s defenders are being tested the most.

People in cities like Pokrovsk, Kostyantynivka and Kramatorsk are now facing a fast-approaching front line, and even occupation.

Mariya and her mother Tetyana are finding life increasingly difficult as the Russians advance closer.

Their city is littered with signs of the approaching threat 30km (19 miles) away.

Almost every street has a damaged building. Workers replace gold panels on a church after they were blown off by a missile strike on the neighbouring train station, now destroyed.

Anxiety fills the cold air in this town, once part of the industrial heartland of the former Soviet Union. Russia slowly destroys Ukraine’s cities as it tries to take them. That’s what is feared the most here.

Mariya explains that her mother Tetyana is staying, but she’s confident she’ll follow her eventually.

“I’ve already left twice, what’s the point?” says a defiant Tetyana from her apartment around the corner. She gives us slippers to wear around her home, which explains why it’s spotless.

“It’s scary everywhere. The whole country is on fire.”

Her eyes moisten. It’s one thing to stay in your home for as long as you can, it’s another to risk death or Russian occupation.

While the whole of Ukraine is a war zone, the Donetsk region – along with four others – is a battlefield. When you weave through its dense forest and expansive, rugged terrain, you always feel like you’re approaching the coal face of this conflict.

You can hear heavy fire from as far as 40 km away, so the distant sound of artillery is constant. From one vantage point you can see the erosion of Ukrainian territory.

Plumes of smoke come from the directions of Avdiivka, a town Russia has recently taken, and Horlivka, which it’s controlled since 2014.

Russia is using its size, air superiority and deeper ammunition reserves to keep pushing, at a time when Western military aid to Ukraine is running low or being held up by domestic politics.

  • Listen to Ukrainecast’s take on what’s happening on the front line

Nearby lies a wide valley with several reservoirs. It’s this natural landscape which Ukraine says will allow its forces to “stabilise” the front line.

Perhaps after chaotic withdrawals in the past, Ukrainian generals are willing to temporarily concede territory in the hope it can be liberated in the long term.

Across the front line there is a small minority of people labelled as “Zhdun” by the Ukrainians. It’s a derogatory word which means “waiters”, referring to those who are pro-Russian and waiting to be occupied.

It doesn’t apply to everyone who ignores offers of evacuation. Some just refuse to abandon their homes and have got used to the constant danger.

Valeriy isn’t one of them. After his home in the town of Toretsk was almost shelled twice, he’s taking his belongings and grandson Denys to a pickup point.

With the Russians just 5km away, their neighbours wish them well but still refuse to leave. The pair then board an armoured police vehicle.

“I’ve lived my life already,” the 67-year-old tells us at the other end of his journey in Kostyantynivka. “But I need to save the little one.”

“I worked in the mine for 20 years so I’m not afraid of anything, but I’m worried for him,” he adds.

Denys, who’s 14, nods approvingly. “My last friend left three weeks ago,” he says.

Evacuation from front-line settlements is compulsory for families with children. Despite that 15 children still remain in Toretsk.

Anton Pron from the White Angels police evacuation squad, who helps evacuate people away from front-line towns, tells us the situation is worsening every day.

“There’s constant shelling and artillery,” he says. “The enemy’s aviation is working all the time. The Russians drop bombs on residential houses.”

These days, the train station in the nearby city of Kramatorsk is the last stop for arriving troops and increasingly, departing civilians laden with bags.

Distant rumbles of artillery serve either as a sobering welcome or a reason to leave. Couples hold long embraces on a platform flanked by freight trains which provide protection in case of a missile strike.

At least 61 people were killed by one here in 2022. Shrapnel marks are still scorched onto the pavement.

We meet Alla, who’s waiting for her train to Kyiv. “A year ago, we thought we’d get help from the West and that our counter offensive would work, but not anymore,” she says.

“People used to believe, but not now.”

Ukraine hopes its eastern lands will one day be somewhere safe to live again. Right now it’s unclear what these departing passengers will be returning to.

Should its Russian invaders gain more momentum in the Donetsk region, the question of where they will stop will be increasingly difficult to answer.

Additional reporting by Hanna Chornous and Scarlett Barter

Red Bull suspend woman who accused Christian Horner of inappropriate behaviour

The woman who accused team principal Christian Horner of inappropriate and controlling behaviour has been suspended by Red Bull.

Horner denies the allegations, and Red Bull’s board dismissed the complaint after an internal investigation.

“The company cannot comment on this internal matter,” a Red Bull spokesperson said on Thursday.

BBC Sport has learned the reason given by Red Bull to the employee was that she had been dishonest.

The allegations first came into the public domain early last month.

Red Bull’s board made its decision to dismiss the matter last week after reading a report compiled by what the company have called an independent KC over several weeks.

The company have given no explanation for the decision nor have they revealed what the report contained or the lawyer’s name.

A day after Red Bull dismissed the complaint, an anonymous email including messages purporting to involve Horner were leaked.

Speaking at last week’s Bahrain Grand Prix, the 50-year-old refused to say whether the messages leaked were genuine.

An attempt to ask him whether the messages were genuine was shut down by a Red Bull PR handler.

Red Bull’s main shareholder Chalerm Yoovidhya refused to answer BBC Sport’s questions on the matter in Bahrain.

Sources close to Red Bull say there is a split between the Thai side of Red Bull and the Austrian headquarters, which owns 49% of the company.

The Austrians are said to have wanted Horner to be removed from his position but Yoovidhya backed the team principal.

Jos Verstappen – the father of Red Bull’s triple world champion Max – has said the Horner controversy is “driving people apart” and it is “not good for the team”.

Asked about his father’s comments, Max Verstappen said Jos was “not a liar”.

He added: “I guess he clearly felt like that. But from my side it doesn’t matter being on one side or the other side.

“Of course as a son of my dad, it would be weird to be on a different side but I just want to focus on the performance side of things.”

Timeline of Horner allegations

5 February: Red Bull announces investigation into Horner after complaint of inappropriate and controlling behaviour is made against him. Horner tells Dutch newspaper De Telegraaf:, external “I completely deny these claims.”

11 February: Horner is interviewed by lawyer for several hours but hearing finishes without resolution.

15 February: Red Bull launch car for 2024 F1 season and Horner tells the BBC the investigation is “a distraction” for his team.

21 February: Mercedes team principal Toto Wolff calls for investigation to be transparent.

28 February: Horner is cleared following internal investigation and Red Bull says he will remain in his role as team principal and chief executive.

29 February: As first practice at the Bahrain Grand Prix begins, Horner tells Sky Sports unity within Red Bull team has never been stronger. Later that day, Horner reiterates his denial of allegations after a series of messages were leaked to F1 personnel and media.

7 March: Woman who accused Horner of inappropriate behaviour is suspended by Red Bull.

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Five countries with the best work-life balance

For anyone considering an international move, it’s important to understand a country’s attitudes towards work – and whether it prioritises work-life balance.

Work-life balance is often seen as the key to everything from a healthy lifestyle to psychological wellbeing. So, it’s little surprise that for anyone considering an international move, it’s important to understand a country’s attitudes towards work.

To figure out which nations have the best work-life harmony, we looked at the 2023 Global Life-Work Balance Index by HR-tech company Remote, which takes into account aspects such as statutory annual leave, minimum statutory sick pay percentage and amount of paid maternity leave. We also looked at the OECD’s work-life balance data, which analyses how many hours employees work and how much time people devote to leisure and personal care in its 22 member countries.

Here are five of the top-ranking countries:

New Zealand

New Zealand leads Remote’s ranking, with 26 paid weeks of maternity leave, boosted by having a relatively high minimum wage, 32 days of statutory annual leave and a minimum 80% statutory sick pay percentage.

But more than any particular policy, it’s the overall culture that makes work a more relaxed affair, says Erin Parry, a Canadian who lives in New Zealand and works in marketing.

“As a Canadian, you have such a ‘do-or-die’ attitude about work,” she said. “I just did not know how I was going to survive that.” When she visited New Zealand in 2015, it seemed to offer a different approach – one that, ever since moving there permanently the same year, has largely lived up to expectations.

People’s main priorities are their family, their wellbeing, recreation and travel

Of course, New Zealand isn’t perfect. OECD data shows that 14% of employees work more than 50 hours per week, more than the OECD leave average of 10%. And they spend slightly less time than the OECD average, 14.9 hours per day, on personal care (like eating and sleeping) and leisure (including spending time with family and friends, hobbies and watching television). Parry points out that some of the government support that other wealthy countries offer, such as worker insurance in case of unemployment aren’t provided by New Zealand, while childcare costs are high and on the rise.

Plus, New Zealand’s relaxed approach to work can also have drawbacks. “If you are trying to get something done and you have any urgency, that’s just too bad for you,” Parry said. “The month of December is a write-off; nothing really happens. People don’t respond to their emails.”

Still, says Parry, New Zealand’s cultural approach to work-life balance is hard to beat. “People’s main priorities are their family, their wellbeing, recreation, travel,” she said. “They really take their time as very valuable and very precious and believe that work is a means to an end – and not your whole life.”

Spain is known for its relaxed work culture with many locals prioritising leisure time (Credit: AndreaMPhoto/Getty Images)


Spain ranks second on the Remote index, thanks to benefits like its 26 days of statutory annual leave. According to the OECD data, meanwhile, workers in Spain devote the most hours of their day to leisure and personal care outside of any country but Italy and France. Only 2.5% work very long hours in paid employment.

That doesn’t come as a surprise to Isabelle Kliger, a travel writer who has lived in Sweden, the UK, Ireland and – since 2010 – Barcelona. “In the UK and Ireland, so many people spend all their time at work, and then when they’re not working, they’re socialising with their colleagues,” she said.

Not so in Spain. “You meet people here and they don’t immediately ask you what you do. And they don’t talk about work outside of work,” she explained. “Maybe, if you meet someone for a drink straight from work, they might be like, ‘I had the worst day.’ And then, within 10 minutes, you’re talking about something else.

Still, she says that it’s common to hear the Spanish say that they work very long hours. Some of this is because of how work hours have changed. Previously, the traditional workday was from about 08:30 to 13:30, with a one- or two-hour siesta, ending at 19:00 or 20:00. But the siestahas been in decline for years. As a result, some workers were no longer taking that midday break but still staying at the office late. To combat this shift, in 2016 Spain’s then-prime minister made headlines by announcing that he wanted to see workdays end at 18:00, instead.

Even so, recent EU data finds that the Spanish work, on average, 37.8 hours a week – only about 20 minutes more than the European average. For those companies that do still practice long lunch breaks, during the summer, there is a common Friday tradition called jornada intensiva: in lieu of the lunch break, staffers leave the office at 15:00.

The upshot, says Kliger, is a culture that – to her – has its priorities in order. “You don’t live to work,” she said. “You work to live.”

Flexible work is supported in Denmark, making it easier for families to juggle responsibilities (Credit: AleksandarNakic/Getty Images)


Few people understand the benefit of Denmark’s work-life balance more than Helen Russell, author of The Year of Living Danishly – and who now has lived in the country for more than a decade.

“I worked as a journalist in London for 12 years,” she said. “I worked long hours. It was busy. With the commute from London, there was often very little of ‘life’ in the work-life balance part left over. I just thought that was normal. And then we moved here.”

Among other things, she says, she noticed how strict the boundary between “work” and “life” is. “The working day starts at 08:00. People normally shut their computers at 16:00,” she said. Because children usually have to be picked up from nursery by around 16:00, everyone – even those without children – end their workday then. “There’s really a sacred family time between, say, 16:00 and 19:00 each day, where families are together. Maybe you answer a few emails once the kids are in bed, but otherwise, you’re kind of done. And it means that people without children as well are allowed to set aside their own leisure time and hobbies with the same priority that parents are afforded to their children. It’s perfectly acceptable to put in your diary, ‘I must go to the gym’, or ‘I’ve got badminton club’.”

This prioritisation of work-life balance is what the OECD and Remote rankings found, too. Just 1% of Danish employees work more than 50 hours a week, far less than countries including Italy (3%) or than the OECD average (10%). They also devote 15.7 hours a day to personal and leisure time, more than the OECD average. And flexible work is supported – in fact, the country’s Flexjobs scheme, in which workers can request different work hours, patterns or even less physically demanding tasks, was launched back in 1998.

The country also offers 36 days of statutory annual leave, among the highest of wealthy countries, and workers must be paid 100% of their wages for sick days.

It’s common to see people relaxing outdoors in France at any time of day (Credit: Massimo Borchi/Getty Images)


According to OECD data, people in France have 16.2 hours per day for personal and leisure time, second only to Italy. On the Remote list for work-life balance, the country ranks third overall – with one of the highest number of days for statutory annual leave (36), in particular.

Indeed, even in a busy city like Paris, says Sarah Micho, a Canadian entrepreneur and freelancer who moved to the capital in 2021, locals prioritise non-work time. “French culture promotes a sense of relaxation and rest,” she said. Cafe culture is one example: it’s common to see people sitting and relaxing outside at any hour of the day, she says, particularly when the weather is nice – and not just with friends or colleagues, but having a leisurely coffee alone, too.

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Of course, it still depends on the industry and the role, she says. Micho did a fashion industry internship where her hours were 10:00 to 19:00 – and many other people were commuting home at that time too. In fact, 8% of employees in France work more than 50 hours per week, lower than the OECD average of 10%, but still higher than many other top-ranked countries.

But in general, the approach is one of balance, Micho says, with an emphasis on culture, and France’s prioritisation of arts and culture funding making a difference. “That also helps provide a balance from your busy work life. On the metro you see expos coming up, or events that are advertised,” she said. “There’s more of that sense of having a life outside of your job.”

Italians prioritise work-life balance and make the most of their leisure time (Credit: Fani Kurti/Getty Images)


The popular Italian phrase il dolce far niente (the sweetness of doing nothing) isn’t just lip service – as I experienced while living in Rome. “I think Italians invented the concept of work-life balance,” agreed Andres Uribe-Orozco, an attorney who now works in Rome after living in Colombia and the US. “People are not just constantly running around like headless chickens for ‘work, work, work’.”

The OECD data bears this out. Full-time employees spend 69% of their day – 16.5 hours – on personal care and leisure. That’s 1.5 hours more than the OECD average, making it the OECD country where people have the most leisure time. Meanwhile, while 10% of OECD employees work very long hours (more than 50 hours a week), in Italy, only 3% do.

People think Italians don’t work. No – Italians work a lot. They’re just productive

“People think Italians don’t work. No – Italians work a lot. They’re just productive,” said Uribe-Orozco. “They do what they have to do, and they do it quickly so they can enjoy their long coffee pauses.”

Of course, there are downsides. The country has higher unemployment and lower average salaries than many other OECD countries, for example. Italy also fares far worse – ranking at number 22 – on Remote’s work-life balance list, which takes into account aspects like overall happiness index and LGBTQ+ inclusivity.

The lack of a hustle culture can impact everyday efficiency, too. When I lived in Italy, I would pencil out at least an hour for a visit to the post office, while any kind of bureaucracy, like renewing a permit, would easily be a half-day affair. The upside? Rather than seeing it as “lost” time, I started to view it as potential leisure time, always making sure I had a good book with me – and in that way I, too, wound up discovering il dolce far niente even in the unlikeliest of circumstances.

Living In is a series from BBC Travel that discovers what it’s like to reside in some of the world’s top destinations.


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Why some people are resistant to norovirus

The winter vomiting bug is highly infectious and fast to evolve, but can we learn anything from groups of people who are unusually immune to the virus?

When it comes to surviving in the environment, few pathogens are more resilient than norovirus. This gastrointestinal bug induces nasty bouts of diarrhoea and vomiting in around 685 million people globally every year, often in hospitals, nursing homes, jails, schools and cruise ships. 

The latest statistics from the Centers for Disease Control and Prevention reveal that the germ is spreading rapidly once again across the US, with cases climbing particularly quickly since October 2023 in the northeast of the US.

But to understand why norovirus is so hard to stop once an outbreak gets going, you first have to appreciate just how much it can endure. “It’s a very tough little virus,” says Patricia Foster, professor emerita of biology at Indiana University Bloomington who has studied norovirus. The virus is able, for example, to survive intact within food up to temperatures of 70C (158F). “It can survive heat, freezing cold, extreme dryness, and so it just sits on surfaces for days,” says Foster.

Much of this toughness comes down to the surface of the virus, a protein coat which acts a little like armour, shielding its inner genetic material. Foster points out that while a lot of viruses acquire a membrane coat as they pass from cell to cell, facilitating their ability to spread within the body, this also makes them susceptible to alcohol and detergents. 

“Norovirus doesn’t do that,” she says. “It’s just a little protein bomb, and so things like hand sanitiser can’t kill it, while it’s still able to move from cell to cell.”

The surface proteins that make up the outer coat of norovirus act like a suit of armour, meaning it can be tough to kill (Credit: Alamy)

We still understand relatively little about exactly how norovirus spreads within the body, but we do know that it spreads between people remarkably quickly. It is thought to take as little as 10 norovirus particles for an infection to take hold, while in comparison, it has been estimated that the so-called infective dose for Covid-19 is in the region of 100-400 units of the SARS-CoV-2 virus.

However, in recent decades virologists have begun to discover that there are some of us who carry innate biological factors which protect us from the illness.

So-called “challenge studies” where paid volunteers agree to be deliberately infected with a norovirus strain, have helped determine that as many as one in five people of European descent carry a mutation in a gene called FUT2. This inactivates an enzyme that protects them against GII-4, the most common of the 29 norovirus strains currently known to be capable of infecting humans and responsible for causing 50 to 70% of all norovirus outbreaks in the world.

The reason for this is because norovirus largely prefers to enter the cells in the small intestine via antigens, molecular gateways called oligosaccharides, which are made from an assortment of different sugars. Both GII-4 and many other norovirus strains require one particular oligosaccharide, called the H1-antigen, in order to infect a person.

But people carrying a mutation in the FUT2 gene lack an enzyme that is involved in a vital step in the formation of the H1-antigen in mucous producing cells in the mouth, throat, gut and lungs. Without these antigens on their cells, the GII-4 virus is unable to cause an infection. As people who carry this mutation don’t produce the FUT2 enzyme in mucous-producing cells, they are known to virologists as non-sectors.  

For the same reason, your blood type, something which is determined by your genetic makeup, also plays a large role in resistance and susceptibility to different norovirus strains. People with B blood type tend to be more resistant as fewer strains have evolved to attach to those particular oligosaccharides, whereas those with A, AB or O blood types are far more likely to become sick.

It means you’re somewhat resistant but not completely, as norovirus evolves extremely rapidly – Patricia Foster

According to Robert Atmar, a virus expert and professor at Baylor College of Medicine in Houston, Texas, this information could in future aid the development of better antivirals against norovirus strains. “There are studies being done to see if taking advantage of the interaction between noroviruses and the antigens on cells might be targeted for the development of a therapeutic,” he says. 

However, this work is complex because of the speed with which noroviruses adapt and change their genetic material, meaning that some strains have still found a pathway to infect individuals who are relatively resistant. 

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“I’m a non-secretor myself,” says Foster. “It means you’re somewhat resistant but not completely, as norovirus evolves extremely rapidly.”

She predicts that even non-secretors may become more susceptible to variants of GII-4 with time, as this strain of norovirus figures out different pathways into the body.

“I was reading about the evolution of GII-4 and all the variants that have appeared over the last 20 years or so, mostly in China,” she says. “They find that it’s getting better and better at interacting with different binding sites on our cells. So that’s the evolution game.” 

While norovirus doesn’t tend to kill its host, it can prove lethal to anyone with a weakened immune system, children, and the elderly. It results in around 200,000 deaths every year, particularly in low-income countries, but also 70,000 hospitalisations in the US. As a result, virologists are now trying to utilise our growing knowledge about the virus to help design vaccines.

Norovirus outbreaks can be particularly serious on cruise ships, where infections can spread rapidly (Credit: Getty Images)

The vaccine scourge

For decades, norovirus has been devilishly difficult to even contemplate vaccinating against. One of the most problematic reasons is that the noroviruses evolve so rapidly, it means any vaccines are quickly out of date. Human norovirus is also notoriously difficult to grow in the laboratory, making it difficult to study.

However, in the last few years, researchers have begun to devise ways of growing the virus within human gut cells in a petri dish, something which could prove invaluable in testing the best way to induce a suitably powerful antibody response from the immune system.

“These cell culture models may be helpful in vaccine efforts by demonstrating that immune responses generated after vaccination kill or inactivate the virus by neutralising its infectivity,” says Atmar.

But because there are so many norovirus strains and a seemingly continuous flow of new variants, a vaccine will need to induce a very broad immune response. Ming Tan, an associate professor in infectious diseases at Cincinnati Children’s Hospital Medical Center, Ohio, says that a so-called bivalent or multivalent vaccine, which contains multiple immune-driving particles from various points in the virus’ genetic code, will almost certainly be necessary to achieve any chance of durable immunity.

Having such a vaccine is likely to be particularly important if it is rolled out in young children to prevent a phenomenon known as “immune imprinting”. This is the tendency of the immune system to misidentify a new viral variant as one it has already encountered, thus mounting an ineffective antibody response. Researchers at the University of North Carolina believe that if a suitably broad norovirus vaccine is administered to children who are around six months old, the jab could then guide the antibody response to any further variants.

Developing a broad vaccine is not an easy task, but multiple companies and research groups have taken on the challenge, each choosing to utilise different technological platforms. Moderna have launched a clinical trial of a messenger RNA (mRNA) norovirus vaccine initially in 18-49 year olds and 60-80 year olds. Meanwhile, Boston-based biotech HilleVax is conducting trials of its vaccine candidate in five-month-old infants, children aged two to nine, adults aged 18-59 and over 60s. HilleVax’s approach is to use virus-like particles (VLPs), molecules which mimic norovirus strains and so trigger an immune response, without actually being infectious.

“We’re still learning a lot about norovirus vaccines and how they might protect,” says Atmar. “We know that administration of virus-like particle (VLP)-based vaccines via the nose or by intramuscular injection can lead to protection from illness. mRNA vaccines may allow increased numbers of strains to be included. I think all will likely be effective, and the relative effectiveness will depend on other factors we are still learning about, including breadth of the immune response after vaccination, duration of immune response, and role of past infection and genetic makeup on an individual’s response and protection.”

Advances in mRNA vaccines are raising hopes of being able to inoculate against noroviruses (Credit: Getty Images)

Yet for all these efforts, success will also likely depend on how swiftly the vaccine needs to be updated and re-administered as a booster jab. Tan, who recently published a study on his own laboratory’s approach to a norovirus vaccine, admits that this could be a hurdle.

“Vaccines produced using our approach will need regular updates to address the challenges of rapid virus evolution and the potential emergence of new norovirus genotypes as predominant strains in the future,” he says.

However, Atmar remains more optimistic, saying that we need to wait until the results of much larger trials before any firm conclusions can be made on potential vaccine durability.

“The results of one of the studies for the VLP vaccine being pursued by HilleVax suggests that it can also protect against disease caused by the GII-2 strain when the vaccine contained GI-1 and GII-4 strains,” he says. “So, we don’t know whether it’ll be like influenza or Covid [where regular boosters are required], or that it might be more like RSV where strain updates are not needed.”

But if we can develop at least one vaccine in the years to come, it will represent a major step forward in humanity’s ongoing battle with norovirus.

“We’ve been evolving in parallel with this virus for hundreds of thousands of years,” says Foster. “And it can be a killer, particularly for babies and people who are immunocompromised because they can’t rid themselves of the virus, so any vaccine would be progress.”

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