Heart and skeletal muscle inflammation (HSMI) is an infectious disease causing losses to the Norwegian salmon farming industry due to increased mortality and high morbidity in infected salmon. The disease is listed as a notifiable disease on list 3 (national list) by the Norwegian Food Safety Authority. HSMI is believed to be a viral disease, but the association to the recently discovered Piscine reovirus (PRV) remains unclear. Undoubtedly, other factors interact to determine whether PRV-infected fish develop disease or not.