Gastroenteritis is inflammation of the lining of the stomach and small and large intestines. It can be caused by the norovirus.
Norovirus is very contagious and spreads from person to person.
Typically, people have diarrhea, vomiting, and abdominal cramps.
The diagnosis is based on a person’s history of recent contact with contaminated food, water, or people infected with the virus; recent travel; and sometimes laboratory tests.
Thoroughly washing the hands after a bowel movement or contact with fecal matter and avoidance of undercooked foods and contaminated water are the best ways to prevent infection.
Fluids are usually the only treatment needed, but some people may be given medications to help stop diarrhea.
Norovirus infects people of all ages. It is now the most common cause of gastroenteritis in the United States in all age groups, including children (peak age is between 6 months and 18 months).
Infections occur year-round in the United States, but most occur from November to April. Most people are infected after swallowing contaminated food or water.
Because norovirus is highly contagious, infection can easily be spread from person to person. This virus causes most cases of gastroenteritis epidemics on cruise ships and in nursing homes.
(See also Overview of Gastroenteritis.)
Symptoms of Norovirus Gastroenteritis
Norovirus typically causes vomiting, abdominal cramps, and diarrhea. Children have more vomiting than diarrhea, whereas adults have more diarrhea. Symptoms start 1 to 2 days after infection and last 1 to 3 days.
Vomiting and diarrhea can lead to mild to severe dehydration.
People may also have fever, headache, and body aches.
Diagnosis of Norovirus Gastroenteritis
A doctor's evaluation
Sometimes stool tests
The diagnosis of norovirus is usually based on typical symptoms, especially if an outbreak is currently ongoing. Sometimes other family members or coworkers have recently been ill with similar symptoms. Other times, norovirus can be traced to contaminated water or inadequately cooked, spoiled, or contaminated food. Recent travel, especially on a cruise ship, may give clues as well.
To confirm the diagnosis of norovirus, doctors sometimes test stool specimens.
Treatment of Norovirus Gastroenteritis
Fluids and rehydration solutions
Sometimes medications
Rehydration
Usually the only treatment needed for norovirus gastroenteritis is getting bed rest and drinking an adequate amount of fluids. Even a person who is vomiting should drink as much as can be tolerated, taking small frequent sips.
If vomiting or diarrhea is prolonged or the person becomes severely dehydrated, fluids and electrolytes given by vein (intravenously) may be needed. Because children can become dehydrated more quickly, they should be given fluids with the appropriate mix of salts and sugars. Any of the commercially available solutions designed to replace lost fluids and electrolytes (called oral rehydration solutionsbreastfeeding should continue.
As the symptoms subside, the person may gradually add foods to the diet. Although often recommended, there is no need to limit the diet to bland foods such as cereal, gelatin, bananas, rice, applesauce, and toast. However, some people are unable to tolerate milk products for a few days after having diarrhea.
Medications
Antibiotics and antiviral medications are not given.
Prevention of Norovirus Gastroenteritis
Handwashing
Avoiding high-risk food and beverages
Good hygiene practices are important at all times, not just when there is an outbreak of gastroenteritis.
Because most norovirus infections are transmitted by person-to-person contact, particularly through direct or indirect contact with infected stool, good handwashing with soap and water after a bowel movement is the most effective means of prevention. If soap and clean water are unavailable, an antibacterial hand sanitizer should be used.
To prevent foodborne infections, hands should be washed before touching food, knives and cutting boards used to cut raw meat should be washed before use with any other food, meat and eggs should be cooked thoroughly, and leftovers should be refrigerated promptly after cooking. Only pasteurized dairy products and pasteurized apple juice should be used.
Travelers should try to avoid high-risk foods and beverages, such as those sold by street vendors.
To prevent recreational water illness, people should not swim if they have diarrhea. Infants and toddlers should have frequent diaper checks and should be changed in a bathroom and not near the water. Swimmers should avoid swallowing water while swimming.
For prevention in children, caregivers should wash their hands thoroughly with soap and water before preparing bottles for formula-fed infants. They should also wash their hands after changing diapers. Diaper-changing areas should be disinfected with a freshly prepared solution of household bleach (¼ cup bleach diluted in 1 gallon of water).
Children with diarrhea should not go to a day care center until their symptoms are gone.
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