Norovirus

It is norovirus, like rotavirus infection , that is responsible for all gastrointestinal inflammations (gastroenteritis), if they are not of bacterial origin.

What is norovirus?

For the first time, doctors discovered norovirus in the United States in 1972 in the city of Norwalk. That's why for a long time it was called the Norwalk virus. Since then, the virus has spread throughout the world.

Norovirus is not a specific microbe. This concept refers to a whole group of microorganisms. Colloquially, infection with these viruses is also called “norovirus.”

This infection is to blame for every third case of gastroenteritis in children and every second case in adults worldwide.

Most often, outbreaks of this intestinal infection occur between November and March. It especially affects children, the elderly and people with weakened immune systems.

How does the disease progress?

Usually the disease begins acutely, with severe vomiting and diarrhea. These symptoms last from one to three days. After this, for several more days there is general malaise, lethargy, and lack of appetite. But in general, the duration of the disease depends on the person’s health status.

In children, the disease may occur without diarrhea, while in adults both symptoms are almost always present.

Symptoms

Often, in addition to the main symptoms (vomiting and diarrhea), a number of others are added:

• nausea
• headache,
• pain in the limbs,
• pain in the upper abdomen,
• general malaise,
• low-grade fever (37.1-37.3),
• brokenness.

Symptoms in children

Children with norovirus infection may exhibit different symptoms than adults. Often the disease in children goes away without vomiting, less often only nausea and vomiting without diarrhea appear. Children often experience an increase in temperature; fever may occur, but is very rare.

Children lose water faster and are less able to compensate for water and electrolyte losses. Significant electrolyte abnormalities may occur. This can lead to circulatory problems, kidney failure and seizures.

Babies express abdominal pain often with a high-pitched cry and characteristic twisting of their legs.

To replenish fluids, the child should be given plenty of fluids immediately after the first symptoms appear. You need to feed your child with boiled water, alternating it with rehydron. You can give your child medicinal charcoal. It is necessary to change the diet, exclude dairy products, vegetables, fruits. Give food often and in small portions. Hospitalization is usually needed for young infants or if the child refuses to drink and the mother cannot cope on her own.

Newborns can only get sick if there is a sick person at home. Therefore, it is necessary to isolate the child from the patient and strictly observe hygiene.

To avoid complications, you should consult a doctor in a timely manner.

Incubation period

The time from infection with norovirus to the onset of symptoms varies among individuals. Most patients develop symptoms within a few hours, but several days may pass between infection and outbreak of the disease.

How is it transmitted?

Norovirus is extremely resistant to adverse environmental influences. These viruses live on surfaces for 12 hours and can withstand temperatures of 60 degrees. Many disinfectants do not kill these microorganisms.

These viruses are highly contagious and aggressive. A small number of viruses that enter the body can cause disease. Even one infected person can cause a local epidemic.

Norovirus infection most often occurs through hands and objects (fecal-oral route). In addition, when a patient defecates and vomits, a huge amount of viruses remains in the environment and can enter the mouths of healthy people.

Infection can also occur through contaminated water and food. At one time, there were outbreaks of the disease from salads and fruits.

Diseases are quite common in public institutions with poor compliance with sanitary and hygienic standards.

During the cold season, the human immune system is under strain, so outbreaks of the disease occur especially often during the winter months. In addition, doctors noticed a connection between the frequency of virus infections and worsening living conditions, nutrition and stress.

It is important to know that people with norovirus remain contagious for 48 hours after all acute symptoms have disappeared. Viruses can remain in stool for up to 14 days or even several weeks after the onset of the disease.

Do I need to see a doctor?

If you suspect a norovirus infection, you should consult a doctor, since a sick person is highly contagious to others.

Diagnosis occurs in three stages. First, a medical history (anamnesis) is collected. The doctor asks the patient what he is complaining about, how he is feeling, what he has eaten, and whether he has interacted with people with similar symptoms.

During a physical examination, the doctor listens and palpates the abdomen.

It is very important to exclude other, more serious diseases with similar symptoms.
After this, laboratory tests are performed to definitively confirm the diagnosis of norovirus infection. The material for them is stool and vomit samples.

Treatment

There is no drug treatment. The main thing in treatment is to compensate for the symptoms. If the disease is mild, treatment at home is possible. The main thing in this case is to restore the loss of water and electrolytes. Electrolytes are salts such as sodium, potassium, etc., which are lost in large quantities through vomiting and diarrhea. Large losses of these substances are dangerous, as they can lead to loss of consciousness or heart rhythm disturbances.

It is recommended to drink ready-made solutions of glucosalan and rehydron.
In addition, you need to drink non-carbonated mineral water and unsweetened herbal teas. Medical nutrition is recommended, diet 4b .

There are a number of rules for treating diarrhea at home .

If the symptoms are severe and if it is not possible to replace the fluid at home (this often happens in children and the elderly), you should call an ambulance and, possibly, admit the patient to a hospital. In a hospital setting, glucose-salt liquid is administered intravenously.

Patients with norovirus should take care of themselves. Bed rest is recommended.

Prevention measures

• Prevention is compliance with sanitary and hygienic standards.
• If there is a person with norovirus in the house, it is necessary to disinfect all the things that he uses, all door handles, toilets and sinks.
• Bed linen should be washed separately at 90 degrees.
• Disinfect your hands regularly.
• These measures should be followed even after the vomiting and diarrhea disappear, since the person remains contagious for several weeks after feeling better.

To avoid getting infected, you must follow these simple rules:

• wash your hands before eating and after using the toilet,
• drink clean water, do not drink milk sold on tap raw,
• wash vegetables and fruits thoroughly,
• fry and boil meat, fish, poultry, seafood, eggs well,
• Do not store prepared food at room temperature for more than two hours,
• Store salads with mayonnaise in the refrigerator for no more than 18 hours,
• Do not store food in the refrigerator unopened.

Norovirus during pregnancy

Especially often, expectant mothers are concerned about what will happen if an infection occurs. If a woman becomes infected during pregnancy, it is not scary for the fetus. The norovirus won't harm him.

However, vomiting or diarrhea can lead to premature contractions and cause premature labor. Therefore, expectant mothers should consult a doctor for advice on how to manage symptoms and ensure that they are getting enough fluids, electrolytes and nutrients.

Consequences of the disease

In the absence of complications and complete restoration of water and electrolyte balance, norovirus passes without consequences for health. Hospitalization is necessary in rare cases.

Complications arise only when the loss of fluid and electrolytes is not compensated, which leads to damage to internal organs. And only in exceptional cases does norovirus lead to death.

How is norovirus different from rotavirus?

At first glance, these two diseases are similar. They have common routes of infection, such as diarrhea, vomiting, weakness, nausea, sweating.

However, these are completely different diseases. Rotavirus begins acutely, with diarrhea and increased body temperature. Norovirus is more insidious. Body temperature does not increase in the first days. It starts with vomiting, not diarrhea. Moreover, a single vomiting is possible and then, if you follow the diet, there seem to be no manifestations. Only weakness, sweating, and headaches bother me a little.

As a result, a person may mistake these symptoms for quite a long time for mild food poisoning. And during this period, the norovirus continues its destructive effect. The virus releases toxins that poison the body and cause dehydration. Therefore, if a single case of vomiting is accompanied by a deterioration in the general condition, it is better to consult a doctor.

The final difference is that rotavirus infection occurs throughout the year. Norovirus is especially active in winter. Sometimes it is called “winter vomiting.”