Norovirus

Norovirus, also known as Norwalk virus and sometimes referred to as the winter vomiting disease, is the most common cause of gastroenteritis. Infection is characterized by non-bloody diarrhea, vomiting, and stomach pain. Fever or headaches may also occur. Symptoms usually develop 12 to 48 hours after being exposed, and recovery typically occurs within one to three days. Complications are uncommon, but may include dehydration, especially in the young, the old, and those with other health problems.

Norovirus
Other namesWinter vomiting bug, stomach bug
Transmission electron micrograph of Norwalk virus. The white bar = 50 nm.
SpecialtyEmergency medicine, pediatrics
SymptomsDiarrhea, vomiting, stomach pain, headache
ComplicationsDehydration
Usual onset12 to 48 hours after exposure
Duration1 to 3 days
CausesNorovirus
Diagnostic methodBased on symptoms
PreventionHand washing, disinfection of contaminated surfaces
TreatmentSupportive care (drinking sufficient fluids or intravenous fluids)
Frequency685 million cases per year
Deaths200,000 per year

The virus is usually spread by the fecal–oral route. This may be through contaminated food or water or person-to-person contact. It may also spread via contaminated surfaces or through air from the vomit of an infected person. Risk factors include unsanitary food preparation and sharing close quarters. Diagnosis is generally based on symptoms. Confirmatory testing is not usually available but may be performed by public health agencies during outbreaks.

Prevention involves proper hand washing and disinfection of contaminated surfaces. There is no vaccine or specific treatment for norovirus. Management involves supportive care such as drinking sufficient fluids or intravenous fluids. Oral rehydration solutions are the preferred fluids to drink, although other drinks without caffeine or alcohol can help. Alcohol-based hand sanitizers are not effective against the norovirus, according to the NHS information page on the subject; this is due to norovirus being a non-enveloped virus.

Norovirus results in about 685 million cases of disease and 200,000 deaths globally a year. It is common both in the developed and developing world. Those under the age of five are most often affected, and in this group it results in about 50,000 deaths in the developing world. Norovirus infections occur more commonly during winter months. It often occurs in outbreaks, especially among those living in close quarters. In the United States, it is the cause of about half of all foodborne disease outbreaks. The virus is named after the city of Norwalk, Ohio, US, where an outbreak occurred in 1968.

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