Norovirus: Transmission, Symptoms and Treatment

As the director of the Montefiore Einstein Department of Pathology’s Clinical Microbiology Laboratory, I’m often a bit taken aback when people tell me they’re suffering from the “stomach flu.” Although influenza virus has a wide variety of signs and symptoms, gastrointestinal illness is not a major part of this syndrome.

Unfortunately, during the same months when influenza is rampant in the northeastern United States, simultaneously another virus, norovirus (and its cousin, sapovirus), is lurking on hands and surfaces. Noroviruses are the major worldwide cause of viral gastroenteritis, accounting for 21 million cases of gastroenteritis in the U.S. each year.

Since April 2018, Montefiore has used the infectious gastroenteritis panel for diagnosis of microbial gastroenteritis. This winter, along with our influenza increase, we also see a marked increase in norovirus infections.

Vulnerable Age Groups

Noroviruses are especially troublesome in long-term care facilities and hospitals and pose a particular threat to both the very old and the very young. These viruses lack lipid envelopes, which accounts for their resistance to disinfectants and their ability to persist in physical environments.

Norovirus can be particularly scary when a young child is infected. Recently, a two-year-old with no significant past medical history presented with acute onset vomiting and diarrhea. The child did not have fever or symptoms of a urinary tract infection. No other family members had been ill, and she did not attend daycare. She had, however, eaten fresh fruit and chicken nuggets. She was confirmed to have norovirus and was admitted to our children’s hospital for rehydration.

Treating Norovirus

According to the Centers for Disease Control and Prevention, there is no medicine to treat norovirus infection. The best way to deal with the illness is to drink plenty of liquids in order to replace fluid lost from vomiting and diarrhea. The goal is to prevent dehydration, which can lead to serious complications.

[See: Pharmacist Recommended Stomach and GI Products.]

Know the Symptoms, Limit the Spread

Symptoms of norovirus include profound fever, cramps and head and body aches, along with profound gastroenteritis, cramping, diarrhea and vomiting. Symptoms can arise gradually or abruptly and usually resolve within 48 to 72 hours.

Here are some tips to limit the risk of transmitting norovirus:

— Use bleach to disinfect your soiled clothing and contaminated surfaces;

— Wash your hands frequently and carefully, with soap and water;

— Wash all fruits and vegetables and cook seafood thoroughly;

— Avoid physical contact or proximity with others when you’re sick. For example, don’t prepare meals, make beds, cuddle young children or visit the elderly in care facilities.

Travel Advisory

Cruise ships, airplanes and subway cars are notoriously fertile breeding grounds for norovirus. Reports of several outbreaks on cruise ships made international headlines in January 2019.

Also, I’ve noticed this year that airport restrooms have a grading system that asks you to press an emoji to indicate whether or not the staff is doing a good job keeping the place clean. A piece of advice: Do not push those smiley face buttons when you leave an airport restroom, or you may soon be wearing a sickly frown.

[See: 14 Myths and Misconceptions About the Flu Vaccine.]

Did You Know?

When you’re sick with norovirus, you can shed billions of virus particles in your vomit and poop. It only takes a few of these particles to make someone sick during the first few days after you recover from norovirus illness.

You can still spread norovirus for days after you feel better. So, remember to wash your hands.

Norovirus is a leading cause of foodborne illness. You can get norovirus from contaminated food or water, an infected person or by touching contaminated surfaces.

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