Overview
Norovirus is the most common cause of gastroenteritis in the UK with an increased prevalence in colder months. Since immunity is not long-lasting, infection can occur in people of all ages. It is also known as the ‘winter vomiting bug’.
Pathophysiology
Norovirus transmission is via the faecal-oral route, which may be from person–to–person, eating contaminated food, or contact with contaminated surfaces. It is also associated with outbreaks in semi-closed environments such as hospitals, schools, care homes, and cruise ships. Upon entering the body, it replicates in the small intestine.
Presentation
Symptoms emerge up to 48 hours after infection and can last up to 5 days. Features include:
- Acute nausea followed by projectile vomiting and watery diarrhoea
- Associated features include fever, headache, abdominal pain, and myalgia
Investigations
Diagnosis can be made via stool culture and polymerase chain reaction (PCR).
Management
Overview
Norovirus is usually self-limiting. In rare cases, intravenous fluids may be given if severe dehydration occurs.
People should be isolated where possible, due to the risk of transmission and effective hand hygiene with soap and water is crucial. Alcohol hand gel has been shown to be less effective.
Prognosis
- In most people, norovirus is self-limiting and most people fully recover within 1-2 days
