Norovirus Treatment & Management

Updated: Sep 27, 2018
  • Author: Zartash Zafar Khan, MD, FACP; Chief Editor: Michael Stuart Bronze, MD  more...
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Treatment

Medical Care

Oral fluid and electrolyte replacement is generally adequate for the treatment of norovirus infections.

In cases of severe volume depletion, intravenous fluid and electrolyte resuscitation may be necessary.

Symptomatic relief can be achieved using antiemetics for nausea and vomiting and analgesics for myalgias and headache.

Antiperistaltic agents should generally be avoided in cases of infectious diarrhea but could be considered in patients with severe diarrhea.

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Consultations

In all epidemic outbreaks (2 or more people who shared a common meal), the local and/or state health department should be contacted for investigation of potential sources.

For questions, the gastroenteritis section of the CDC can be reached at 404-639-3607. Frequently asked questions are addressed at the CDC’s Viral Gastroenteritis Web site.

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Diet

See the list below:

  • Electrolyte replacement liquids such as Pedialyte or Gatorade

  • Regular diet as tolerated

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Activity

Activity may be performed as tolerated.

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Prevention

In cases of norovirus outbreaks, several measures should be taken to prevent further transmission, as follows:

  • Contaminated sources should be identified and eliminated.

  • Strict hand hygiene is necessary. Food handlers should be thoroughly educated on the infectivity of norovirus, and updated hygienic codes should be maintained. [25]  Although virucidal efficacy of alcohol against feline calicivirus is inferior to that of povidone-iodine, it is greatly variable depending on different formulations, concentrations, and contact times. In one study, only a 0.5-1 log10 reduction in virus titer was achieved after exposure to ethanol (62%-99.5%) for 30 seconds. Another study showed a 2 and 3 log10 reduction in virus titer when 80% ethanol was used for 30 seconds and 1 minute, respectively. Successful control of a norovirus outbreak using 80% alcohol-based hand rubs was reported in an infirmary. [26]  Hand washing with soap and water is necessary for hands that are visibly soiled. [27]

  • Environmental sanitization and disinfection should be performed.

  • Instruct individuals with viral gastroenteritis to self-quarantine.

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