Family Medicine

I heard a news story about a possible norovirus outbreak among children. What is norovirus?

Weiss, Richard  DO

Norovirus is the suspected cause of recently reported outbreaks of gastrointestinal illnesses among schoolaged children in North Jersey.

Norovirus is the name for a group of viruses that commonly surface at this time of the year. The U.S. Centers for Disease Control and Prevention (CDC) has settled on “norovirus” as the name for this group of ailments, but you’ve probably heard it called many names in the past, including stomach flu, 24 (or 48) hour virus, gastroenteritis and Norwalk-like virus. Regardless of the name, norovirus is unpleasant and can be a reason for concern, particularly when it infects young children or elderly individuals.

Norovirus symptoms can appear suddenly, including diarrhea, nausea and vomiting, headache and a low-grade temperature for two to three days. Because it is caused by a virus, antibiotic medicines (which work against bacterial infections) will have no effect on it. At the same time, anti-viral medications have not been shown to be effective against norovirus. A specific vaccine for norovirus is currently under development.

Norovirus spreads easily from person to person, either through direct contact or by sharing food or drink with an infected individual, and outbreaks have occurred in nursing homes, hospitals and on cruise ships. People of all ages are susceptible to norovirus, but in this country, it more often affects older children and adults. In Third World countries, younger children appear more affected by the virus. The outbreaks on cruise ships appear to have been related to drinking water. Properly chlorinated water is safe, but nonchlorinated water is problematic.

When caring for someone who is ill with norovirus, you can also contract the virus when handling clothing or linens that have been soiled after an episode of the illness. Keep in mind that individuals can spread the virus from the moment they begin to feel ill until up to 72 hours after they have recovered.

Prevention takes on added importance when a norovirus outbreak occurs. Remind your family members to wash their hands thoroughly and frequently, especially after being out in public, before preparing or eating foods and after caring for someone who is ill. When a family member becomes ill with norovirus, the CDC recommends keeping toilets and related household surfaces clean with bleachbased cleaners and immediately laundering in hot water of any soiled clothes or bed linens.

Norovirus is not considered a serious illness, but those with the virus will feel very sick. Treatment focuses mainly on symptom relief. Over-the-counter, nonaspirin pain relievers such as acetaminophen are good choices for fever and body aches. One concern is the potential for dehydration in an individual who has experienced repeated episodes of diarrhea or vomiting. Dehydration can be serious, particularly in a child or an elderly person.

When caring for someone with an illness like norovirus, encourage that individual to drink plenty of liquids. Half strength juices and water are the preferred choices, but any non-alcoholic or caffeine-free liquid is acceptable. You can also provide soda or sports drinks if the individual is unable to tolerate the preferred liquids.

A number of rehydration products are also available in food and drug stores. Contact your physician’s office, if you have any questions about which products to use or if an individual’s condition suddenly worsens, including a sudden high fever or uncontrolled diarrhea or vomiting.

Originally published in The University Doctor's MedicaLink- 02/10