Norovirus

Background
  • Most common cause of acute gastroenteritis across all age groups
    • Noroviruses cause 50-80% of all acute infectious diarrhea in the US
    • More common in winter
  • Fecal-oral transmission (e.g. foods touched by contaminated hands)

Clinical Features
  • Onset typically 12-72h after exposure
  • Symptoms last 12h-9d
  • Nausea/vomiting
  • Diarrhea, abdominal cramping
  • +/- fever, malaise, headache

Differential Diagnosis

Diffuse Abdominal pain

Evaluation
  • Clinical diagnosis
  • PCR for norovirus available but rarely used
  • Evaluate for other causes of symptoms
  • Evaluate for hypovolemia, electrolyte abnormalities (e.g. BMP, electrolytes)

Management
  • Supportive
  • IVF or oral rehydration therapy
  • Antiemetics, antidiarrheals
  • Good hygiene super important for preventing spread!!!
    • Virus shed in stool for up to 2 weeks after symptoms resolved
    • Virus can be aerosolized during vomiting or flushing toilet
    • Wash hands with soap and water

Disposition
  • Discharge if uncomplicated and tolerating PO

See Also

References
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