Sudden diarrhea is often caused by infection with noroviruses. Small children and the elderly are particularly often affected by this virus.
The norovirus (formerly also called Norwalk-like virus) is a highly contagious pathogen that can cause vomiting diarrhea. About 10 to 100 noroviruses are enough to cause an infection to an individual.
If you want to prevent norovirus infection, you have to pay attention to thorough hand hygiene. This can effectively reduce the risk of illness. Wash your hands properly before eating and preparing food as well as after toilet use.(1)
How To Diagnose Norovirus Infection?
The only way to safely diagnose a Norovirus infection is to detect the causative virus. So far, this has only been possible in special laboratories. There are three methods that can be used to detect noroviruses in stool:
- Optical detection with the electron microscope
- Detection of virus proteins (ELISA)
- Detection of virus genetic information (RT-PCR)
- The cultivation of noroviruses in cell cultures is not possible.
The actual treatment would not change if the pathogen was detected. These elaborate detection methods are therefore only used:
- If no other cause of diarrhea (with or without vomiting) is known
- If symptoms such as diarrhea and vomiting affect several people in institutions such as kindergartens, schools, old people’s homes or hospitals.(5)
What Is The Best Medicine For Norovirus Infection?
So far, there is no best medicine that works specifically against a norovirus infection. Antibiotics are not suitable for treatment because these drugs only work against bacteria. Therefore, when trying a norovirus infection, the main thing is to alleviate the symptoms.
In the case of a mild norovirus infection, the following measures are recommended for treatment:
- Drink a lot of fluids to compensate for the loss of fluid and electrolytes caused by diarrhea and vomiting (mineral water, unsweetened herbal teas, oral rehydration solution)
- Eat enough to replace the lost energy
- Take bed rest
If the norovirus infection is associated with severe vomiting, medications for nausea and vomiting (so-called antiemetics) may be used for the treatment – after medical consultation – to improve the symptoms.
For infants, toddlers, pregnant women, the elderly and debilitated people, diarrhea due to Norovirus infection can pose risks. They should, therefore, consult a doctor if diarrhea persists for more than two to three days – especially if additional symptoms such as fever, poor circulation and/or vomiting occur. Children are more sensitive than adults to the loss of fluid associated with diarrhea and vomiting. The loss of water is sometimes even life-threatening. You may not only need sufficient water as a treatment, but a special electrolyte solution to compensate for the losses.(6)
Norovirus Infection: Typical Symptoms
With a norovirus infection, the symptoms typically start suddenly. The first signs are severe diarrhea and gushing vomiting. The complaints usually arise out of nowhere in apparently healthy individuals. Noroviruses can cause significant fluid loss within a few hours. Occasionally there may only be diarrhea or only vomiting (instead of vomiting and diarrhea).
In addition, a Norovirus infection can trigger other symptoms, such as:
- Body aches
- Fatigue
- Headache
- Nausea
- Stomach pain
- A strong feeling of sickness
Moreover, the body temperature may be slightly increased, but in most cases, there is no fever. Generally, the symptoms resolve after 12 to 48 hours. For some people, a norovirus infection only leads to weak symptoms or causes no symptoms at all.(2)(3)
Norovirus Infection: Incubation Period
The period between infection and the onset of the symptoms of a disease is called the incubation period. In a norovirus infection, the incubation period can be about 6 to 50 hours, often it is rather short.
Norovirus infection is one of the common causes of sudden diarrhea. The pathogen is highly contagious and is often responsible for acute vomiting diarrhea, especially in children. It is believed that noroviruses are responsible for almost every third non-bacterial diarrheal disease in children, and about every second in adults.(3)
Information About The Pathogen
Noroviruses were first detected in 1972 and belong to the Caliciviridae family. The name of this virus family is derived from the Latin word Calix (= cup, goblet) and refers to the surface structure of the virus. The Caliciviridae are divided into four groups: two – the noroviruses and the sapoviruses – can cause disease in humans, the other two in animals.(4)
- Blazevic V, Malm M, Salminen M, et al. Multiple consecutive norovirus infections in the first 2 years of life. European journal of pediatrics. 2015;174(12):1679-1683.
- Teunis P, Sukhrie F, Vennema H, Bogerman J, Beersma M, Koopmans M. Shedding of norovirus in symptomatic and asymptomatic infections. Epidemiology & Infection. 2015;143(8):1710-1717.
- Weinberg GA. Outbreak Epidemiology: One of Many New Frontiers of Norovirus Biology. Oxford University Press US; 2018.
- Grant LR, O’Brien KL, Weatherholtz RC, et al. Norovirus and sapovirus epidemiology and strain characteristics among Navajo and Apache infants. PloS one. 2017;12(1):e0169491.
- Hardstaff JL, Clough HE, Lutje V, et al. Foodborne and food-handler norovirus outbreaks: a systematic review. Foodborne pathogens and disease. 2018;15(10):589-597.
- Cardemil CV, Parashar UD, Hall AJ. Norovirus infection in older adults: epidemiology, risk factors, and opportunities for prevention and control. Infectious Disease Clinics. 2017;31(4):839-870.
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