What Is The Prognosis For Norovirus Infection?

The norovirus is a very common cause of gastrointestinal disorders. Typical of a Norovirus infection are symptoms such as diarrhea, nausea, and vomiting when the digestive tract unbalanced and paralyzed by the effects of the virus.

The pathogen is distributed worldwide. Scientists first characterized the causative agent of the calicivirus family in 1972. Previously, norovirus was also called Norwalk-like virus. Human is the only host of this virus. Norovirus infections can occur throughout the year, but more common in the cool months of October through March.(1)

What Is The Prognosis For Norovirus Infection?

Infection with the norovirus is usually violent and short. The symptoms usually last for one to three days. If no complications occur and the fluid and electrolyte balance is well maintained, norovirus usually heals without any problem.

Children under the age of six should not visit a community facility (such as kindergarten) within two days after the (suspected) norovirus infection has resolved. Care must be taken to ensure hygiene.

Especially in people who are older or have weakened immunity by other diseases (such as HIV), the course of the norovirus and the duration of the symptoms can be more serious. This often also applies to infants and toddlers. These patients may require treatment in the hospital. This is especially true when there is severe loss of fluids and electrolytes in the form of feces and vomits. This may cause a risk of internal organs getting damaged. Only in extremely rare cases, norovirus infection may lead to death.(5)

Norovirus Triggers Gastrointestinal Flu

The norovirus triggers the majority of diarrheal diseases that are not caused by bacteria. In children, it is responsible for around 30% of gastrointestinal inflammation (gastroenteritis), and in adults for up to 50%.

An infection with Norovirus is subject to a proper diagnosis. The norovirus particularly infects children under the age of five and people over the age of 70. It can cause havoc in community facilities (day-care centers, kindergartens, schools) as well as nursing homes, with outright Norovirus outbreaks.

You can only prevent infection by thorough hygiene measures because there is no vaccination against this highly contagious virus.(1)(2)

Incubation Period

The norovirus incubation period is the period between the norovirus infection and the onset of symptoms. It varies slightly from person to person. In most patients, the first symptoms appear just a few hours after being infected. In others, a day or two passes between infection and the onset of the disease. Overall, the norovirus incubation period can be six to 50 hours.(3)

Symptoms Set In Quickly

The first signs of norovirus infection are usually quick after infection. The following symptoms often appear just a few hours after being infected:

  • A pronounced feeling of sickness, lassitude, and fatigue
  • Headache
  • Mild fever in some cases (usually the norovirus causes no fever)
  • Muscle pain and body aches
  • Nausea and gushy, violent vomiting
  • Severe diarrhea (the stool smell of norovirus infection is often acrid, sometimes bloody mucus is visible)
  • Stomach pain

There are severe, mild, and even asymptomatic courses of norovirus infection. Some people experience norovirus infection without vomiting and only have diarrhea. Conversely, some patients vomit only and the disease progresses without diarrhea. Rarely, patients experience norovirus infection without any symptoms.(4)

Treatment To Relieve The Symptoms

There is no specific norovirus treatment that targets the root of the cause – the virus. Targeted medicines for norovirus do not exist (anti-viral drugs against norovirus). Incidentally, antibiotics cannot do anything against noroviruses because they only work against bacteria. Thus, doctors can only alleviate the unpleasant symptoms that accompany the norovirus infection. Otherwise, the body has to deal with the virus alone and you will get rid of the virus through the immune system.(5)

Course Of Infection

The course of a norovirus infection can be summarized as:

  • The infection course is brief and violent. How long an infection with norovirus will last depends on the patient and vary from individual to individual.
  • Most of the symptoms gradually fade after a period of one to two days. A high risk of infection exists even if the symptoms have disappeared (for up to 14 days, patients still excrete norovirus) and may infect others.
  • Long-term consequences are not to be expected with a norovirus infection. Once the fluid and the electrolyte balance is back, the patients start feeling better.

References:

  1. Robilotti E, Deresinski S, Pinsky BA. Norovirus. Clinical microbiology reviews. 2015;28(1):134-164.
  2. 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.
  3. Pringle K, Lopman B, Vega E, Vinje J, Parashar UD, Hall AJ. Noroviruses: epidemiology, immunity and prospects for prevention. Future microbiology. 2015;10(1):53-67.
  4. Weinberg GA. Outbreak Epidemiology: One of Many New Frontiers of Norovirus Biology. Oxford University Press US; 2018.
  5. 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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