From the Guidelines
There is no specific antiviral treatment for Norwalk virus infection, and treatment focuses on supportive care to manage symptoms and prevent complications, with the primary approach involving maintaining adequate hydration and preventing spread through thorough handwashing with soap and water, as recommended by the most recent guidelines 1. The primary goal of treatment is to prevent dehydration and manage symptoms.
- Maintaining adequate hydration with oral rehydration solutions or, in severe cases, intravenous fluids is crucial.
- Over-the-counter medications like acetaminophen (Tylenol) can help relieve fever and body aches.
- Anti-diarrheal medications such as loperamide (Imodium) may be used cautiously in adults but should be avoided in children and if there's fever or bloody diarrhea.
- Rest is essential to recovery, and most people recover completely within 1-3 days without specific treatment. Preventing the spread of the virus is also critical, and this can be achieved through:
- Thorough handwashing with soap and water, as this is the most effective method to reduce norovirus transmission 1.
- Disinfecting contaminated surfaces with bleach-based cleaners.
- Avoiding food preparation for others while ill and for 48 hours after symptoms resolve. It's also important to note that antibiotics are ineffective against norovirus since it's a viral infection, not bacterial. While some studies suggest that certain medications, such as bismuth subsalicylate, may reduce the duration of Norwalk infection 1, the most recent and highest-quality evidence prioritizes supportive care and prevention of spread 1.
From the Research
Norwalk Virus Infection Treatment
The recommended treatment for Norwalk virus infection is primarily focused on managing symptoms and preventing dehydration.
- Oral rehydration solutions are widely used for rehydration in diarrheal illness, including Norwalk virus infection, as stated in the study 2.
- The preferred oral rehydration solution is one similar to the glucose-containing reduced osmolarity World Health Organization ORS.
- It is recommended to consume fluids and a sodium-containing snack at least 4 hours before exercise to maintain hydration, and during exercise, individuals require 200 to 800 mL/hour of liquid that should contain 20 to 30 mEq/L of sodium, as mentioned in the study 2.
- There is no specific antiviral treatment for Norwalk virus infection, and the focus is on supportive care, such as rest, hydration, and nutrition.
Prevention of Norwalk Virus Transmission
Prevention of Norwalk virus transmission is crucial, and hand hygiene plays an important role.
- The hands of infected individuals can be contaminated with Norwalk virus, as shown in the study 3, which detected NV RNA in 25.4% of hand rinse samples collected from infected volunteers.
- Good hand hygiene strategies are essential to prevent NoV transmission, as highlighted in the study 3.
- The study 4 estimates the average probability of infection for a single Norwalk virus particle to be close to 0.5, exceeding that reported for any other virus studied to date, emphasizing the importance of prevention measures.
Understanding Norwalk Virus
Norwalk virus is a highly infectious agent that can cause severe gastroenteritis.
- The study 5 calculated the 50% human infectious dose to be 3.3 reverse transcription polymerase chain reaction units for secretor-positive blood group O or A persons and 7.0 for all secretor-positive persons.
- The study 6 found that experimental human infection with Norwalk virus elicits a surrogate neutralizing antibody response with cross-genogroup activity, indicating the potential for developing a broadly cross-protective NoV vaccine.