From the Guidelines
The approach to norovirus involves supportive care as there is no specific antiviral treatment, focusing on preventing dehydration and practicing strict hand hygiene with soap and water, as recommended by the 2017 Infectious Diseases Society of America clinical practice guidelines 1.
Key Components of Supportive Care
- Preventing dehydration by drinking plenty of clear fluids like water, broths, or oral rehydration solutions such as Pedialyte
- Adults can take over-the-counter medications like acetaminophen (Tylenol) for fever and pain, while avoiding anti-diarrheal medications unless directed by a healthcare provider
- Rest is essential to recovery
Infection Control Measures
- Practice strict hand hygiene with soap and water (hand sanitizers are less effective) 1
- Disinfect contaminated surfaces with bleach-based cleaners
- Isolate from others for at least 48 hours after symptoms resolve
- Launder contaminated clothing and linens thoroughly
High-Risk Groups
- The elderly, young children, and immunocompromised individuals should seek medical attention if unable to maintain hydration, as they are at higher risk of complications and death 1
Prevention
- Norovirus spreads through the fecal-oral route, contaminated food or water, and aerosolized vomit particles, making prevention through proper hygiene and food handling crucial 1
- Avoid eating or drinking unpasteurized dairy products or undercooked meat, and avoid recreational water activities while symptomatic 1
From the Research
Approach to Managing Norovirus Infection
The approach to managing norovirus infection is primarily focused on supportive care and prevention of dehydration, as well as measures to prevent the spread of the virus.
- Treatment of norovirus illness is focused on early correction of dehydration and maintenance of fluid status and nutrition 2.
- Supportive measures are the primary approach to treating norovirus gastroenteritis, particularly in healthy immunocompetent individuals 3.
- For immunocompromised patients, several treatment strategies have been suggested, including nitazoxanide, ribavirin, and enterally administered immunoglobulin, although further research is needed to determine their effectiveness 4.
Prevention and Control Measures
Prevention and control measures are crucial in managing norovirus outbreaks, particularly in high-risk settings such as long-term care facilities.
- Hand hygiene, exclusion of ill individuals, and environmental cleaning are important for norovirus outbreak prevention and control 2, 5.
- Early identification of norovirus infection and prompt initiation of appropriate supportive therapy are required to reduce morbidity and mortality 5.
- Measures to prevent outbreaks and reduce the risk of norovirus infection in long-term care facilities include timely diagnosis and implementation of infection control interventions to limit virus transmission 5.
- Development of licensed vaccines against noroviruses may provide another important tool for infection prevention among high-risk individuals 5, 6.
- Common practices such as hand washing are used to control the spread of norovirus, as there are no specific control measures available 6.