From the Guidelines
The approach to managing Norovirus infection focuses on supportive care, with an emphasis on maintaining hydration, managing symptoms, and implementing strict hygiene measures to prevent transmission, as outlined in the 2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea 1.
Key Components of Management
- Maintaining hydration by drinking plenty of clear fluids like water, diluted fruit juices, or oral rehydration solutions to replace lost fluids and electrolytes
- Using over-the-counter medications such as acetaminophen (Tylenol) for fever and body aches, while loperamide (Imodium) may help with diarrhea in adults, though it should be avoided in children
- Implementing strict hygiene measures, including washing hands thoroughly with soap and water for at least 20 seconds, disinfecting contaminated surfaces with bleach-based cleaners, and immediately washing soiled clothing or linens
- Avoiding preparation of food for others and staying home from work or school until at least 48 hours after symptoms resolve
High-Risk Groups
- The elderly, young children, and immunocompromised individuals may need medical attention if they develop severe dehydration, which can manifest as decreased urination, dry mouth, dizziness, or extreme fatigue
- These groups are at increased risk of complications and may require closer monitoring and more aggressive management
Prevention and Control
- Preventing transmission through proper hand hygiene, food preparation, and storage, as well as avoiding high-risk foods and water
- Implementing infection control measures in healthcare settings, including standard practices and transmission-based precautions
- Educating patients and caregivers about the risks of norovirus infection and the importance of hygiene and prevention measures, as recommended in the 2017 IDSA guidelines 1 and 1
From the Research
Approach to Managing Norovirus Infection
The approach to managing norovirus infection is primarily focused on supportive care and prevention of outbreaks.
- Treatment of norovirus illness is focused on early correction of dehydration and maintenance of fluid status and nutrition 2.
- Supportive measures such as rehydration therapies are used to manage the infection, especially in vulnerable populations like infants, the elderly, and immunocompromised individuals 3, 4.
- For immunocompromised patients, several treatment strategies have been suggested, including nitazoxanide, ribavirin, and enterally administered immunoglobulin, with varying results 5.
Prevention and Control
Prevention and control of norovirus outbreaks are crucial, especially in high-risk settings like long-term care facilities, daycares, and hospitals.
- Hand hygiene, exclusion of ill individuals, and environmental cleaning are important for norovirus outbreak prevention and control 2, 6.
- Early identification of norovirus infection and prompt initiation of appropriate supportive therapy are required to reduce morbidity and mortality 6.
- Measures to prevent outbreaks and reduce the risk of norovirus infection include timely diagnosis and implementation of infection control interventions to limit virus transmission 6.
Vaccine Development
There are currently no FDA-approved norovirus vaccines, but several candidates are in development.