Can Norovirus Cause Fever?
Yes, norovirus can cause low-grade fever, though it is not the predominant symptom and occurs less consistently than vomiting and diarrhea. 1
Clinical Presentation of Norovirus
According to CDC guidelines, norovirus gastroenteritis is characterized by:
- Acute onset of nonbloody diarrhea, vomiting, nausea, and abdominal cramps as the primary symptoms 1
- Low-grade fever and body aches may also be associated with infection, though these are secondary features 1
- Some patients experience only vomiting or diarrhea without fever 1
Fever Characteristics in Norovirus
The fever associated with norovirus is typically low-grade, distinguishing it from other causes of gastroenteritis 1:
- The incubation period is 12-48 hours, followed by vomiting, diarrhea, abdominal pain, myalgia, and low fever 1
- The term "stomach flu" is often used to describe the illness, though there is no biologic association with influenza 1
Duration and Course
Symptoms typically resolve within 1-3 days in otherwise healthy persons, though more prolonged courses lasting 4-6 days can occur in:
- Young children 1
- Elderly persons 1
- Hospitalized patients 1
- Immunocompromised individuals may experience prolonged illness lasting months to years 2
Clinical Pitfalls
Do not rely on fever as a diagnostic criterion for norovirus, as it is inconsistently present and typically mild when it occurs 1. The hallmark features remain acute vomiting and diarrhea with rapid onset after a 12-48 hour incubation period 1.
In immunocompromised patients, norovirus can cause severe and prolonged gastroenteritis with potential for villous atrophy, severe malnutrition, and continuous viral shedding 2.