What is the treatment for norovirus or rotavirus infections in adolescents?

Treatment of Norovirus and Rotavirus in Adolescents

The treatment for norovirus and rotavirus infections in adolescents is supportive care focused on oral rehydration therapy to prevent and correct dehydration, with early refeeding and no role for antiviral medications or antibiotics. 1

Primary Treatment Approach

Oral Rehydration Therapy (ORT)

• Oral rehydration solutions are the cornerstone of treatment and have dramatically reduced morbidity and mortality from viral gastroenteritis. 1
• ORT should be initiated early to prevent dehydration, which is the main complication and risk during these infections 2, 3
• The widespread availability of oral rehydration solutions has been recommended by the American Academy of Pediatrics and CDC as the primary intervention 1

Early Refeeding

• Resume normal diet as soon as rehydration is achieved 4
• Do not interrupt breast-feeding in younger patients 4
• Early refeeding should be combined with ongoing oral rehydration 4

Clinical Course and Duration

Norovirus

• Incubation period: 12-48 hours 1, 2
• Symptoms typically resolve in 12-72 hours in immunocompetent adolescents 1, 2
• Characterized by acute onset of vomiting (prominent feature), nonbloody diarrhea, nausea, and abdominal cramps 1
• Low-grade fever and body aches may occur 1

Rotavirus

• Incubation period: 1-3 days 1, 2
• Symptoms generally persist for 3-8 days 1, 2
• Begins with acute onset of fever and vomiting, followed 24-48 hours later by watery diarrhea 1, 2
• Vomiting is usually brief, lasting 24 hours or less 2

What NOT to Do

Avoid Antibiotics

• Antibiotics are not recommended as these are viral infections 4
• No antiviral therapy is available or indicated 5, 6

Symptomatic Treatments

• Most symptomatic treatments are not routinely recommended 4
• Anti-emetic drugs can be indicated only in select cases 5

When to Escalate Care

Alternative Routes if ORT Fails

• Nasogastric tube rehydration 4
• Intravenous fluid therapy 1, 4

Signs Requiring Medical Evaluation

• Persistent vomiting beyond expected duration 2
• Signs of severe dehydration requiring immediate evaluation 2
• Symptoms persisting beyond typical duration (>72 hours for norovirus, >8 days for rotavirus) 2

Special Considerations for Adolescents

• Adolescents typically have milder disease than young children due to previous exposure and immunity 1
• The main risk remains dehydration and electrolyte imbalance 2
• Most adolescents will have self-limited illness requiring only supportive care 1, 3

Infection Control

• Norovirus is highly contagious, requiring strict hand hygiene and contact precautions 2
• Transmission can occur through as few as 10 viral particles 2
• Infected individuals should be excluded from group settings during acute illness 3