What is norovirus? What are it's symptoms and how to prevent it's infection?
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Norovirus, also called the winter vomiting bug causes a significant number of cases of gastroenteritis in the world. It causes, vomiting, loose motions, and gastric pain. Fever with or without headache might be present. Usually, dehydration is less but common in young, old, and those that have co-morbid conditions.
Norovirus
The virus gets its name from Norwalk in Ohio where it was first reported in 1968. It is a non-enveloped virus and is a single-stranded positive-sense RNA virus. RNA is around 7.5 kB long. The virus has an icosahedral structure. It replicates cytoplasmically. It has 7 genogroups and several genotypes. Most infections are of genogroups GI and GII. Infectivity is high and just 5-20 viral particles can cause it. Transmission is person to person and through contaminated surfaces and food. Salad and shellfish are notorious to cause it. Breathing aerolized particles can also cause infection. Viral shedding continues for a long time after symptoms subside.
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Symptoms of the infection
Norovirus spreads by fecal-oral route. The symptoms arise 1/2 to 2 days after the virus enters the body. Symptoms that are predominantly noticed are vomiting, loose motions, and stomach pain. There may be fever and headache. If water intake is low due to any reason, it could cause dehydration. This is more common in extremes of age and patients with other associated health conditions. The infection is self limiting and lasts for a day to 3 days.
Around the globe, annually 685 million cases of noroviral gut I section are reported. And 200k deaths occur per year due to it. It occurs in both developed and developing world. Cases and deaths are more in under 5 age group. It commonly occurs in winter and in outbreaks in overcrowded housing conditions.
Diagnosis is by PCR which is reliable. ELIZA with antibodies has less sensitivity and specificity. Usually these tests are not available but done only during outbreaks.
Treatment and prevention
No specific treatment exists. Drink lots of oral fluids. Intravenous fluids may be required in some. Antiemetic or antidiarrhoeal drugs are needed in some with excessive symptoms.
Immunity lasts against the specific genotype of norovirus for 6 months to 2 years. Hand hygiene and decontamination of infected surfaces can help prevent infection. Alcohol-based sanitizers are not useful because the virus is not enveloped and alcohol acts only via disruption of the viral envelope.
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