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VOL: 102, ISSUE: 23, PAGE NO: 21

What is it?


What is it?
- Norovirus refers to a group of viruses that represent the most common cause of gastroenteritis in the UK.



- It can cause severe diarrhoea and vomiting and is easily passed from person to person.



- It can be dangerous in older people or the very young due to the degree of dehydration.



- An estimated 600,000 to one million people are affected each year in the UK.



- The condition has also been known as winter vomiting disease and Norwalk virus (after Norwalk in Ohio, site of the first identified outbreak).



- It is transmitted from person to person by the oral-faecal route and spreads quickly in enclosed environments such as hospitals, schools and nursing homes.



- It can be contracted through the aerosols of projectile vomit.



- Environment is also a factor. It can be contracted from contaminated surfaces, for example in toilets.



- Contaminated food and drink, especially oysters and mussels, also present a risk.



- Incubation is usually 24-48 hours but can be only 12 hours. Symptoms usually last 12-60 hours and include:



- Projectile vomiting;



- Nausea;



- Pyrexia;



- Watery diarrhoea;



- Abdominal cramps;



- Seizures (occasionally);



- Dehydration.



- Recovery usually takes 1-2 days but diarrhoea may persist.



- There will be an absence of tenderness and no guarding on abdominal examination.



- Severe dehydration can necessitate hospital admission in infants and older people.



- In severe cases the dehydration caused by persistent diarrhoea and vomiting can cause electrolyte imbalance, hypotension and eventual collapse.



- Diagnosis is usually made by observation of the symptoms.



- Laboratory investigation of stool and vomit samples is usually only carried out to determine the cause of an outbreak and rule out other conditions such as salmonella or typhoid.



- There is no specific treatment except for letting the condition run its course.



- Drinking plenty of water is essential to guard against dehydration.



- Special care should be taken with infants and older people, as dehydration is more common in these age groups.



- Adults can use over-the-counter anti-diarrhoea medicine such as loperamide. This can help reduce the amount of diarrhoea. These medicines should never be given to children as the side-effects may be harmful.



- Outbreaks of norovirus are common in semi-closed public areas such as in hospitals, schools, nursing homes and cruise ships.



- Infection cannot be entirely prevented. However, there are measures that can be taken to minimise the impact of an outbreak:



- Frequent handwashing around people who are infected is crucial to prevent spread of the virus;



- Implementing basic hygiene and food handling measures;



- Disinfection of contaminated areas;



- Isolation of those infected for 48 hours after their symptoms have ceased.



- Control measures required in healthcare settings, such as closing wards to new admissions at the beginning of the outbreak, should be implemented within four days.

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