Norovirus Infections

Noroviruses are the most common cause of gastroenteritis(inflamed stomach and intestines) in the U.S.  It is estimated that there are 20 million cases worldwide, 70,000 hospitalizations and about 800 deaths per year in the U.S.

Symptoms include vomiting, diarrhea and stomach cramps.  Less common symtoms include fever, chills, headache, muscle aches, and general weakness or fatigue.

The virus is highly contagious and spreads via feces.  Contaminated hands then touch food or other objects. Norovirus season is year round.

The virus is resistant to extreme temperatures and most germicides, including alcohol, chlorine, and chlorhexidine.  The virus can survive on hard surfaces for 12 hours or more, on fabrics for 12 days, and in standing water for months, and perhaps years.  Washing carefully with soap and water is considered the best way to decontaminate.

After exposure to this virus, the incubation period is 1-2 days before symtom onset.  For most people the infection lasts 1-2 days.  Severity of illness varies from person to person and may be mild to severe.

There is no cure except the cure of time.  No vaccine is available, and a person can be infected repeatedly.

Treatment is symptomatic, i.e. we can treat the symptoms, but not cure the disease.

Mild nausea can sometimes be relieved by drinking ginger containing beverages, such as ginger tea, or by eating fresh or candied ginger or by chewing on a few fennel seeds.

Drinking liquids in small amounts that are quickly absorbed by the stomach lining may also help to reduce nausea and promote hydration.  Liquids with a small amount of glucose are rapidly absorbed.  Electrolyte replacement solutions such as Powerade or Gatorade are good choices for most people, unless they are diabetic or have other medical or dietary restrictions.

Homemade Electrolyte Replacement Solution Recipe

• your favorite non-acidic juice 1/2 cup (~118mL)
• sugar 9 tablespoons (~160 mL)
• salt 1/2 teaspoon (~3 mL)
• water 2 quarts (~2 Liters) or to taste.
• Numerous other versions of this recipe can be found online

Severe nausea may be quickly eliminated with medication prescribed by your doctor.

Anti-diarrheal medications may be bought over-the-counter without a prescription, and are considered safe to use for most, but not all, situations.  Again, consult with your doctor if you have questions about the use of these medications as they apply to your own personal situation.

For those with persistent vomiting, diarrhea, or serious dehydration, more aggressive treatment including IV fluids may be needed.

For most otherwise healthy adults, 2 liters (about 2 quarts) of IV saline can be infused rapidly (about 1 hour with Dr John's rapid infusion method) and dramatic patient relief ensues. IV fluids alone will relieve the nausea for most.

Not all gastroenteritis is caused by noroviruses, and in rare cases these symptoms may be the manifestation of more serious conditions.  If you are unsure about the seriousness of your condition, we recommend that you consult your doctor or go to your nearest emergency department.

Again, washing hands and other contaminated surfaces with soap and water is the best way to prevent the spread of this miserable and sometimes serious disease.  If nothing else, wash your hands before you eat.