norovirus in adults
Norovirus is the causative agent of viral gastroenteritis, an infectious disease that affects the gastrointestinal tract. In our country, norovirus is the cause of approximately one in six acute intestinal infections.

Norovirus in adults is accompanied by characteristic symptoms of an intestinal disorder: nausea, diarrhea, and abdominal pain. Because of this, infectious gastroenteritis is often confused with food poisoning. However, unlike it, norovirus infection causes the characteristic symptoms of SARS: runny nose, sore throat and fever.

In this article, together with our experts, we will find out what danger the norovirus poses to adults. We will talk about the symptoms of the disease and talk about adequate methods of treatment and prevention.

What is norovirus

Norovirus is an RNA virus from the Caliciviridae family.1. The family includes 6 genera of viruses, two of which – Sapporo and Norwalk – are pathogenic for humans.1.

Norovirus infection is caused by Norwalk, which was first identified in 1968 in Norfolk, Ohio (USA)1.

Norovirus is not easy to get rid of because it:

  • remains viable in water, on food, objects and surfaces for 3–4 weeks;
  • withstands freezing and contact with alcohol-containing liquids;
  • resistant to common detergents.

The causative agent is highly contagious – from 10 to 100 viral units are enough for infection3. It is established that 1 patient with norovirus on average infects 14 people3. If you follow strict hygiene measures, this figure drops to two people.3. Therefore, isolation of the patient and compliance with sanitary standards is an effective measure for the prevention of noravirus in adults and children.

Viruses of the genus Norwalk are active all year round, with seasonal outbreaks occurring in autumn and winter.2. Viral gastroenteritis affects patients of all ages, but most often people aged 28–35 and older than 60 years.

People with the first blood type have a congenital predisposition to norovirus infection, so they get sick more often1. In contrast, people with the third and fourth groups are less susceptible to the pathogen1.

Causes of norovirus in adults

The most common cause of norovirus in adults is contact with a virus carrier. In Europe, in 2001-2006, several outbreaks of norovirus gastroenteritis were analyzed and found that in 88% of cases, a sick person became the source of infection3. The infection was transmitted from a sick person to a healthy person by airborne droplets and contact, through dishes and household items: doorknobs, furniture, computer keyboards, remote controls3.

Other causes of norovirus in adults are consumption of contaminated food (10%) and water (2%)3. Most often, the source of infection is products that have not undergone heat treatment:

  • greenery;
  • fresh vegetables and fruits;
  • ice cream.

Infection by water occurs if you drink tap water, unboiled or from a poorly treated cooler.

Reduced immunity can be an indirect cause of norovirus in adults. Physically weakened people and patients with severe illnesses are more likely to become infected and less able to tolerate viral gastroenteritis.

Symptoms of norovirus in adults

The disease has a short incubation period. The first symptoms of norovirus in adults are observed 6-48 hours after infection3. In most cases, norovirus gastroenteritis begins in an acute form with a sharp deterioration in well-being3.

Common symptoms of norovirus in adults:

  • short-term increase in temperature up to 38–38,8°С;
  • muscle and headache;
  • chills and body aches;
  • sore throat, runny nose, dry cough;
  • aching or cramping pain in the abdomen;
  • nausea;
  • vomiting;
  • diarrhea.

Clinical symptoms of norovirus in adults persist for 24-60 hours2. Well-being usually returns to normal in 3-4 days, and sometimes faster, but a person remains a carrier of the virus for up to 1 month and during this period can infect others2. A complicated course of norovirus gastroenteritis with convulsions, dehydration, cardiovascular disorders is observed in the elderly and patients with severe chronic pathologies.

Due to the high variability of norovirus, persistent immunity is not formed. Studies have shown that re-infection with norovirus infection is possible 27-42 months after the illness3.

Treatment of norovirus in adults

There is no specific treatment for norovirus in adults. Most often, the body clears the infection on its own within a few days. In severe cases, the disease is prescribed:

  • antipyretics to reduce fever;
  • probiotics and prebiotics to restore intestinal microflora;
  • rehydration formulations to prevent dehydration.

In difficult cases, norovirus treatment takes place in a hospital. Patients are prescribed symptomatic therapy to eliminate intoxication, restore water-salt balance and prevent disturbances in the functioning of internal organs.

Prevention of norovirus in adults at home

Like many intestinal infections, norovirus is called the dirty hand disease. Therefore, personal hygiene is the best prevention of norovirus in adults. Wash your hands after using the toilet, before eating and preparing food. Fruits and vegetables should not only be washed with running water, but also poured over with boiling water. Drinking water should be safe – boiled or bottled.

Isolation of a sick person is another measure to prevent norovirus in adults and children. A patient with norovirus infection should have as little contact with other family members as possible and eat from separate dishes.

Popular questions and answers

Popular questions about the treatment and prevention of norovirus in adults, we asked our experts: Kirill Yuvchenko, doctor of clinical laboratory diagnostics, and Nikolai Dubinin, sanitary doctor and epidemiologist. The answers of experts will be useful to anyone who has experienced norovirus gastroenteritis or would like to avoid this unpleasant disease.

What diet to follow with norovirus?

Since we are talking about an intestinal infection, the diet should be gentle on the damaged mucosa of the gastrointestinal tract. It is necessary to exclude coarse fiber, marinades and hot sauces, seasonings, sweets, dairy products and, of course, alcohol. You need to give up coffee, carbonated drinks, vegetable and fruit juices. With viral gastroenteritis, the body loses water. To restore the water-salt balance will help special formulations for rehydration, which can be bought at the pharmacy.

How many days do people have norovirus?

The disease has a short incubation period, up to 48 hours. In most cases, norovirus infection is mild, and full recovery occurs as early as the third or fourth day after the onset of symptoms.

Why is norovirus dangerous?

The main danger of norovirus is dehydration. This condition can lead to heart failure, kidney failure, poor circulation, and blood clots. Therefore, those who have been ill with norovirus are advised to monitor the state of the body for some time. It makes sense to take blood tests a couple of weeks after recovery.

Which doctor should I contact for norovirus?

The symptoms of norovirus gastroenteritis are very similar to many other intestinal infections, poisonings, and diseases that require surgical treatment. Therefore, during the diagnosis, it is necessary to exclude:

● other viral and bacterial gastroenteritis;

● ulcerative lesions of the intestine;

● appendicitis;

● ectopic pregnancy;

● myocardial infarction.

An accurate diagnosis should be made by a general practitioner or infectious disease specialist. You may need to consult a narrow specialist: a gastroenterologist and a surgeon.

When to call an ambulance for norovirus?

Norovirus gastroenteritis is usually mild, but there is still a risk of complications. The cause of the severe course of the disease can be a general weakening of the body, old age, a decrease in immunity due to medication and against the background of other diseases. Emergency medical assistance may be required:

● the elderly;

● pregnant women;

● patients with severe dehydration;

● patients with pathologies of the kidneys and the cardiovascular system.

You should immediately call an ambulance if the patient has an increased feeling of thirst, aching pains and cramps in the hands appear, dry skin and mucous membranes are observed. These symptoms indicate a violation of the water and electrolyte balance and possible complications from the circulatory and urinary systems.

  1. Viral gastroenteritis: rotaviruses, noroviruses, adenoviruses. Ph.D. Taran Tatyana Viktorovna. https://snipchi.ru/updoc/2020/%D0%94%D0%BE%D0%BF%20%

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    D0%B0%D0%BD%D0%B8%D0%B5/5_4_TAR.pdf

  2. Clinical recommendations for the provision of medical care to children with norovirus infection. FSBI NIIDI FMBA of RUSSIA, Public Organization “Eurasian Society for Infectious Diseases”, Public Organization “Association of Doctors of Infectious Diseases of St. Petersburg and the Leningrad Region” (AVISPO). http://www.ngdphmao.ru/doc/standart/Fed_9.pdf
  3. Norovirus infection of the gastrointestinal tract. I.V. Shestakova. Moscow State University of Medicine and Dentistry A.I. Evdokimov Ministry of Health of the Russian Federation. https://medsestrajournal.ru/sites/default/files/fulltext-pdf/25879979-2014-08-06.pdf

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