Makindo Medical Notes

Related Subjects: |Rotavirus |Norovirus |Diarrhoea (Children) |Dehydration (Child) |Viral Gastroenteritis (Adults and Children) |Gastroenteritis in Children

🦠 The "winter vomiting bug" (Norovirus) is a highly infectious viral cause of gastroenteritis. It usually causes vomiting and diarrhoea lasting 24–48 hours. Though unpleasant, it is self-limiting in most healthy people, but outbreaks can be severe in hospitals, care homes, and cruise ships.

📖 About Norovirus

• 💥 Most common cause of acute infectious gastroenteritis in the UK and worldwide.
• 🔁 Highly contagious: Spread easily person-to-person, via contaminated food/water, or environmental surfaces.
• 👩‍⚕️ Healthcare setting outbreaks are a major challenge due to rapid transmission.

🧬 Aetiology

• RNA virus, part of the Calicivirus family.
• Outbreaks often occur in hospital wards, schools, cruise ships, military camps.
• 🍽️ Food handlers can transmit infection through poor hygiene.
• 👐 Virus is stable in the environment → survives on surfaces for days.

🤒 Clinical Features

• Sudden onset of vomiting (often projectile) and watery diarrhoea.
• Fever, headache, abdominal cramps, and malaise may accompany GI symptoms.
• ⏱️ Incubation: 24–48 hours.
• Most patients recover within 1–3 days, but dehydration is a risk in children, elderly, or immunocompromised.

🔬 Investigations

• 🧫 Stool PCR: Most sensitive and specific for confirming outbreaks.
• 🔍 Electron microscopy (EM): Detects viral particles, but less common now.
• ⚠️ Usually not required for individual community cases, but important in public health outbreaks.

💊 Management

• 💧 Supportive care: Oral rehydration (ORS), IV fluids if severe dehydration.
• 🚪 Isolation: Symptomatic patients should remain isolated until 48 hours after symptoms resolve.
• 🧴 Infection control: Clean contaminated surfaces with chlorine-based disinfectants (alcohol gels are less effective against norovirus).
• 🍲 Resume diet gradually once vomiting stops; avoid dairy/fatty foods initially.

⚠️ Public Health Note

• 🏥 In hospitals/care homes → strict infection control and closure of affected bays/wards may be required.
• 👩‍🍳 Food handlers should not return to work until 48 hours symptom-free.

📚 References

• CDC – Norovirus
• UKHSA – Norovirus guidance