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Norovirus - hospital

Alternative names

Gastroenteritis - norovirus; Colitis - norovirus

What is norovirus?

Norovirus is a virus (germ) that causes an infection of the stomach and intestines. Symptoms include vomiting, diarrhea, and stomach pain.

Many viruses belong to the norovirus group, and they spread very easily. Outbreaks in health care settings occur rapidly and can be hard to control.

More about norovirus

Symptoms start within 24 to 48 hours of infection, and can last for 1 to 3 days. Diarrhea and vomiting can be severe, leading the body to not have enough fluids (dehydration).

Anyone can become infected with norovirus. Hospital patients who are very old, very young, or very ill are harmed the most by norovirus illnesses.

Norovirus infection can occur at any time during the year. It can be spread when people:

  • Touch objects or surfaces that have been contaminated, then put their hands in their mouths. (Contaminated means the norovirus germ is present.)
  • Eat or drink something contaminated.

It is possible to be infected with norovirus more than once in your life.

Most cases do not need testing. In some cases, testing for norovirus is done to understand an outbreak, such as in a hospital setting. This test is done by collecting a stool or vomit sample and sending it to a lab.

Treating norovirus

Norovirus illnesses are not treated with antibiotics because antibiotics kill bacteria, not viruses. Receiving plenty of extra fluids through a vein (IV, or intravenous) is the best way to prevent the body from becoming dehydrated.

Symptoms will most often resolve in 2 to 3 days. Although patients may feel better, they can still spread the virus to others for up to 72 hours (in some cases 1 to 2 weeks) after their symptoms have resolved.

Preventing the spread of norovirus

Hospital staff and visitors should always stay home if they feel sick or have a fever, diarrhea, or nausea. This helps protect others in the hospital. Remember, what may seem like a small health problem for you can be a big health problem for someone in the hospital who is already sick.

Even when there is not a norovirus outbreak, staff and visitors must clean their hands often:

  • Washing hands with soap and water prevents the spread of any infection.
  • Alcohol-based hand sanitizers can be used between hand washing.

Patients infected with norovirus are placed in contact isolation. This is a way to create barriers between people and germs.

  • It prevents the spread of germs among the staff, patient, and visitors.
  • Isolation will last 48 to 72 hours after symptoms have gone way.

Staff and health care providers must:

  • Use proper garments, such as isolation gloves and a gown when entering an isolated patient's room.
  • Wear a mask when there is a chance of splashing bodily fluids.
  • Always clean and disinfect surfaces patients have touched using a bleach-based cleaner.
  • Limit moving patients to other areas of the hospital.
  • Keep patient belongings in special bags and throw away any disposable items.

Anyone who visits a patient who has an isolation sign outside their door should stop at the nurses' station before entering the patient's room.

References

MacCannell T, Umscheid CA, Agarwal RK, et al., Healthcare Infection Control Practices Advisory Committee-HICPAC. Guideline for the prevention and control of norovirus gastroenteritis outbreaks in healthcare settings. Infect Control Hosp Epidemiol. 2011;32:939-969.

Thomsen K. Standard precautions. In: Dehn RW, Asprey DP, eds. Essential Clinical Procedures. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 2.


Review Date: 5/12/2014
Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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