NorovirusNoroviruses are among the most frequent triggers of diarrhea. Everything you need to know about symptoms, causes and treatment of norovirus infections.
Norovirus gastroenteritis, norovirus vomiting diarrhea, norovirus gastrointestinal inflammation
Physicians refer to norovirus infections as norovirus gastroenteritis. Translated, this means: gastrointestinal inflammation caused by noroviruses. Noroviruses are among the most contagious pathogens of all. Just a few viruses are enough to cause the usually extremely severe symptoms of norovirus infection. These symptoms usually include very severe diarrhea. Very often also severe vomiting. Infections with the rotavirus cause a similar clinical picture.
Typically, norovirus infections pass within 48 hours without leaving permanent damage. However, this is no reason to take this diarrheal disease lightly. This is because the massive loss of fluids and electrolytes sometimes results in serious complications, including circulatory or cardiac failure, particularly in children and the elderly or sick.
Because norovirus infections are so highly contagious, they are among the notifiable diseases under the Infection Protection Act. This ensures, for example, that community facilities such as kindergartens, schools, canteens or retirement homes can be identified as sources of infection and visitors can be warned accordingly.
The incidence of norovirus infections has skyrocketed since 2016. In the 5 previous years, the Robert Koch Institute had recorded an average of about 7.800 confirmed cases registered. In 2016, the number climbed to more than 84.000 cases. For 2017, the RKI recorded nearly 72 cases, according to the Epidemological Bulletin of early 2018.000 infections with noroviruses. By mid-September 2018, the number of norovirus infections is 52.300. RKI has not yet published final figures for 2018. In view of the large number of illnesses in winter, it can therefore be expected that the high number of cases of the disease is unlikely to decrease. And the rising trend continues. In the first 24 weeks of 2019, the number of norovirus infections is just over 47.000. That is almost 4.000 more cases than in the same period in 2018.
The characteristic symptoms of norovirus infections are rapid-onset and severe diarrhea and vomiting in people who had just felt healthy. In about one third, vomiting is mild or, rarely, absent. In the majority of cases, the vomiting is gushing. Diarrhea and vomiting last about 24 to 36 h, sometimes up to 2 days.
Unlike many other diarrheal illnesses, norovirus infections are usually exceedingly agonizing. Diarrhea and vomiting are accompanied by a usually violent feeling of illness and severe, sometimes cramping, stomach and abdominal pain. It is not uncommon to experience fever and headaches and aching limbs. The infection weakens children and the elderly in particular to such an extent that circulatory problems with dizziness or fainting occur.
Diarrhea and vomiting lead to a massive loss of fluids and electrolytes. This can put such a strain on the circulation that a collapse (shock) occurs. Therefore, it is of fundamental importance to compensate for this loss, especially in children, the elderly and the sick.
The cause of the norovirus infection is – as the name suggests – an infection with noroviruses. Noroviruses are widespread throughout the world and are extremely hardy. Human noroviruses as the cause of gastroenteritis are among the most contagious viruses of all. Just a few viruses are enough to infect a person. Noroviruses are transmitted by smear infections, especially through the hands or by inhaling virus particles, for example virus-containing droplets during gushing vomiting.
Cause of rapidly increasing number of norovirus infections
The number of norovirus infections has increased sharply in recent years. According to the Robert Koch Institute, this is because a new variant of the human norovirus has been spreading since the beginning of 2016. This recombinant virus is therefore overly aggressive and contagious.
Norovirus infections cannot be treated causally. Therapy must therefore be limited to alleviating the symptoms, preventing complications and avoiding further spread of the disease. It should be borne in mind that noroviruses can be excreted for up to 14 days after the onset of the disease, and in exceptional cases even longer.
Treatment of norovirus infections
The best remedy for norovirus infection is as much rest as possible. Under no circumstances should you reach for diarrhea stoppers such as loperamide and tannin or anti-nausea medications (antiemetics) such as dimenhydrinate and ginger root. With these medications you would only prolong the duration of the disease. Diarrhea and vomiting are protective measures taken by our body to remove the viruses as quickly as possible. This process cannot be accelerated.
Explicitly warned against the use of antibiotics. Even if many people do not want to admit it: Viruses do not respond to treatment with antibiotics. The use of antibiotics against viruses is not only useless. It even endangers health because it promotes the formation of antibiotic resistance.
Drink plenty of fluids and replace electrolytes
To compensate for the loss of fluids and electrolytes, it is essential that those affected drink plenty of fluids. Otherwise, there is a risk of cardiovascular problems such as cardiac arrhythmias or even shock. The kidneys can also be damaged due to the lack of fluids.
Fruit juice spritzers or salty soups such as chicken soup or vegetable broths are well suited as drinks and electrolyte suppliers. Children, the sick, the elderly and pregnant women are particularly at risk. In consultation with the attending physician, the use of so-called anti-dehydration solutions (oral rehydration solutions) can be useful here. The so-called WHO solution, for example, contains glucose to provide energy. All the necessary electrolytes in an ideal mixed ratio.
Noroviruses are so highly contagious that it is almost impossible to avoid infection. However, the risk can be reduced by scrupulous hygiene in the vicinity of the sick person. Hand hygiene plays a prominent role in this process. In almost all cases, the virus passes from person to person via the hands or the skin.