In connection with a strong and sometimes life-threatening, eponymous infection of the stomach and intestinal tract, the noroviruses or the resulting norovirus infection in particular have come into discussion in the present.
What is a norovirus infection?
Noroviruses are at the center of what is known as norovirus gastroenteritis in terms of persistent diarrhea. Because of this fact, norovirus can cause worrisome complications in the elderly and children. Noroviruses are considered to be highly infectious, which means that norovirus infection is one of the communicable and contagious diseases. Novovirus is an exceedingly viable virus that consists of three types in total. Within these individual types, there are in turn about 20 subspecies of norovirus. Norovirus infection can also spread so extremely quickly because the human immune system cannot build up a natural defense. Noroviruses are considered to be enormously resistant. The prerequisite for this is their amazing and almost frightening mutability.
Causes
Norivores, as the cause of norovirus infection, survive by transmission routes known as fecal-oral. This means that a person who is already carrying norovirus will shed the carriers in his or her feces. Oral contact occurs by ingestion of the noroviruses through the mouth. This route of transmission of noroviruses for norovirus infection is based on direct contact from the infected person to the healthy person. In addition, people can become infected through various foods that contain the noroviruses, which are ingested by mouth while eating. How dangerous noroviruses are is shown by the fact that even an amount of 10 noroviruses is enough to get sick with a norovirus infection.
Symptoms, complaints and signs
The first signs of a norovirus infection are sudden onset of abdominal pain and nausea, followed by gushing vomiting and diarrhea. All the typical symptoms of gastroenteritis appear. The patient feels extremely ill, is tired and weak, and is barely able to get out of bed or stand upright. In addition, there are headaches and aching limbs, and every movement hurts. Body temperature may be slightly elevated; true fever rarely occurs. Depending on the general health of the body, symptoms may be more severe or less severe. In babies, children and older adults, whose organism is more susceptible, the acute phase of the disease can be very severe and may even become life-threatening. The severe loss of fluids caused by diarrhea and vomiting may result in signs of dehydration, such as dry skin and mucous membranes, rapid heartbeat, or decreased urination. Seizures, circulatory problems or kidney failure may also occur as a result of dehydration. In severe cases, the extremely strong intestinal movements may even cause intussusception, which causes colicky abdominal pain and requires medical monitoring. In a normal course, symptoms subside after about 12 to 48 hours. In some people, norovirus infection runs completely without symptoms or with only very attenuated symptoms.
Course of illness
After the noroviruses enter the organism, the incubation phase occurs first, during which the noroviruses multiply. After this incubation period, which usually lasts no longer than 2 days, the first symptoms of norovirus infection occur. In addition to acutely occurring violent diarrhea and vomiting without prior impairment of well-being, the norovirus infection is characterized by an extreme loss of body fluid. This is accompanied, as it were, by a shift in the electrolyte balance, which causes circulatory failure and a partial or complete loss of function of various organs due to the noroviruses. A classic sign that persists throughout the course of the disease in norovirus infection is persistent vomiting diarrhea. Especially in infants, children, and those weakened by age or illness, norovirus infection can quickly lead to death.
Complications
Infection with norovirus rarely feels complications.If they do occur, small children and elderly people are particularly affected and must then receive appropriate medical care. Noroviruses dehydrate the body very strongly due to their characteristic of triggering diarrhea and vomiting. Accordingly, an increased supply of fluids and nutrients must be ensured. If this is not done, the body can be severely weakened by the loss of water and electrolytes. This can lead to seizures, thrombosis and shock. Dehydration can lead to cardiovascular failure, which may be fatal. Damage to the internal organs is also possible due to dehydration and a metabolic imbalance in the cells. Organs that participate in metabolic cycles are particularly affected. These include, for example, the kidneys and the liver. If the body can no longer withstand the short-lasting but severe symptoms of the disease, death is imminent. However, this is the case in less than 0.1 percent of illnesses and can be easily prevented by sufficient administration of water and food. Most people who ultimately die from norovirus complications are over 80 years old.
When should you go to the doctor?
Even though infection with noroviruses results in severe watery diarrhea and vomiting, in principle it heals without complications after a few days, even without seeing a doctor. However, there are cases in which a visit to the doctor is advisable. On the one hand, this is the case if the symptoms are severe, and on the other hand, if the patient belongs to certain risk groups. Those who have an infection with noroviruses often lose a lot of fluid and thus also electrolytes through diarrhea and vomiting, which can lead to cramps and circulatory weakness. If the lack of fluids or electrolytes cannot be compensated for by drinking enough, a visit to the doctor is advisable: he or she can compensate for both by administering an infusion in sufficient quantities. The symptoms then often improve rapidly. Patients at risk should consult a doctor for professional monitoring and treatment if they become infected with norovirus. An increased risk exists for older people, for newborns and very young children, for pregnant women, and for people with concomitant diseases such as heart failure or diabetes. Cancer patients, especially those with currently weakened immune systems due to chemotherapy, also belong in immediate medical care when infected with norovirus.
Treatment and therapy
For the treatment of norovirus infection, measures suitable for everyday use include an abundant intake of fluids containing minerals and electrolytes. If this is not possible by mouth when patients are severely debilitated, then infusions are a suitable alternative to rebalance the electrolyte and fluid balance. Ingested fluids also have a beneficial effect in norovirus infection to flush the noroviruses out of the intestine. Other therapeutic measures for norovirus infection include rest and no physical exertion. Dietary food should keep the body strong during norovirus infection. In addition, saline special fluids or infusions mixed with potassium chloride and dextrose or glucose can protect highly vulnerable groups of people from circulatory failure caused by norovirus infection. To simultaneously combat both vomiting and diarrhea, norovirus infection is controlled by administering anti-vomiting and anti-nausea medications called antiemetics. Antibiotics are not effective against norovirus.
Outlook and prognosis
For people with a fundamentally healthy and stable immune system, the outlook for recovery from norovirus infection is favorable. In these cases, the body’s own defense system can successfully defend itself against the pathogens after a few days, even without medical care. Often, if a few guidelines are followed, a slowly beginning alleviation of the symptoms can be documented within three days. A healthy diet and sufficient rest are important for this. Helpful and supportive for a shortened healing process, medical care should nevertheless be sought. By administering medication, the viruses can be prevented from spreading further more quickly and at the same time die off more quickly. Recovery is then usually possible within a few days or weeks.The weaker the immune system of the affected person and the more previous illnesses there are, the less favorable the prognosis. In the event of a severe course of the disease, high-risk patients in particular are at risk of premature death. An increased risk exists in newborns, children, chronically ill and elderly patients. People aged 80 years are particularly at risk of not surviving the infection, as the organism is severely weakened here. Therefore, in the event of a medical emergency or acute health development, immediate medical attention is necessary.
Prevention
In the context of preventive measures against norovirus infection, both the people in their private environment themselves and public institutions are required. Basically, there is no protective vaccination against norovirus. The spread of noroviruses can only be contained if hygiene is given top priority. Cleaning, or better, disinfecting hands after going to the toilet and intensive cooking of food that may contain noroviruses are extremely effective prophylactics to prevent norovirus infection. Primarily raw fish and various seafood often carry the norovirus. Protective clothing and hygiene compliance are essential in community settings to avoid contracting norovirus.
Follow-up
Norovirus infection often runs its course without complications, but is nevertheless frequently associated with severe symptomatology and a marked weakening of the body of those affected. Targeted aftercare can significantly accelerate recovery. This includes, above all, replacing the fluids that are usually lacking in the body due to vomiting and diarrhea. In order not to put any more strain on the sensitive gastrointestinal system after infection with noroviruses, sugary and acidic drinks such as soft drinks or fruit juices should be replaced with water and herbal teas. Addition of electrolytes such as magnesium or potassium through dietary supplements is usually not necessary if the patient pays attention to a balanced diet. The weakened body after norovirus infection often makes itself felt through circulatory problems. The circulation can be slowly reactivated by taking quiet walks in the fresh air. On the other hand, it is better to avoid sweaty activities as well as hot tub baths or saunas. Restful sleep with a sufficient number of hours is also important in the aftercare. Once the gastrointestinal tract has stabilized, a healthy diet rich in vitamins and vegetables helps to sustainably strengthen the immune system again. This is often particularly successful when nicotine and alcohol are avoided. Psyllium husks are a natural remedy when the regulation of disturbed digestion needs gentle support.
This is what you can do yourself
To replace the fluids and electrolytes lost due to vomiting and diarrhea during a norovirus infection, care must be taken to ensure adequate fluid intake. For this purpose, especially still mineral water, unsweetened herbal teas or a lightly salted broth are suitable, sweet drinks such as cola, which is often recommended as a home remedy, should be avoided. For more severe symptoms, special solutions for fluid and electrolyte substitution are available from pharmacies. Children and the elderly dehydrate particularly easily – if they are unable to obtain sufficient fluids, infusion treatment may be necessary in hospital. During the acute phase of the disease, the stomach and intestines should be kept to a minimum: Rusk and gruel are well-suited as sick food. Even after the symptoms have subsided, the digestive system is usually still quite sensitive to fatty or strongly spiced foods: It is therefore advisable to eat easily digestible light foods for the first few days. Bed rest and physical rest help the body to fight the noroviruses. If the symptoms persist after two to three days or even worsen, a visit to the doctor is urgently recommended. Due to the high risk of infection, contact with other people should be avoided as far as possible; increased hygiene measures such as thorough hand washing and disinfection of the toilet also reduce the risk of transmission.
