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COUNTRY : WORLDWIDE

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Norovirus, sometimes called Norwalk virus or small round structured virus causes winter vomiting disease. Although commoner in the winter months, it can occur at any time of the year. It is the commonest cause of vomiting and diarrhoea in the UK and is highly infectious. Indeed if it appears in the hospital setting it frequently leads to ward closure since this is often the only way to contain the infection.

Hand-washing alone often is not enough to contain the virus. It is not, however, a hospital acquired infection as such and is brought in by a member of staff, visitor or patient who has acquired it in the community. It is important, therefore not to visit patients if you have recently suffered from a brief episode of diarrhoea because of the havoc this virus can cause to the everyday running of a hospital. Usually you are no longer infectious after being symptom free for 48 hours.

Norovirus is transmitted very easily in the following ways:

Not washing hands after using the toilet

Being exposed to the virus when cleaning up vomit or diarrhoea of infected person

By breathing in virus from the air e.g. after projectile vomiting

Touching surfaces that have virus on them eg toilet seats, furniture, door handles, keyboards etc.

By eating contaminated food eg oysters contaminated from sewage in sea water

Here are some commonly asked questions regarding Norovirus infection:

NOROVIRUS : FREQUENTLY ASKED QUESTIONS

COUNTRY : ENGLAND

What are the symptoms?

The most common symptoms are nausea, vomiting and diarrhoea. Symptoms often start with the sudden onset of nausea followed by projectile vomiting and watery diarrhoea. However, not all of those infected will experience all of the symptoms. Some people may also have a raised temperature, headaches and aching limbs.

Symptoms usually begin around 12 to 48 hours after becoming infected. The illness is self-limiting and the symptoms will last for 12 to 60 hours. Most people make a full recovery within 1-2 days, however some people (usually the very young or elderly) may become very dehydrated and require hospital treatment.

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COUNTRY: INTERNATIONAL

On the other side of the World Health Organisation’s brochure mentioned in yesterdays post, there is information on how to treat gastro-intestinal infections when travelling.

DOWNLOAD THE WORLD HEALTH ORGANISATION PAMPHLET “PREVENTION OF FOODBORNE DISEASES: FIVE KEYS TO SAFER FOOD

Most diarrhoeal attacks are self-limited and clear up in a few days. Diarrhoea may be accompanied by nausea, vomiting and/ or fever. The important thing is to avoid becoming dehydrated. Ensure that you always drink sufficient amounts of fluids, particularly when travelling in a hot climate. This is extremely important for children. If the child is restless or irritable, or shows signs of strong thirst, or has sunken eyes, or dry skin with reduced elasticity, dehydration is already progressing and immediate medical attention should be sought.
Should bowel movements be very frequent, very watery or contain blood, or last beyond 3 days you should seek medical help. Where there is no medical help available a complete 3-day course of ciprofloxacin* (500 mg twice a day for adults, 15mg/kg twice a day for children) can be taken.
As soon as diarrhoea starts, drink more fluids, such as oral rehydration formula, boiled, treated or bottled water, weak tea, soups or other safe fluids. Avoid any drinks that tend to remove more water from the body, including coffee, overly sweetened drinks, some medicinal teas and alcohol.
Age group Amount of fluids or ORS** to drink
Children less than 2 years Up to ½ cup after each loose stool
Children 2-10 years Up to 1 cup after each loose stool
Older children and adults Unlimited amount
Contrary to common belief, medicines which reduce bowel movements are not recommended. In children, these preparations should never be used as they may cause intestinal obstruction.

* generic name – can be sold under other names

** If ORS are not available, mix 6 teaspoons of sugar plus
one level teaspoon of salt in one litre of safe water (“taste of
tears”) and drink as indicated in the table.

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