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Medical Author:

Mary D. Nettleman, MD, MS, MACP

Mary D. Nettleman, MD, MS, MACP

Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.

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Medical Editor:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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In this Article

• Norovirus infection facts
• What is a norovirus?
• What causes a norovirus infection?
• What are norovirus infection symptoms and signs in adults, children, and babies?
• What is the incubation period for a norovirus infection? How long are people infected with norovirus contagious?
• How is a norovirus infection diagnosed?
• What is the treatment for norovirus infections in adults, children, and babies?
• What are possible complications of a norovirus infection?
• What is the prognosis of a norovirus infection?
• Can norovirus infections be prevented? Is there a vaccine?
• Where can people get more information about norovirus infections?
• Patient Comments: Norovirus Infection - Symptoms
• Find a local Gastroenterologist in your town
• Norovirus Infection Index

Once a person is sick, it is important for caretakers and household contacts to use good hand hygiene. This includes washing hands after coming into contact with the person or his environment. Hands should also be washed before preparing food or touching the face. Alcohol-based hand sanitizers are effective and have been shown to reduce the rate of transmission in some settings. Silverware and dishes should not be shared. Diluted chlorine bleach (5 to 25 tablespoons of bleach per gallon of water) may be used to clean solid surfaces.

Norovirus infections can be prevented by using good hand hygiene and avoiding contact with sick individuals and their environment. This is much harder than it sounds. One sick crew member on a cruise ship can contaminate food served to hundreds of people. Contamination while picking fresh vegetables or fruit can lead to widespread outbreaks as the product is sold across the country. Strict hygiene standards for food handlers can help reduce the risk of outbreaks. Many investigators suggest routine washing of fruits and vegetables before serving may also help reduce or prevent infections.

Noroviruses may also be spread in a hospital or nursing-home environment. The CDC has published guidelines for institutions to follow to reduce the infection rate. Hand hygiene is highlighted as the single most important component of these infection-control measures. Hospital epidemiologists and people with infection-control training should be contacted whenever an outbreak is suspected within a hospital or institution. Public-health officials should be notified whenever there is suspicion for a community-based outbreak.

Unfortunately, people who get norovirus do not have immunity against future infections. Although the body makes antibodies against the infecting strain, there are many strains that cause infection. The virus constantly creates small mutations in its RNA to make new strains that evade the human immune system.

Because there are many different strains of norovirus, it has been difficult to make a vaccine. However, this is an active area of research and there are some vaccines that have shown promise in mouse (murine) models. Vaccine trials are now beginning in humans.