Norovirus Infection (cont.)

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Can norovirus infections be prevented? Is there a vaccine?

Once a person is sick, it is important for caretakers and household contacts to use good hand hygiene. This includes washing hands after coming in contact with the person or his environment. Hands should also be washed before preparing food or touching the face. The CDC recommends washing hands with soap and water over using hand sanitizers although 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. Other disinfectants like Lysol can help decontaminate some 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. The major risk factor for norovirus infection is close contact with a person who has the infection or with any items they touch or may cough on. The risk is increased if an infected person prepares your food or lives with you and others in a relatively confined space (dorm, cruise ship, school).

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, but there is no commercial vaccine currently available.

Medically Reviewed by a Doctor on 9/27/2013

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