Norovirus Infection

  • Medical Author:
    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.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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How is a norovirus infection diagnosed?

Because the symptoms of norovirus are similar to those of other common viral diarrheas like rotavirus, it is necessary to do specific tests to identify the virus. Norovirus cannot be cultured in a laboratory. However, the RNA inside the virus may be detected directly using polymerase chain reaction (PCR) tests, and these tests are the ones that are most commonly used. Enzyme-based immunoassays (EIA) can also be used to detect the virus in stool samples. EIAs use special antibodies that attach to virus particles. In addition, the Ridascreen Norovirus 3rd Generation EIA assay is approved for use to detect norovirus when a number of people have simultaneously contracted gastroenteritis and there is a clear avenue for virus transmission, such as a shared location or food source. However, this new test is not sensitive enough for definitive diagnosis of norovirus infection in an individual. The human body makes antibodies against norovirus, and these can be identified with immunoassay testing of blood samples. Unfortunately, it takes 10-14 days for the body to make antibodies, so this test is not useful for real-time diagnosis. It is also possible to see the virus particles using electron microscopy, although this is mostly a research tool. Currently, the preferred test for norovirus according to the CDC is the PCR test. This test helps distinguish between other diseases (for example, rotavirus and Salmonella infections) that may produce similar symptoms.

Once norovirus has been confirmed in an outbreak setting, it is not necessary to test every person. Rather, people with typical symptoms are assumed to have acquired the virus. Continue Reading

Reviewed on 10/28/2015
References
REFERENCES:

Glass, R.I., U.D. Parashar, and M.K. Estes. "Norovirus Gastroenteritis." N Engl J Med 361 (2009): 1776-1785.

United States. Centers for Disease Control and Prevention. Division of Viral Diseases, National Center for Immunization and Respiratory Diseases. "Updated Norovirus Outbreak Management and Disease Prevention Guidelines." MMWR Recomm Rep 60.RR-3 (2011): 1-20.

United States. Centers for Disease Control and Prevention. "Norovirus." Sept. 30, 2015. <http://www.cdc.gov/norovirus/>.

United States. Centers for Disease Control and Prevention. "Norovirus: NoroSTAT Data." May 29, 2015. <http://www.cdc.gov/norovirus/reporting/norostat/
data.html>.

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