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Does norovirus cause fever: The Symptoms of Norovirus | CDC


Norovirus (Winter Vomiting Bug): Symptoms, Treatment, Prevention

What Is Norovirus?

Norovirus is thought to be the most common cause of acute gastroenteritis (diarrhea and vomiting illness) around the world. It spreads easily through food and drink and can have a big impact on people’s health.

Norovirus was originally called the Norwalk virus, after the town of Norwalk, OH, where the first confirmed outbreak happened in 1972.

On average, noroviruses cause 19 million to 21 million cases of acute gastroenteritis in the U.S. per year and send more than 450,000 people to the emergency room, according to the CDC. They cause more than half of all foodborne disease outbreaks each year. There are many types of noroviruses, and exposure to one type may not protect you from the others.

Although norovirus can strike year-round, it’s more common in the winter. People sometimes call it the “winter vomiting bug.” Noroviruses also are sometimes called food poisoning, because they can be transmitted through contaminated food. They aren’t always the result of food contamination, though.

Norovirus Symptoms

If you come down with a norovirus infection, you’ll probably go from feeling completely healthy to absolutely miserable within a day or two after being exposed. Typical symptoms include nausea, vomiting (more often in children), watery diarrhea (more often in adults), and stomach cramps.

Other norovirus symptoms include:

Most of these symptoms aren’t serious, but diarrhea and vomiting can deplete your body of the fluid it needs, and you can become dehydrated. Children and the elderly are most susceptible to dehydration, as well as malnutrition from not getting enough nutrients.

If you have norovirus symptoms, your doctor can give you a stool test to confirm that you have the illness. But a norovirus diagnosis is usually made based only on symptoms.

How long is norovirus contagious?

It’s possible to shed the virus for up to 8 weeks. This means there’s a chance you could make other people sick. It usually gets less and less infectious over time.

In most cases, you can return to work or school after you have been symptom-free for 48 hours. Food service workers are generally encouraged to wait 72 hours before they handle food.

When should you call your doctor?

Call your doctor’s office if you still have symptoms after 3 days. Also, watch for symptoms of dehydration, which may also require a doctor’s attention.

In rare cases, vomiting could mean something more serious than norovirus. If your vomit is green or yellow, that could be a sign of a bowel obstruction. See a doctor right away.

Norovirus vs. Stomach Flu

Norovirus is not related to the flu, which is an infection of the respiratory system that causes fever, chills, aches, and pains. In fact, there’s no such thing as stomach flu

Norovirus Causes and Risk Factors

People become infected with noroviruses when they eat or drink contaminated foods and beverages. Raw or undercooked oysters and raw fruits and vegetables have been blamed in some outbreaks. You can also get infected if you touch an object or surface that has been infected with the virus and then touch your nose, mouth, or eyes.

Noroviruses thrive in close quarters, such as restaurants, day-care centers, and nursing homes, because they are hardy and highly contagious. They can survive temperature extremes in water and on surfaces.

Once someone is infected from contaminated food, the virus can quickly pass from person to person through shared food or utensils, by shaking hands, or through other close contact.

When someone with the virus vomits, the virus can spread through the air and contaminate surfaces. The virus also spreads through feces, meaning someone who doesn’t thoroughly wash their hands after using the bathroom can pass it along. Dirty diapers can also harbor norovirus.

Young children, the elderly, and people who have weakened immune systems are particularly more vulnerable to noroviruses. The spread can be hard to control because it’s contagious before symptoms appear. In other words, you can spread the virus before you know you’re sick.

Norovirus Diagnosis

If you have norovirus symptoms, your doctor can give you a stool test to confirm that you have the illness. But a norovirus diagnosis is usually made based only on symptoms.

Norovirus Treatment

Noroviruses, like other viruses, don’t respond to antibiotics, which are designed to kill bacteria. No antiviral drug can treat norovirus, but in healthy people, the illness should go away on its own within 1 to 3 days.

Norovirus Complications

Most people don’t have any long-term problems from the virus.

Norovirus infection can lead to dehydration, especially in children, older people, and those with weakened immune systems.

Symptoms of dehydration include:

  • Dizziness when standing
  • Dry mouth
  • Peeing less
  • Unusual sleepiness
  • Fussiness or crying with few to no tears
  • Listlessness
  • Lethargy

To prevent dehydration, make sure to drink plenty of liquids, especially water and juices. Give children an oral rehydration solution (such as Pedialyte) to replace lost fluids and electrolytes. Avoid sugary drinks, which can make diarrhea worse, as well as alcohol and caffeinated beverages, which can dehydrate you further.

If severe dehydration develops, contact your doctor. Severe dehydration is sometimes treated with intravenous (IV) fluids.

Norovirus Prevention

Good hygiene is the key to preventing a norovirus infection, especially when you’re close to a lot of other people.

  • Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom or changing a baby’s diaper, and before you prepare or eat food. Alcohol-based cleansers are not as effective as soap and water.
  • Carefully throw away any contaminated items (such as dirty diapers).
  • Wash raw fruits and vegetables thoroughly. Cook oysters and other shellfish before eating them.
  • Clean and disinfect surfaces with a mixture of detergent and chlorine bleach after someone is sick.

If you have norovirus, don’t prepare food for at least 2 to 3 days after you feel better. Try not to eat food that has been prepared by someone else who is sick.

Norovirus | NHS inform

Norovirus causes diarrhoea and vomiting and is one of the most common stomach bugs in the UK. It’s also called the ‘winter vomiting bug’ because it’s more common in winter, although you can catch it at any time of the year.

Norovirus can be very unpleasant but usually clears up by itself in a few days.

You can normally look after yourself or your child at home.

Avoid going to your GP, as norovirus can spread to others very easily. Phone your GP practice or NHS 24 on 111 if you’re concerned or need advice.

Symptoms of norovirus

You’re likely to have norovirus if you experience:

Some people also have a slight fever, headaches, painful stomach cramps and aching limbs.

The symptoms appear one to two days after you become infected and typically last for up to two or three days.

How is norovirus spread?

Norovirus spreads very easily in public places such as hospitals, nursing homes and schools.

You can catch it if small particles of vomit or stools (poo) from an infected person get into your mouth through:

  • close contact with someone with norovirus who may breathe out small particles of the virus that you then inhale
  • touching contaminated surfaces or objects, as the virus can survive outside the body for several days
  • eating contaminated food, which can happen if an infected person doesn’t wash their hands before preparing or handling food

Norovirus is most infectious from the start of symptoms until 48 hours after all symptoms have stopped. You may also be infectious for a short time before and after this.

You can get norovirus more than once because the virus is always changing and your body is unable to build up long-term resistance to it.

Preventing norovirus

It’s not always possible to avoid getting norovirus, but following the advice below can help stop the virus spreading. You should:

  • stay off work or school until at least 48 hours after the norovirus symptoms have stopped
  • avoid visiting anyone in hospital during this time
  • wash your hands frequently and thoroughly with soap and water particularly after using the toilet and before preparing or handling food
  • be aware alcohol-based hand gels don’t kill the virus

Maintain basic hygiene and cleaning to help stop the spread of norovirus by:

  • disinfecting any surfaces or objects that could be contaminated, using a bleach-based household cleaner.
  • washing any items of clothing or bedding that could have become contaminated separately on a hot wash (60 °C) to ensure the virus is killed.
  • not sharing towels and flannels
  • flushing any poo or vomit in the toilet and cleaning the surrounding area with a bleach-based household cleaner
  • avoiding eating raw, unwashed food
  • only eating oysters from a reliable source as they can carry norovirus

What to do if you have norovirus

If you experience sudden diarrhoea and/or vomiting, the best thing to do is to stay at home until you’re feeling better.

There’s no treatment for norovirus, so you have to let it run its course.

You don’t usually need to get medical advice unless there’s a risk of a more serious problem.

To help ease your own or your child’s symptoms drink plenty of fluids to avoid dehydration.

You need to drink more than usual to replace the fluids lost from vomiting and diarrhoea – as well as water, adults could also try fruit juice and soup.

Avoid giving fizzy drinks or fruit juice to children as it can make their diarrhoea worse. Babies should continue to feed as usual, either with breast milk or other milk feeds.

You can also:

  • take paracetamol for any fever or aches and pains
  • get plenty of rest
  • use special rehydration drinks, available from community pharmacies if you have signs of dehydration, such as a dry mouth or dark urine

If you feel like eating, try plain foods, such as soup, rice, pasta and bread.

Babies and young children, especially under a year old, have a greater risk of becoming dehydrated.

When to get medical advice

You don’t normally need to see your GP if you think you or your child has norovirus, as there’s no specific treatment for it.

Antibiotics won’t help because norovirus is caused by a virus.

What Is the Difference Between Norovirus and Flu?

The signs of flu are usually marked by symptoms such as fever, headache, sore throat, stuffy nose, body aches and loss of appetite — ailments that Malani says “most people would associate with a cold.”

The flu spreads mainly from droplets that travel when you cough, talk or sneeze.

How noroviruses are diagnosed

Most people won’t need medical care for norovirus; recovery can occur at home.

To confirm norovirus, it’s helpful to find out if others in recent close contact — day care classmates or roommates, for example — have also become sick. Multiple cases might prompt a school or workplace to close temporarily to stem the tide.

SEE ALSO: What You Should Know About E. Coli Outbreaks

“It doesn’t take a lot to spread this,” Malani says.

Likewise, most flu patients won’t need to see a doctor. Those who are coughing up blood, have trouble breathing or experience a very high fever should seek medical care, as should people with compromised immune systems and those who don’t get better after a few days.

How long does norovirus last?

Although norovirus infections come on fast, they also resolve quickly.

“Within 24 to 48 hours you’re feeling better, if not close to normal,” says Malani, who urges all affected people, especially food service and health care workers, to stay home during that time.

There is no specific medical treatment for norovirus. Patients’ symptoms typically improve after three days. Vomiting and diarrhea can cause dehydration, so it’s important to consume water or sports drinks to replenish lost fluids.

The flu, which might not surface for two or more days after initial exposure, also has no medical cure. Compared with that of norovirus, recovery time also lasts longer. For some patients, it might be five days or longer before signs of improvement begin.

Flu patients also will benefit from fluids and rest. Cough drops and an alternating regimen of acetaminophen and ibuprofen can help, Malani says. Antiviral therapy is prescribed in certain clinical circumstances.

How to prevent noroviruses

The most important preventive measure? Frequent and proper hand-washing, especially after using the bathroom or before preparing or consuming food. Alcohol-based hand rubs will not kill norovirus germs.

Gymgoers should wipe down all weights and machines with disinfectant wipes. (“Other people will still go to the gym if they’re sick,” Malani says.)

SEE ALSO: Getting a Flu Shot Can Help Protect Your Heart, Too

And a thorough sterilization at home during and after a norovirus infection is key.

“Take time to clean everything as much as possible,” Malani says. Wash sheets in hot water, and wipe down bathroom and high-traffic surfaces — doorknobs, remote controls, light switches and the like — with a bleach-based cleaner.

Good hand hygiene can help keep the flu from spreading, as can covering your mouth when you cough or sneeze.

Just as crucial: getting a flu shot, which helps protect both the recipient and vulnerable populations. “A vaccine might not prevent all flu, but it tends to make the illness less severe,” Malani says.

Symptoms & Causes of Viral Gastroenteritis (“Stomach Flu”)

In this section:

What are the symptoms of viral gastroenteritis?

The symptoms of viral gastroenteritis include

What are the symptoms of dehydration?

Symptoms of dehydration, the most common complication of viral gastroenteritis, may include the following in adults

  • extreme thirst and dry mouth
  • urinating less than usual
  • feeling tired
  • dark-colored urine
  • decreased skin turgor, meaning that when a person’s skin is pinched and released, the skin does not flatten back to normal right away
  • sunken eyes or cheeks
  • light-headedness or fainting

If you are the parent or caretaker of an infant or young child with viral gastroenteritis, you should watch for the following signs of dehydration

  • thirst
  • urinating less than usual, or no wet diapers for 3 hours or more
  • lack of energy
  • dry mouth
  • no tears when crying
  • decreased skin turgor
  • sunken eyes or cheeks

Seek care right away

In most cases, viral gastroenteritis is not harmful. However, viral gastroenteritis can become dangerous if it leads to dehydration. Anyone with signs or symptoms of dehydration should see a doctor right away. A person with severe dehydration may need treatment at a hospital.

Viral gastroenteritis symptoms may be similar to the symptoms of other health problems. Certain symptoms may suggest that a person has a different health problem.

The symptoms listed below may suggest that an adult or child has a severe case of viral gastroenteritis, dehydration, or a more serious health problem instead of viral gastroenteritis.


Adults with any of the following symptoms should see a doctor right away

  • change in mental state, such as irritability or lack of energy
  • diarrhea lasting more than 2 days
  • high fever
  • vomiting often
  • six or more loose stools in a day
  • severe pain in the abdomen or rectum
  • stools that are black and tarry or contain blood or pus
  • symptoms of dehydration

Adults should also see a doctor if they aren’t able to drink enough liquids or oral rehydration solutions—such as Pedialyte, Naturalyte, Infalyte, and CeraLyte—to prevent dehydration or if they do not improve after drinking oral rehydration solutions.

Older adults, pregnant women, and adults with a weakened immune system or another health condition should also see a doctor right away if they have any symptoms of viral gastroenteritis.

Infants and children

If an infant or child has signs or symptoms of viral gastroenteritis, don’t hesitate to call a doctor for advice. Diarrhea is especially dangerous in newborns and infants, leading to severe dehydration in just a day or two. A child with symptoms of dehydration can die within a day if left untreated.

If you are the parent or caretaker of an infant or child with any of the following signs or symptoms, seek a doctor’s help right away

  • change in the child’s mental state, such as irritability or lack of energy
  • diarrhea lasting more than a day
  • any fever in infants
  • high fever in older children
  • frequent loose stools
  • vomiting often
  • severe pain in the abdomen or rectum
  • signs or symptoms of dehydration
  • stools that are black and tarry or contain blood or pus

You should also seek a doctor’s help right away if a child has signs or symptoms of viral gastroenteritis and the child is an infant, was born prematurely, or has a history of other medical conditions. Also seek a doctor’s help right away if the child is not able to drink enough liquids or oral rehydration solutions to prevent dehydration or if the child does not improve after drinking oral rehydration solutions.

If a child has signs or symptoms of a viral gastroenteritis, don’t hesitate to call a doctor for advice.

What kinds of viruses cause viral gastroenteritis?

Many different viruses can cause viral gastroenteritis. The most common causes of viral gastroenteritis include

  • norovirus. Norovirus is the most common cause of viral gastroenteritis. Symptoms usually begin 12 to 48 hours after you come into contact with the virus and last 1 to 3 days.2
  • rotavirus. Symptoms usually begin about 2 days after you come into contact with the virus and last for 3 to 8 days.3Vaccines can prevent rotavirus infection.
  • adenovirus. Symptoms typically begin 3 to 10 days after you come into contact with the virus and last 1 to 2 weeks. 4
  • astrovirus. Symptoms typically begin 4 to 5 days after you come into contact with the virus and last 1 to 4 days.5,6

Norovirus causes infections in people of all ages. Rotavirus, adenovirus, and astrovirus most often infect infants and young children, but they can also infect adults.

Viruses may cause viral gastroenteritis any time of the year. In the United States, norovirus, rotavirus, and astrovirus are more likely to cause infections in the winter.

Do flu viruses cause viral gastroenteritis (“stomach flu”)?

Although some people call viral gastroenteritis “stomach flu,” influenza (flu) viruses do not cause viral gastroenteritis. Flu viruses cause infections of the respiratory system, while viral gastroenteritis is an infection of the intestines.

Are viruses the only cause of gastroenteritis?

No. While viruses cause viral gastroenteritis, bacteria, parasites, and chemicals may cause other kinds of gastroenteritis.

When gastroenteritis is caused by consuming foods or drinks contaminated with viruses, bacteria, parasites, or chemicals, this is called food poisoning.

How does viral gastroenteritis spread?

Viral gastroenteritis spreads from person to person through contact with an infected person’s stool or vomit.

If you have viral gastroenteritis, viruses will be present in your stool and vomit. You may spread the virus in small bits of stool or vomit, especially if you don’t wash your hands thoroughly after using the bathroom and

  • touch surfaces or objects used by other people
  • prepare or serve foods and drinks for other people
  • shake hands with or touch another person

Infected people who do not have symptoms can still spread viruses. For example, norovirus may be found in your stool before you have symptoms and up to 2 weeks after you recover.2

Norovirus is especially contagious, meaning that it spreads easily from person to person. Norovirus can live for months on surfaces such as countertops and changing tables. When an infected person vomits, the virus may become airborne and land on surfaces or on another person.

Viral gastroenteritis may spread in households, day care centers and schools, nursing homes, cruise ships, restaurants, and other places where people gather in groups.

If water comes into contact with stools of infected people, the water may become contaminated with a virus. The contaminated water can spread the virus to foods or drinks, and people who consume these foods or drinks may become infected. People who swim in contaminated water may also become infected.


[2] Norovirus: clinical overview. Centers for Disease Control and Prevention website. https://www.cdc.gov/norovirus/hcp/clinical-overview.html. Updated February 13, 2013. Accessed August 31, 2017.

[3] Rotavirus: clinical information. Centers for Disease Control and Prevention website. https://www. cdc.gov/rotavirus/clinical.html. Updated August 12, 2016. Accessed August 31, 2017.

[4] Boyce TG. Overview of gastroenteritis. Merck Manual: Professional Version website. https://www.merckmanuals.com/professional/gastrointestinal-disorders/gastroenteritis/overview-of-gastroenteritis Updated May 2017. Accessed August 31, 2017.

[5] Cohen MB. Bacterial, viral, and toxic causes of diarrhea, gastroenteritis, and anorectal infections. In: Podolsky DK, Camilleri M, Fitz G, et al. eds. Yamada’s Textbook of Gastroenterology. 6th edition. John Wiley & Sons, Ltd.: 2016:1196–1248.

[6] Garza JM, Cohen MB. Infectious diarrhea. In Wyllie R, Hyams J. Pediatric Gastrointestinal and Liver Disease. 4th edition. Philadelphia, PA: Saunders: 2011:405–422.

Norovirus – HSE.ie

Norovirus, which causes diarrhoea and vomiting, is one of the most common stomach bugs in Ireland. It’s also called the winter vomiting bug. This is because it’s more common in winter, although you can catch it at any time of the year.

Norovirus can be unpleasant but it usually clears up by itself in a few days.

You can normally look after yourself or your child at home.

Try to avoid going to your GP, as norovirus can spread to others very easily.

Symptoms of norovirus

You’re likely to have norovirus if you experience:

  • feeling sick
  • being sick (vomiting)
  • diarrhoea

Some people also have a slight fever, headaches, painful stomach cramps and aching limbs.

The symptoms start 1 to 2 days after you become infected and last for up to 2 or 3 days.

Treatment for norovirus

The best thing to do is to stay at home until you’re feeling better. There’s no cure for norovirus, so you have to let it run its course.


Antibiotics won’t help because it’s caused by a virus.

You don’t usually need to get medical advice unless there’s a risk of a more serious problem.

Read about how to treat diarrhoea and vomiting in children and adults

How norovirus is spread

Norovirus spreads very easily in public places such as hospitals, nursing homes and schools.

You can catch it if small particles of vomit or poo from an infected person get into your mouth. This can happen through:

  • close contact with someone with norovirus. They may breathe out small particles containing the virus that you could inhale
  • touching contaminated surfaces or objects. The virus can survive outside the body for several days
  • eating contaminated food. This can happen if an infected person does not wash their hands before handling food

You are most infectious from when your symptoms start until 48 hours after all your symptoms have passed. You may also be infectious for a short time before and after this.

You can get norovirus more than once because the virus is always changing. Because of this, your body is unable to build up long-term resistance to it.

Preventing norovirus

It’s not always possible to avoid getting norovirus, but following the advice below can help stop the virus spreading.

  • Stay off work or school until at least 48 hours after the symptoms have passed. You should also avoid visiting anyone in hospital during this time.
  • Wash your hands frequently and thoroughly with soap and water. Do not rely on alcohol hand gels, as they do not kill the virus.
  • Disinfect any surfaces or objects that could be contaminated. It’s best to use a bleach-based household cleaner.
  • Wash any items of clothing or bedding that could have become contaminated separately on a hot wash to ensure the virus is killed.
  • Don’t share towels and flannels.
  • Flush away any infected poo or vomit in the toilet and clean the surrounding area.
  • Avoid eating raw, unwashed produce.

Compare causes, symptoms, treatments & more

Rotavirus and norovirus are two causes of viral gastroenteritis, sometimes called ‘stomach flu’

Causes | Prevalence | Symptoms | Diagnosis | Treatments | Risk factors | Prevention | When to see a doctor | FAQs | Resources

Nausea, vomiting, diarrhea—most people refer to these symptoms as having a “stomach bug” or “stomach flu,” but the medical term for the stomach flu is viral gastroenteritis.

Gastroenteritis is an inflammation of your intestines—over 20 million people in the U.S. experience this illness every year. The stomach flu, or viral gastroenteritis, is most often caused by viruses. However, the viruses that cause stomach flu are not the same as those that cause influenza (the flu that causes fever, body pains, and respiratory symptoms). 

Two common causes of viral gastroenteritis are rotavirus and norovirus. Adenovirus, sapovirus, and astrovirus are other viruses that can cause stomach problems but are less common than rotavirus and norovirus. 

Rotavirus is a virus that causes gastrointestinal symptoms, primarily in infants and young children. A vaccine can prevent rotavirus. 

Norovirus is a common virus that can cause gastroenteritis. Norovirus is the most common cause of vomiting, diarrhea, and foodborne illness. 

In this article, we will discuss rotavirus and norovirus. They have many similarities as well as many differences. Continue reading to learn all about rotavirus and norovirus. 



Rotaviruses are wheel-shaped RNA viruses that belong to a family called Reoviridae. 

In most cases, rotavirus spreads from fecal-oral contact. When a person is infected with rotavirus, the virus is shed in the stool. The virus can then infect others. For example, a person may not wash their hands well, and then puts food in their mouth and/or handles food that someone else eats. Or, someone may touch a surface (the virus can live on surfaces for a while) that is contaminated and put their fingers in the mouth. In less common cases, the virus can be spread by sneezing or coughing.


Noroviruses are RNA viruses that belong to the Caliciviridae family and are sometimes referred to as the Norwalk virus. According to the U.S. Centers for Disease Control and Prevention (CDC), if you think you have a stomach bug, stomach flu, or food poisoning, it is likely caused by norovirus. People with norovirus shed billions of microscopic particles in feces or vomit that are very contagious.

It only takes a few particles to get sick. Food can be contaminated with norovirus in several ways, such as when an infected person has feces or vomit particles on their hands and then touches food, or when food is placed on a surface with particles of feces or vomit on it. Most outbreaks occur in food service settings. Water can also become contaminated with norovirus. Surfaces can become infected as well, for example, when an infected person has feces or vomit particles on their hands and touches a surface, or when contaminated food or water is placed on a surface. 

Rotovirsus vs. norovirus causes
  • The virus is shed in the stool and then most often spreads through fecal-oral contact.
  • Poor hand-washing and handling of food can spread rotavirus.
  • Touching a contaminated surface then putting fingers in the mouth can spread rotavirus.
  • The virus is shed in the stool or vomit.
  • Norovirus can contaminate food, water, or surfaces.
  • Most outbreaks occur in food service settings.



In the U.S., rotavirus vaccines are very effective in preventing rotavirus. Before the vaccines were developed, rotavirus caused 2 to 3 million illnesses yearly, with up to 70,000 requiring hospitalization. Now, severe illness from rotavirus is rare in the U.S. Rotavirus is mostly seen in children under 5 years of age. 

Throughout the world, rotavirus causes more than 125 million cases of diarrhea in infants every year. Over 2 million children under 5 years old are hospitalized every year due to rotavirus symptoms. Of these, about half a million children die. 


There are about 19-21 million cases of acute gastroenteritis (stomach and/or intestinal inflammation) in the U.S. due to norovirus every year. Death is very rare. Approximately 570-800 people die yearly from norovirus, mostly young children or older adults, who are vulnerable to severe dehydration. Norovirus can occur any time of year but is most common in the winter. Norovirus outbreaks have occurred in various settings such as restaurants, health care facilities, schools, cruise ships, military ships, and resorts. Norovirus can occur at any age.

Worldwide incidence is not well known in developing countries. In industrial countries, the incidence is similar to the U.S.

Rotavirus vs. norovirus prevalence
  • US: Rotavirus caused 2 to 3 million illnesses yearly before vaccines were developed. Now, severe illness is rare. 
  • Rotavirus mainly occurs in pediatric patients under 5 years old. 
  • Worldwide: Rotavirus causes >125 million cases of diarrhea in infants throughout the world every year, and about 500,000 children die yearly.  
  • US: Norovirus causes 19-21 million illnesses yearly. Death is very rare.
  • Norovirus can occur in people of any age.
  • Worldwide: incidence is not well known in developing countries. In industrial countries, the incidence is similar to that in the U.S. 



The most common symptoms of rotavirus are severe diarrhea, vomiting, fever, and/or stomach pain. Symptoms typically start two days after exposure to the virus. Symptoms can last three to eight days. 

Other symptoms may include appetite loss and dehydration. Dehydration can be very dangerous for infants and young children. Dehydration symptoms include decreased urination, dry mouth, extreme thirst, dizziness when standing up, crying with little or no tears, and being unusually sleepy or fussy. 


The most common symptoms of norovirus are nausea, vomiting, diarrhea, and abdominal pain. Other symptoms may include fever, headache, and body aches. Symptoms generally occur 12 to 48 hours after norovirus exposure. Norovirus symptoms last for about one to three days. When a person has diarrhea or vomits many times a day, dehydration may occur. Dehydration from norovirus is more common in young children, older adults, and those with other medical conditions. 

Rotavirus vs. norovirus symptoms

Rotavirus vs. norovirus symptoms
  • Symptoms usually start 2 days after exposure and last 3-8 days.
  • The most common symptoms are severe, watery diarrhea, vomiting, fever, abdominal pain.
  • Appetite loss and dehydration may occur.
  • Dehydration can be very dangerous in infants and young children. 
  • Symptoms usually start 12-48 hours after exposure and last 1-3 days.
  • The most common symptoms are nausea, vomiting, diarrhea, and stomach pain. 
  • Fever, headache, body aches, and dehydration may also occur. 



Contact a pediatrician if your child is experiencing symptoms such as fever, diarrhea, stomach pain, and/or vomiting. A diagnosis can often be made based on symptoms and an examination. In some cases, the healthcare provider may ask for a stool sample.  


In most cases, the doctor can diagnose norovirus from your symptoms. A stool sample can confirm the diagnosis but is usually not needed.

Rotavirus vs. norovirus diagnosis
  • Healthcare providers can often diagnose based on symptoms and examination.
  • A stool sample may be taken.
  • Norovirus can usually be diagnosed based on symptoms.
  • A stool sample is usually not necessary.


Antibiotics are never used to treat rotavirus or norovirus infections. Antibiotics are for bacterial infectious diseases only and will not help a viral infection. Contact a healthcare provider if you or the person you are caring for shows symptoms of dehydration, such as dry mouth, decreased urination, and dizziness when standing up. Young children, older adults, and people who have other medical conditions are at higher risk of dehydration.  


There is not a specific medication that treats rotavirus. Rotavirus can cause severe diarrhea and vomiting, which can lead to dehydration. Taking in plenty of liquids helps to prevent dehydration. Oral rehydration solutions can be useful for mild dehydration, while severe dehydration may require hospitalization and IV fluids. Resting, staying home, and frequent handwashing are important as well. 


There is no specific medication to treat norovirus. Drinking plenty of fluids will help prevent dehydration. Those with mild dehydration can drink oral rehydration solutions, while those with severe dehydration may require IV fluids in the hospital. Try to rest, stay home to avoid spreading infection, and wash hands frequently. 

Rotavirus vs. norovirus treatments
  • There is no cure for rotavirus. 
  • Drinking plenty of fluids, such as oral rehydration solution, helps mild dehydration.
  • Severe dehydration may require hospitalization and IV fluids. 
  • Rest, stay home, wash hands frequently.
  • There is no cure for norovirus illness.
  • Consuming lots of fluids (such as oral rehydration solution) helps mild dehydration.
  • Severe dehydration may require IV fluids in the hospital.
  • Stay home and rest; wash hands frequently.

Risk factors


In the U.S., children are at the highest risk of getting rotavirus. Children in daycare settings or schools with many young children are at higher risk. The most severe disease occurs in unvaccinated children ages 3 months of age to 3 years old. Some adults are at higher risk. Adults at higher risk are older adults, people caring for a child with rotavirus, and people with compromised immune systems. 


People who have direct contact with an infected person (such as healthcare providers, visitors, or other patients) are at higher risk of getting norovirus. Other risk factors are eating or drinking contaminated foods or liquids or touching contaminated objects or surfaces then touching the mouth. 

Rotavirus vs. norovirus risk factors
  • Children in daycare settings or schools with many young children.
  • The most severe cases occur in children ages 3 months to 3 years old who are not vaccinated. 
  • Older or immunocompromised adults and caretakers of children with rotavirus are at higher risk.
  • Direct contact with a person who is infected with norovirus 
  • Eating or drinking contaminated foods or liquids
  • Touching contaminated surfaces or objects and then placing fingers in the mouth.



The most effective prevention against rotavirus is with the rotavirus vaccine. Most children (about 90%) who are vaccinated with the rotavirus vaccine will be protected from severe illness, and about 70% will be completely protected from rotavirus disease. 

There are two rotavirus vaccines available in the U.S. The first dose should be given before 15 weeks, and all doses should be complete by eight months of age. The vaccines are given by placing oral drops in the baby’s mouth. 

  • RotaTeq is given at 2 months, 4 months, and 6 months of age (3 doses)
  • Rotarix is given at 2 months and 4 months of age (2 doses)

Although the vaccine is the absolute best line of defense against rotavirus, handwashing can also help prevent the spread of infection. However, handwashing is not a substitute for vaccination.


The CDC recommends several ways to prevent norovirus. These include:

  • Handwashing: Wash hands thoroughly (for at least 30 seconds) with soap and water, especially after using the bathroom, after changing diapers, before eating or preparing food, and before taking medicine or giving someone medicine. Hand sanitizers may be used as well but should not be used as a substitute for soap and water, as they are not as effective at removing virus particles. 
  • Food safety: Wash produce carefully. Cook shellfish thoroughly. Foods that may be contaminated should be discarded. People who are sick should be kept out of areas where food is being prepared. 
  • Do not care for others when sick: When you are ill and for at least two days after symptoms stop, do not prepare food for others or take care of others.
  • Clean and disinfect surfaces: When someone has diarrhea or vomits, clean and disinfect the entire area while wearing gloves. Wipe with paper towels, then disinfect with a bleach-based cleaner. Leave the cleaner on the area for at least 5 minutes, then clean again with soap and hot water. Clean and sanitize kitchen utensils and surfaces. 
  • Wash laundry thoroughly: Clothes or bedding that may be contaminated with feces or vomit should be immediately removed or washed. Handle items with gloves, wash items in hot water, and dry on the highest heat setting—wash hands after handling soiled items. 
How to prevent rotavirus vs. norovirus
  • Vaccination (for babies) is the number one defense against rotavirus.
  • Handwashing can help prevent the spread but is not a substitute for vaccination.
  • Handwashing
  • Food safety 
  • When sick, avoid caring for others
  • Clean and disinfect surfaces
  • Wash laundry well

When to see a doctor for rotavirus or norovirus

If you are an adult with gastrointestinal symptoms, contact your doctor if you have been vomiting for more than two days or are vomiting blood, have bloody stools, are dehydrated, or have a fever of 104 F or above. 

If your child is ill, call a pediatrician or seek emergency care if your child has a fever of 102 F or higher, is very lethargic or cranky, is in pain, has blood in the stools, or seems dehydrated. Even if symptoms are not severe, it is always a good idea to report symptoms to the pediatrician so they can provide medical guidance.   

Infants who are vomiting, dehydrated, have bloody stools or severe diarrhea, or are unusually sleepy should be seen by the doctor immediately or receive emergency medical care. In infants, as with children, even if symptoms are not severe, it is a good idea to check in with a pediatrician to report symptoms and receive medical guidance. 

Nausea, vomiting, and diarrhea can also be symptoms of COVID-19 (coronavirus), so you may also want to check with your healthcare provider to see if you need a COVID test, especially if you have been exposed to COVID. 

Frequently asked questions about rotavirus vs. norovirus

Are norovirus and rotavirus the same thing?

Norovirus and rotavirus are different viruses that cause stomach problems, like nausea, vomiting, and diarrhea. Norovirus is more common in adults, while rotavirus tends to affect infants and young children. There is a vaccine to prevent rotavirus, but there is no vaccine to prevent norovirus. There is no cure for either virus. Treatment focuses on hydration— severe cases may require hospitalization. 

What are the common rotavirus symptoms?

The most common rotavirus symptoms are severe, watery diarrhea, vomiting, fever, and stomach pain. Symptoms last anywhere between three to eight days. Other symptoms may include loss of appetite and dehydration. Dehydration can be very dangerous for young children and infants. 

What is the difference between gastroenteritis vs. norovirus?

When someone says they have the stomach flu, they are generally referring to gastroenteritis and they are experiencing symptoms like nausea, vomiting, and diarrhea. Various viruses may cause viral gastroenteritis. Norovirus is the most common cause of gastroenteritis in adults. 

What is the difference between rotavirus vs. stomach bug?

The stomach bug, or stomach flu, as many people call it, is also known as viral gastroenteritis. Different viruses may cause viral gastroenteritis. Rotavirus is a cause of gastroenteritis that mainly affects infants and young children (under 5 years old). So, rotavirus causes gastroenteritis, but gastroenteritis can be caused by different viruses, one of which is rotavirus.

How long is the norovirus contagious period?

According to the CDC, people with norovirus are most contagious while symptoms are present and during the first few days after recovering. However, some studies have shown that norovirus may still be spread for 2 weeks—or longer—after symptoms are gone.   


  • Gastroenteritis in children, American Family Physician
  • Nausea and vomiting, Cleveland Clinic
  • Norovirus, Cleveland Clinic
  • Norovirus, Medscape
  • Norovirus, U.S. Centers for Disease Control and Prevention
  • Prevention of diarrheal illness, Oklahoma State Department of Health
  • Rotavirus, Cleveland Clinic
  • Rotavirus, Medscape
  • Rotavirus, U.S. Centers for Disease Control and Prevention
  • Rotavirus infections, Boston Children’s Hospital
  • Rotaviruses, noroviruses, and other gastrointestinal viruses, U.S. National Library of Medicine
  • Rotavirus questions and answers, Immunization Action Coalition
  • Stomach flu (gastroenteritis), Cleveland Clinic
  • Viral gastroenteritis, National Center for Biotechnology Information

Kids and the Stomach Flu

Gastroenteritis, also known as the stomach flu, is inflammation in the digestive tract, including the stomach and the small and large intestines. It is very common, especially in children. Although gastroenteritis is sometimes called “stomach flu,” the seasonal influenza (flu) virus does not cause it. It is most commonly caused by a virus, such as the rotavirus, but may also be caused by bacteria or parasites. Vaccines are available to protect children from rotavirus. Your pediatrician can explain your options for vaccinating your baby.

Viruses that cause the stomach flu can be found in the vomit and diarrhea of infected people. They can live for a long time outside the body. People who are infected with the virus can spread it to objects they touch, especially if they do not wash their hands after using the bathroom or changing a diaper.

Symptoms of the stomach flu usually begin about one to two days after the virus gets into the body. Common symptoms include nausea, vomiting and watery diarrhea. Other possible symptoms are headache, fever, chills and stomachache.

“The most dangerous consequence of the stomach flu is dehydration,” says Dr. Jeffrey Ho, CHOC pediatric gastroenterologist. “Infants and young children in particular can become dehydrated very easily. Call your child’s doctor right away if you notice any signs of dehydration.”

Parents should watch carefully for signs of dehydration which include decreased urine output, dark-colored urine, dry skin, thirst and dizziness. In younger children, signs of dehydration are dry diapers (from a lack of urination), lack of tears, dry mouth, drowsiness and sunken fontanel (the soft spot on the top of an infant’s head).

In most cases, your child should drink plenty of fluids and rest at home until the virus leaves their system. Helpful home care tips include:

  • Have your child drink plenty of light fluids like ice chips, water, diluted fruit juice and broth. Start with small, frequent volumes and increase slowly as tolerated. For older children, keep in mind that sports drinks are high in sugar and may not be appropriate if they are extremely dehydrated.
  • For infants and younger children, ask your child’s doctor if you should rehydrate your child with an oral rehydration solution such as Pedialyte or Enfalyte. These fluids have the right balance of water, sugar and salts. Some are available as popsicles.
  • It can be dangerous to give plain water to a baby and too much plain water to kids of any age.
  • Avoid drinks that contain milk and caffeine.
  • Keep breastfeeding or feeding your baby formula, but only if they are able to keep it down.
  • Once your child feels hungry again, start with mild, easy to digest foods.

In rare cases, children may need treatment for severe dehydration with IV (intravenous) fluids.

90,000 Named the main diseases that can hopelessly ruin summer vacations

Summer is perhaps the most long-awaited season in our country. It brings warmth and sunshine, which we miss so much 9 months a year. In addition, this is the time for fresh fruits, berries and vegetables.

But this is where the threat lies – acute intestinal infections (ACI). What they are, why they become more dangerous in the summer and how to diagnose them in time in order to avoid serious problems, Valery Savanovich, an expert on the laboratory diagnostics market, tells MK.

Enemy No. 1 – acute intestinal infections

OCI are infectious diseases mainly with a fecal-oral transmission mechanism: i.e. the infected person did not wash his hands after using the toilet, used, for example, a shared plate or towel and voila – infected all family members.

Basically, AEI affect the gastrointestinal tract and are manifested by similar symptoms – nausea, vomiting, diarrhea, fever, spastic abdominal pain.The warm climate promotes the active reproduction of microorganisms that cause AEI, and lack of hygiene exacerbates the situation. Most often from OKI they visit us in summer:

bacterial dysentery (shigellosis) – the causative agent is Shigella bacteria, the incubation period of the disease is 1–4 days, the most common symptoms are diarrhea and abdominal pain, rarely there may be fever;

enterovirus infection – the causative agent is the Enterovirus virus (ECHO virus, Coxsackie virus, poliovirus), which is extremely tenacious and dies only at temperatures above 50 degrees Celsius or treatment with chlorine-containing solutions.The incubation period is 5-7 days, infection often occurs after swimming in a natural reservoir and causes a temperature rise of up to 39 degrees, weakness, headache, abdominal pain, diarrhea, nausea, vomiting, as well as serious complications – meningitis, pericarditis, hepatitis, myocarditis;

rotavirus infection – pathogens – RNA-containing rotaviruses (Rotavirus), the incubation period is from 15 hours to several days, the onset of the disease is acute, with nausea, vomiting, diarrhea, and sometimes fever;

norovirus – the causative agent is a virus of the Caliciviridae family that causes acute infectious gastroenteritis;

Astrovirus infection – causative agent – RNA-containing astroviruses (Astrovirus).The incubation period is 3-4 days, after which acute gastroenteritis occurs with general malaise, headache, nausea, diarrhea, slight fever, and sometimes vomiting.

Photo: Lilia Sharlovskaya

How to recognize the enemy by sight?

Alas, it is almost impossible to determine on your own, without the help of a doctor, which OCI visited you. The symptoms of different AEI, as we have already seen, are very similar. Moreover, they may resemble symptoms of other diseases, such as appendicitis.That is why, for accurate diagnosis, which is necessary for proper treatment, doctors refer patients with suspected OCI for blood and feces tests.

With AEI, feces are analyzed using cultural and molecular genetic methods. They identify the genetic material of the causative agent of AEI and thereby indicate the “culprit.” A blood test helps to determine the concentration of specific immunoglobulins in the blood. In addition to these analyzes, PCR diagnostics is used in the diagnosis of OCI.This is a more specific and sensitive study that helps to determine the causative agent of AEI with almost 100% accuracy.

Then what? Then the doctor will prescribe drugs, select their dosage and duration of administration. If you follow all the doctor’s recommendations, then you will get rid of OCI without serious health consequences. The most important thing here is not to entertain yourself with self-medication, prescribing drugs for yourself using the Internet and the advice of a work colleague. But you can still do something on your own.

First aid for OCI

Very often, AEI is accompanied by diarrhea and vomiting, which leads to dehydration, and therefore the first point of care at home is drinking, you need to give the patient a sufficient amount of fluid. You need to drink often, in small portions and small sips, because Drinking too much and too quickly in one sitting can cause vomiting.

The second point is the intake of sorbents (activated carbon, dioctite, white coal, enterosgel). They absorb harmful substances, help to quickly remove them from the body, and therefore greatly facilitate the patient’s condition.

The third point is the safety of the rest of the family. The sick person should always wash his hands thoroughly after using the toilet, he should have his own dishes and hygiene products. The toilet should be carefully treated with disinfectants, and after contact with a patient, always wash your hands with soap and water.

However, there are things that cannot be done when providing first aid during an OCI. This is, firstly, the unauthorized prescription of antibiotics – you do not know which pathogen caused the disease, what is the correct dosage and schedule for taking the drug.Secondly, you cannot drink anti-diarrhea drugs – as a result, the infection will linger in the intestines, and this can already provoke serious complications.

Thirdly, you cannot drink painkillers, because they will prevent the doctor from making an accurate diagnosis – and this can be critical in the case of appendicitis. Also, you should not put a heating pad or ice on your stomach – this can also cause complications. If the pain is very severe, then the best way out is to call an ambulance.

Prevention of OCI

But it’s best not to get sick, and for this you need to follow simple preventive measures, the main of which is personal hygiene.Always wash your hands after using the toilet and returning from the street, and have children do the same. The second most important aspect is thorough washing of all vegetables, fruits, berries, herbs, mushrooms. Be attentive to cereals – never eat cereals in which something is already stirring!

The kitchen must be kept clean, and garbage should be thrown out more often in the summer – do not save it until the evening, or even more so for several days. If you go on vacation where you cannot cook yourself, do not be tempted to buy pies on the side of the road or any food at all from your hands.In many countries, street food is a culture of its own, but remember, the consequences of being in it may not be the most enjoyable.

Finally, it is important to observe “water safety” – drink only clean, preferably boiled water. When traveling, take bottled water or at least a supply of boiled water. Do not drink water from rivers, streams, ponds, etc.! Do not swim where it is prohibited – the ban may just be associated with contaminated water in reservoirs. And if you swim where it is allowed, make sure that no water gets into your mouth.

Microbiological examination of faeces for norovirus type II

Noroviruses are a genus of RNA viruses that belongs to the Caliciviridae family. There are five genogroups of noroviruses (GI-GV). The most common is the 2nd genogroup (GII), which accounts for up to 80-90% of all cases of noroviral gastroenteritis.

Norovirus infection usually occurs in a mild (in 60-80% of cases) or moderate (in 20-40% of cases) form.The most common clinical manifestations are rapidly onset and progressive nausea (79% of cases), vomiting (69% of cases), diarrhea (66% of cases), fever (37% of cases), chills (32% of cases), symptoms of acute respiratory disease (30 % of cases), headache (22% of cases). The incubation period is 12-48 hours, the duration of the disease is 2-5 days. The source of infection is a sick person or an asymptomatic virus carrier. Virus shedding is maximal on the first and second days after infection, but can last from five to 47 days (on average 28 days) after the disappearance of clinical symptoms.Asymptomatic virus carriers, like patients with an acute manifest form of infection, secrete viral particles for three or more weeks after infection. Viruses are highly contagious (infectious). The main mechanism of transmission of infection is fecal-oral (includes food, contact-household and, less often, water transmission). Infection with noroviruses causes the appearance of specific antibodies that form an immune response against the pathogen and prevent re-infection, but the immunity is temporary.There is a genetically determined immunity to norovirus infection (up to 15% in the population) and the possibility of an asymptomatic course (up to 10-13% in the population).

The diagnosis of norovirus infection is established on the basis of clinical, epidemiological data and laboratory confirmation. Among laboratory methods for diagnosing this infection, the PCR method exhibits the maximum sensitivity and specificity and is preferred.


Today, more and more often, given the height of the holiday season, children and adults get sick with intestinal infections.An intestinal infection in humans can be caused by several types of viruses. Noroviruses are one of the causes of the disease.

By Larisa Kharakhashyan, head of the infectious diseases department of the State Budgetary Institution of the Regional Children’s Clinical Hospital, pediatrician of the highest category:

– Noroviruses were first discovered in 1972 in Norwalk, Ohio, USA, and were initially called the Norwalk virus. For some time, noroviruses and rotaviruses were not distinguished, and everyone was diagnosed with “rotavirus infection”, especially since the manifestations of both intestinal infections caused by these pathogens are clinically similar.
Noroviruses, like rotaviruses, cause outbreaks of acute intestinal infections in public institutions, kindergartens, general education schools, hospitals, nursing homes, etc. According to statistics, 50% of cases of acute intestinal infections in adults and 30% in older children are caused by noroviruses. In young children, noroviruses are the second most common cause of acute intestinal infections after rotaviruses.

Main routes of transmission of norovirus:
– food, i.e.e. a person can become infected, for example, by eating unwashed vegetables and fruits;

– aquatic, when a person becomes infected by drinking a certain amount of liquid containing a virus;

– contact-household, when the virus enters the body through unwashed hands, household items, dishes, etc.

People infected with norovirus are able to infect others during the height of the disease and during the next 2 days, but in some cases the viruses are excreted from the body up to 2 weeks after the onset of the disease.
The first symptoms of the disease appear 24-48 hours after infection. It can be a single, but more often multiple vomiting, diarrhea, severe nausea, fever. Norovirus most commonly causes diarrhea and severe vomiting, but sometimes only vomiting can occur. Digestive system disorders can be accompanied by muscle aches, headaches, and weakness. Usually, the symptoms of norovirus infection resolve on their own within 12-72 hours. Like any intestinal infection, norovirus is dangerous in children by the development of dehydration.

After illness, the body develops immunity to the virus, but for a very short period, about 8 weeks. After this period, a person can become infected with norovirus again and get sick.
There are currently no vaccines for noroviruses. Therefore, the main measures for the prevention of this infection is the observance of the rules of hygiene. This is hand washing after returning from the street, washing all vegetables and fruits before eating.

If there is already a sick person in the house, then hygiene must be very carefully monitored.At least once a day, it is necessary to process all surfaces that the infected person has come into contact with: the bed frame, bedside tables, bathrooms, wooden handles, etc. Even the smallest dust particles with norovirus cause disease. Larisa Egiyanovna emphasizes:

The virus is very viable: wet cleaning with conventional detergents and alcohol-containing agents does not ensure its destruction, the virus is resistant to drying, freezing, heating up to 60 degrees and dies only from chlorine-containing disinfectants.Dishes, washable items used by an infected patient, as well as toys (if a child is sick) should be washed with warm water and bleach. All things that have been stained with vomit must be washed immediately at a temperature of at least 60 degrees.
Such observance of hygiene rules will avoid further spread of infection and re-infection of people.

But special attention must be paid to children, as babies very often pull various objects into their mouths.It is good if this happens at home and if they are clean toys. But it happens that this happens on the street, on the playground and in other places where no one can vouch for the cleanliness of the object taken in the mouth. That is why children often have intestinal infections. In addition, children are often united in children’s groups (kindergarten, school, circle, children’s camp, etc.), where any infection can spread quite quickly.

REMEMBER that the main protection against norovirus infection and other intestinal infections caused by viruses is not only personal hygienic prevention measures, but also timely seeking medical help from medical institutions, especially when it concerns CHILDREN!

90,089 90,000 The reason for hospitalization of students in Slavyansk-on-Kuban may be norovirus

Specialists of the regional Rospotrebnadzor identify the source of the causative agent of intestinal infection, due to which 15 students of Lyceum No. 4 in Slavyansk-on-Kuban were hospitalized yesterday, December 13.As Kommersant-Kuban has already reported, over 250 children did not show up for classes. The educational institution was quarantined. Investigators of the regional TFR began a pre-investigation check on this fact. Samples of food and water were taken, the sanitary condition of the premises is being checked.

As reported in the administration of the Slavyansky district, the medical examination of the schoolchildren has been completed. The inspection of tap water, food products, sanitary condition of the premises is carried out. Catering workers, maintenance workers, and nutritional council staff have been tested for viruses and acute intestinal infections.A meeting of the regional sanitary and anti-epidemic commission was held with the participation of the prosecutor of the Slavyansk region.

MBU “Slavyanskaya CRH” organized 12 teams to actively visit absent children at home and organize, if necessary, preventive treatment. When visiting children at home, parents will be informed about measures to prevent viral intestinal infection.

“Today, viruses are increasingly the cause of intestinal infections in children and adults. There are several types of viruses that can cause intestinal infection in humans.Norovirus is one such virus. Its characteristic manifestations: nausea, vomiting, diarrhea, fever, as well as pain in the abdomen, in some cases there is a loss of taste sensitivity. The first symptoms of the disease appear 24-48 hours after infection. In children, as a rule, vomiting predominates in symptoms, in adults – diarrhea. There may be drowsiness, lethargy, muscle pain and mild fever (temperature rise to 37.5 degrees). Symptoms can last for several days, and if you ignore and do not deal with dehydration due to vomiting and diarrhea, the disease is fraught with life-threatening consequences, ”the Slavyansky District Administration says.

It is specified that people infected with norovirus are able to infect others during the height of the disease and within the next two days, and in some cases within two weeks after the onset of the disease. The risk group includes children, the elderly and patients with weakened immune systems. There is currently no vaccine against norovirus.

Dmitry Mikheenko

90,000 Why rotavirus is dangerous for your child

Rotaviruses are the most common cause of severe diarrheal illness in young children worldwide.As a rule, by the age of 2, almost every child has a rotavirus infection at least 1 time and more than 2/3 get sick again. Some cases can be fatal.

The World Health Organization (WHO) estimated in 2013 that about 215,000 children under the age of 5 die each year from the effects of rotavirus infection – this is 3.4% of all causes of child mortality.

Several types of rotavirus are known – A, B, C, D, E.The most common of these is category A rotavirus. It accounts for more than 90% of human rotavirus infections.

The main sources of rotavirus infection are children attending kindergarten and other childcare facilities. Over time, a child may endure several episodes of rotavirus infection and gain specific immune defenses, but at what cost?

What is “dirty hand disease”

Intestinal infections have long been called “dirty hand disease”.Most often, viruses or bacteria get into the hands of the patient when he does not follow the rules of personal hygiene when visiting the toilet. From his hands, germs remain on linen, dishes, food products, toys, that is, on everything that he touched with his hands – and from them they pass to the hands of a healthy person.

Germs can also be brought into the mouth directly by dirty hands, especially if the child likes to bite his nails, lick his fingers.

A common case of intestinal infections is the consumption of poorly washed vegetables and fruits.

Pathogenic microbes on food can also appear due to insects and rodents. It is known, for example, that a fly on its paws carries up to 30 thousand dangerous microorganisms.



Some examples of intestinal infections are: dysentery, typhoid fever, salmonellosis, and norovirus or rotavirus infection. The latter is the most common among children.Every year, worldwide, rotavirus infection in children in the first 5 years of life causes 25 million cases of the disease requiring medical attention, and up to 2 million cases requiring hospitalization.

Why rotavirus is dangerous for a child

There are three forms of severity of rotavirus infection: mild, moderate and severe. The main criteria are the severity and duration of fever, intoxication, vomiting and diarrhea. In addition, the severity of the disease is determined by the development of dehydration (exsicosis) I-II, less often III degree.

In young children in the acute period of the disease against the background of dehydration, convulsions may develop, which are accompanied by loss of consciousness. Rotavirus infection is also dangerous for the possible development of complications in the form of anemia. Foreign authors described a reliable lesion of the central nervous system in 24 children, who had impaired consciousness and speech of varying degrees, ataxia (impaired coordination of movements). Almost half of the patients had pleocytosis, that is, an abnormal increase in the number of lymphocytes in the cerebrospinal fluid.

Death in rotavirus infection can occur due to dehydration and, as a result, the development of hypovolemic shock. It is caused by either inadequate therapy or the absence of any treatment at all.

Some complications of the disease can develop due to the low immunity of the child. The state of his mother also plays a role: smoking, drinking alcohol, drugs during pregnancy or during breastfeeding contribute to the formation of immunodeficiency in the baby.

How to understand that a child has “caught” rotavirus

Most children have a fever, it can reach 39 ° C and above. Older children may complain of abdominal pain, and toddlers who cannot speak are naughty and very anxious. The hallmarks of rotavirus gastroenteritis are nausea, vomiting, diarrhea, and bloating. In addition, many children develop a runny nose, redness in the throat, and pain when swallowing (therefore, rotavirus infection is sometimes mistakenly called “intestinal flu”).

Due to vomiting and frequent diarrhea, the patient becomes dehydrated. In this case, the child refuses to take liquid due to an increased gag reflex. In this case, hospitals may resort to intravenous drip of fluids. It is important to stay hydrated and remember that losing 8% of your body weight with fluids can be life-threatening for your baby.

How to treat rotavirus infection *

There are no drugs that affect rotavirus.Therefore, the treatment of rotavirus infection is reduced to normalizing the water-salt balance, treating the symptoms of the disease and preventing the development of complications.

First of all, it is necessary to fight dehydration, for this they use rehydration therapy (saline solutions).

In addition to saline solutions, the child can be given sorbents (for example, activated carbon). You can give your child an antipyretic (such as paracetamol) to bring down the fever.

If the rotavirus infection is severe or complicated, hospitalization is necessary.In the hospital, the child undergoes rehydration (replenishment of the circulating fluid volume), food can be supplied through a tube.



During the course of the illness, a gentle diet is recommended. Dairy products, gas-forming products (cabbage, rye bread, legumes, carbonated drinks) are completely excluded. It is recommended to eat in small portions 5-6 times a day.For the patient, porridge on the water, meat dishes from low-fat beef, turkey, chicken in the form of minced meat, soups on low-fat meat broth or with finely chopped or mashed vegetables are suitable.

Breastfeeding is permitted. On the first day of illness, it is worth focusing on the baby’s appetite and, if necessary, reduce the volume of breastfeeding by no more than 50 – 75% of the age-related food volume. Then increase the volume to normal.

Prevention of rotavirus infection

Rotavirus infection can occur with severe clinical manifestations even in an adult, and a child, especially at an early age, is in serious danger when infected with rotavirus.Therefore, it is so important to know the methods of prevention of rotavirus infection, which may be specific and non-specific.

1. Non-specific prophylaxis of rotavirus infection.

Careful hygiene is related to the non-specific prophylaxis of rotavirus infection. It is called nonspecific, since such prophylaxis is universal for any “dirty hand diseases”, which include rotavirus gastroenteritis.

Preventive measures are especially necessary if your child is attending kindergarten or school.In crowded places, where toys and food are common, the likelihood of infection is much higher.

What you need to do to protect your child

– Make sure that the child thoroughly washed his hands with soap and water before every meal.

– Thoroughly wash vegetables and fruits, and before use, additionally rinse them with hot boiled water.

– Do not allow the child to drink raw water.

It is much more difficult to keep track of babies from 1 to 3 years old who crawl on the floor, pull toys into their mouths.It is necessary to carry out wet cleaning of the apartment where the child lives as often as possible and treat his toys daily with soap and soda solution.

If contact with a patient with rotavirus infection has already occurred, it is more difficult to protect against the disease, but there are still chances. Hands should be thoroughly washed and treated with an antiseptic, and the clothes in which the child was in contact should be washed.

What to do if a family member gets sick with rotavirus

Unfortunately, all family members can become infected at the same time, since the virus is highly contagious and is localized mainly in the family.Asymptomatic carriage of viruses is also widespread among children and adults. In about 70% of children, the shedding of rotaviruses continues until the 20th day in the absence of any symptoms of the disease. Cases of virus isolation from children with persistent diarrhea for 66-450 days have been described. These children and other family members are potentially infectious to those around them.



And yet, in case it was possible to identify the disease earlier, there is a certain set of rules for the family in addition to washing hands and the methods described above:

– If possible, minimize contact with a sick person, if possible, the sick person is given a separate room for 5-7 days.It is necessary to give the patient personal hygiene items and cutlery.

– Ventilate all areas of the house regularly.

– Change your bedding often. It can also stop the spread of the virus.

– Treat the toilet bowl with antiseptics every time a sick person visits the toilet.

2. Specific prevention of rotavirus infection.

However, even careful adherence to all the rules of personal hygiene does not guarantee protection against rotavirus infection, since the virus itself is considered highly contagious, that is, very infectious.There is a second reason, already mentioned above – a sick person is contagious to others, although he himself may not show symptoms of the disease.

Therefore, in accordance with the WHO recommendation, specific prophylaxis of rotavirus infection is required – vaccination. It is known that in those countries that, on the recommendation of WHO, introduced routine vaccination, for example, in the United States, the incidence of rotavirus gastroenteritis in children has significantly decreased.

In the Russian Federation, vaccination against rotavirus infection has been included in the vaccination calendar for epidemic indications.According to the WHO recommendation, the first dose of rotavirus vaccine should be administered as soon as possible after the child reaches 6 weeks of age.

Information provided with the support of MSD Pharmaceuticals LLC,
Russia, 119021, Moscow, st. Timur Frunze 11k1
Tel .: +7 495 916 7100 Fax: +7 495 916 7094 www.msd.ru

* Consultation with a healthcare professional required.

RU-ROT-00088 dated 06.2020

Ebola haemorrhagic fever – Etiology

The Ebola virus belongs to the Filoviridae (filoviruses) family (genus Ebolavirus; order: Mononegavirales).These viruses are elongated filamentous structures of various lengths. [Figure caption and citation for the preceding image starts]: Transmission electron microscopy shows some ultrastructural morphology of the Ebola virion. Centers for Disease Control and Prevention [Citation ends].

Initially acquired virus is believed to be transmitted by contact with body fluids or tissues of infected animals such as bats, monkeys and lower primates; however, the natural reservoir of the pathogen and the mode of its transmission to humans have not been confirmed.[31] Peters CJ, LeDuc JW. An introduction to Ebola: the virus and the disease. J Infect Dis. 1999 Feb; 179 Suppl 1: ix-xvi.

Laboratory testing of the ability to serve as a reservoir of the pathogen shows that effective transmission is possible from bats and rodents, but not from plants or arthropods. [32] Swanepoel R, Leman PA, Burt FJ, et al.Experimental inoculation of plants and animals with Ebola virus. Emerg Infect Dis. Oct-Dec 1996; 2 (4): 321-5.

[33] Reiter P, Turell M, Coleman R, et al. Field investigations of an outbreak of Ebola hemorrhagic fever, Kikwit, Democratic Republic of the Congo, 1995: arthropod studies. J Infect Dis. 1999 Feb; 179 Suppl 1: S148-54.
https: // jid.oxfordjournals.org/content/179/Supplement_1/S148.long

[34] Pigott DM, Golding N, Mylne A, et al. Mapping the zoonotic niche of Ebola virus disease in Africa. Elife. 2014 Sep 8; 3: e04395.

Animal-to-human transmission of the virus can occur during hunting and through ingestion of these reservoir animal species or infected monkeys and lower primates.The local custom of eating bushmeat or food contaminated with the droppings of infected bats (reservoir bats include 3 species of bats that inhabit trees) is also thought to be an infection factor.

[Figure caption and citation for the preceding image starts]: Ecological data for ebolaviruses indicate enzootic and epizootic cycles Centers for Disease Control and Prevention [Citation ends].

Human-to-human transmission occurs through contact with the body fluids of infected patients.[35] Dowell SF, Mukunu R, Ksiazek TG, et al. Transmission of Ebola hemorrhagic fever: a study of risk factors in family members, Kikwit, Democratic Republic of the Congo, 1995. Commission de Lutte contre les Epidemies à Kikwit. J Infect Dis. 1999 Feb; 179 Suppl 1: S87-91.

In previous epidemics, many nosocomial transmissions have been caused by the reuse of non-sterile injecting equipment.[24] Report of an International Commission. Ebola haemorrhagic fever in Zaire, 1976. Bull World Health Organ. 1978; 56 (2): 271-93.

However, although this phenomenon is still a risk factor, most cases result from close physical contact or contact with body fluids (for example, sweat, blood, feces, vomit, saliva, secretions from the genital tract (including semen), as well as breast milk) of infected patients.

The amount of virus in the blood increases during the course of the disease, and patients become most contagious in the later stages of the disease (ie, during diarrhea, vomiting and bleeding). [36] Osterholm MT, Moore KA, Kelley NS, et al. Transmission of Ebola viruses: what we know and what we do not know. MBio. 2015 Feb 19; 6 (2): e00137.

A large number of viruses are found on the skin and, since sweat can also contain the virus, touching an infected patient can transmit the pathogen.[37] Kreuels B, Wichmann D, Emmerich P, et al. A case of severe Ebola virus infection complicated by gram-negative septicemia. N Engl J Med. 2014 Dec 18; 371 (25): 2394-401.

Events associated with the extraordinary spread of the virus in community settings are also increasingly recognized as a conducive to infection: 300 cases were associated with the funeral of a healer in Sierra Leone in 2015.[38] World Health Organization. Sierra Leone: a traditional healer and a funeral. 2014 [internet publication].
One study found that extreme spread factors were responsible for approximately 61% of infections during the 2014 outbreak. [39] Lau MS, Dalziel BD, Funk S, et al. Spatial and temporal dynamics of superspreading events in the 2014-2015 West Africa Ebola epidemic. Proc Natl Acad Sci U S A.2017 Feb 28; 114 (9): 2337-42.


In a study aimed at determining the intensity of viral shedding in different body fluids, the Ebola virus was isolated from saliva, breast milk, stools, tears and semen of patients within a period of up to 40 days after the onset of the disease. [40] Bausch DG, Towner JS, Dowell SF, et al. Assessment of the risk of Ebola virus transmission from bodily fluids and fomites.J Infect Dis. 2007 Nov 15; 196 Suppl 2: S142-7.

[41] Emond RT, Evans B, Bowen ET, et al. A case of Ebola virus infection. Br Med J. 11977 Aug 27; 2 (6086): 541-4.


[42] Rowe AK, Bertolli J, Khan AS, et al.Clinical, virologic, and immunologic follow-up of convalescent Ebola hemorrhagic fever patients and their household contacts, Kikwit, Democratic Republic of the Congo. Commission de Lutte contre les Epidemies à Kikwit. J Infect Dis. 1999 Feb; 179 Suppl 1: S28-35.
The virus can be detected in semen even 12 months or more after recovery from infection, possibly due to the fact that testicular tissue is an immunologically protected area.[43] World Health Organization. Clinical care for survivors of Ebola virus disease: interim guidance. April 2016 [internet publication].
This means that sexual transmission is possible even after a long time after recovery from infection, [40] Bausch DG, Towner JS, Dowell SF, et al. Assessment of the risk of Ebola virus transmission from bodily fluids and fomites. J Infect Dis. 2007 Nov 15; 196 Suppl 2: S142-7.https://jid.oxfordjournals.org/content/196/Supplement_2/S142.long

[41] Emond RT, Evans B, Bowen ET, et al. A case of Ebola virus infection. Br Med J. 11977 Aug 27; 2 (6086): 541-4.


[42] Rowe AK, Bertolli J, Khan AS, et al. Clinical, virologic, and immunologic follow-up of convalescent Ebola hemorrhagic fever patients and their household contacts, Kikwit, Democratic Republic of the Congo.Commission de Lutte contre les Epidemies à Kikwit. J Infect Dis. 1999 Feb; 179 Suppl 1: S28-35.
[44] Rogstad KE, Tunbridge A. Ebola virus as sexually transmitted infection. Curr Opin Infect Dis. 2015 Feb; 28 (1): 83-5.
[45] Sonnenberg P, Field P. Sexual and mother-to-child transmission of Ebola virus in the post-convalescent period. Clin Infect Dis.2015 Mar 15; 60 (6): 974-5.
and such cases were confirmed during and after the outbreak in 2014. [46] Mate SE, Kugelman JR, Nyenswah TG, et al. Molecular evidence of sexual transmission of Ebola virus. N Engl J Med. 2015 Dec 17; 373 (25): 2448-54.

[47] Crozier I. Ebola virus RNA in the semen of male survivors of Ebola virus disease: the uncertain gravitas of a privileged persistence.J Infect Dis. 2016 Nov 15; 214 (10): 1467-9.

[48] ​​Thorson A, Formenty P, Lofthouse C, et al. Systematic review of the literature on viral persistence and sexual transmission from recovered Ebola survivors: evidence and recommendations. BMJ Open. 2016 Jan 7; 6 (1): e008859.

http: // www.ncbi.nlm.nih.gov/pubmed/26743699?tool=bestpractice.com
The Ebola virus has also been found in vaginal secretions. [49] Rodriguez LL, De Roo A, Guimard Y, et al. Persistence and genetic stability of Ebola virus during the outbreak in Kikwit, Democratic Republic of the Congo, 1995. J Infect Dis. 1999 Feb; 179 Suppl 1: S170-6.

Virus shedding can also continue in urine and sweat.In one patient in Germany who recovered from infection, the virus was detected in urine 14 days after serum testing for the virus became negative, and in sweat up to 19 days after becoming undetectable in serum. [37] Kreuels B, Wichmann D, Emmerich P, et al. A case of severe Ebola virus infection complicated by gram-negative septicemia. N Engl J Med. 2014 Dec 18; 371 (25): 2394-401.

http: // www.ncbi.nlm.nih.gov/pubmed/25337633?tool=bestpractice.com

It has been shown that the inhalation route of infection – through inhalation of the infectious agent – is possible among monkeys and lower primates; however, there is no evidence of airborne transmission of the virus in humans. [14] Mahanty S, Bray M. Pathogenesis of filoviral haemorrhagic fevers. Lancet Infect Dis. 2004 Aug; 4 (8): 487-98.

http: // www.ncbi.nlm.nih.gov/pubmed/15288821?tool=bestpractice.com
[50] Judson S, Prescott J, Munster V. Understanding Ebola virus transmission. Viruses. 2015 Feb 3; 7 (2): 511-21.

It should also take into account the possibility of opportunistic airborne transmission of the virus present in the air during severe vomiting (similar to that observed with norovirus infection), as well as during aerosol-generating procedures associated with surgical intensive care measures.

Outside endemic regions, Ebola virus infection is rare and is usually imported. [51] Beeching NJ, Fletcher TE, Hill DR, et al. Travelers and viral haemorrhagic fevers: what are the risks? Int J Antimicrob Agents. 2010 Nov; 36 Suppl 1: S26-35.

Travelers arriving from the contaminated area, as well as laboratory scientists and other workers who come into contact with potentially infectious materials and animals, are at high risk of infection.

Centers for Disease Control and Prevention (CDC): Ebola transmission
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Norovirus is … What is Norovirus?

Transmission electron microscope photograph of norovirus. Resolution = 50 nm
Scientific classification
Domain: Viruses [1]
Family: Caliciviridae
Gender: Norovirus
International scientific name


Baltimore Group

IV: (+) ssRNA viruses

Norovirus (originally named Norwalk virus) is an RNA virus of the Caliciviridae family [2] .In about 90% of cases, this virus is the cause of epidemics of gastrointestinal diseases of a non-bacterial nature worldwide [3] [4] , and in the USA it is responsible for the occurrence of gastroenteritis in 50%. [5] Noroviruses can affect people of all ages. Viruses are transmitted through direct contact with a sick person and much less often through the fecal-oral route through contaminated food or water. [6]

In a person who has been ill, immunity is usually not fully developed and is temporary. [7] There is a congenital predisposition to infection, people with the first blood group get sick more often [3] [8] , while the third and fourth blood groups are less susceptible to the pathogen.

Outbreaks of diseases caused by norovirus are more likely to occur in closed or semi-closed facilities such as hospitals, prisons, hostels and cruise ships, where the virus once appeared and the infection spreads very quickly from person to person or through contaminated food. [9] In many cases, norovirus has been transmitted through food as soon as one infected person touches it. [10]

Norovirus can be quickly deactivated with chlorine-containing disinfectants, but because these viral particles are lipidless, norovirus is more resistant to alcohol and detergents. [11]

Several norovirus genogroups are distinguished, and most of the norovirus infecting humans are classified into the GI and GII genogroups. [12]


Norovirus was originally named Norwalk-like virus in Norwalk, Ohio, where an outbreak of acute gastroenteritis was reported in November 1968 among elementary school students. In 1972, as a result of immunoelectron microscopy of canned fecal samples, a virus was discovered, which was called the Norwalk virus. Since then, numerous illnesses with similar symptoms have been reported. Cloning and sequencing of the Norwalk virus genome has shown that these viruses have the same genomic organization as viruses of the Caliciviridae family. [13] The name norovirus (genus Norovirus) was approved by the International Committee on Virus Taxonomy in 2002. [14]

Typical diseases caused by noroviruses include diseases of the gastrointestinal tract in the autumn-winter period, one of the symptoms of which is nausea, viral gastroenteritis [6] , as well as the popularly known “stomach flu” – the list can be supplemented by diseases associated with inflammation of the stomach and arising from other viruses and bacteria.

Some other former names may be used to search PubMed and the Internet: Norwalk Virus, SRSVs (Small Round Viruses), Sapporo-type Virus and Snow Mountain-type Virus. [15]


The incubation period is from 10 to 72 hours, in most cases the symptoms develop in a day or two.

This is usually a self-healing disease, its characteristic signs are nausea [16] , vomiting, diarrhea, as well as pain in the abdomen, in some cases loss of taste sensitivity.In children, as a rule, vomiting predominates in symptoms, in adults – diarrhea. Drowsiness, lethargy, muscle pain, and mild fever may occur. Symptoms can last for several days, and if dehydrated is ignored and not dealt with, the disease can be life-threatening. The risk group includes children, the elderly and patients with weakened immune systems. Once in the human body, norovirus replicates in the small intestine.


Norovirus is usually diagnosed by polymerase chain reaction (PCR) tests or by real-time PCR tests, which show the result within a few hours.These analyzes are quite sensitive and can determine the concentration of up to 10 viral particles. [17]

Tests such as enzyme-linked immunosorbent assay (ELISA) using antibodies against different strains of norovirus are commercially available, but they lack accuracy and sensitivity. [18]

Prevention and infection control

Hand washing remains one of the most effective means of preventing the spread of pathogens (in this case, norovirus).Norovirus can enter the air through the patient’s vomit. All surfaces in places where Norovirus may be present should be disinfected.

In order to prevent nosocomial infection in medical institutions, a number of activities are carried out, including daily wet cleaning. In medical institutions where the spraying of chlorides and other caustic compounds negatively affects medical electronics, NAV-CO2 systems are used. [19]

Ligocyte is developing a vaccine and has already started the first clinical phase of trials. [20]

Foodborne contamination

Noroviruses are transmitted through direct contact with a sick person or indirectly through contaminated water or food. A report from the Center for Disease Control (CDC), which targeted 11 outbreaks in New York State, said that 7 cases were thought to be transmitted from person to person, 2 cases from foodborne illness, 1 case from water and the cause of another case is unknown. Contaminated water enters the human body in several ways, it can be tap water, water from a well, open public reservoirs, swimming pools and water from vending machines with ice cubes. [21]

Seafood and Salad Ingredients is the food most often associated with Norfolk outbreaks. Eating raw or poorly cooked shellfish and oysters poses a high risk of Norfolk virus infection. Other food items can be contaminated from the sick person while they are preparing food. [22]


In the USA, viral gastroenteritis is second only to the common cold in the number of registered visits to the doctor.Despite the fact that many different viruses can cause viral gastroenteritis, it is believed that about 1/3 of cases of the causative agent of the disease in infants from 6 to 24 months were noroviruses. In developing countries, the percentage of people who develop immunity at an early age is very high. In the United States, the percentage gradually increases over time and has reached 50% among the population over 18 years old. Nevertheless, post-infectious immunity is short-lived and does not exclude re-infection. According to modern research, the third and fourth blood groups have partial protection against symptomatic infection. [23] [24]

Course of the disease and complications

Norovirus causes acute gastroenteritis. The incubation period lasts from 24 to 48 hours, more often 33-36 hours, the disease lasts 24-60 hours. Complications are rare: most often, patients are treated in emergency rooms and are rarely referred to regular hospitals. According to experts, every year in the United States, about 300 patients die from this infection, primarily young children, the elderly and people with weakened immune systems.

The most common genotype in hospitalized children is GII.4 and an increased dose of viral particles (7.2 x 107) was found in them. So, Norovirus GII.4 was most often identified, other genotypes were identified in a smaller percentage of cases, including the new GII.18-NICA. [ source not specified 1307 days ]

Detection of norovirus in food

Standard reverse transcriptase polymerase chain reaction (PCR) tests for norovirus (RNA virus) in edible shellfish and oysters are requested by government laboratories such as the FDA in the United States.At the same time, standard methods for determining the presence of the virus in food are not always readily available due to the heterogeneous origin of different products, which affects the concentration and extraction of the virus, and the presence of factors that make PCR (polymerase chain reaction) analysis methods ineffective. [25]



Photograph of norovirus particles in feces taken using a transmission microscope

Noroviruses (NoV) are viruses without an outer envelope of the family Caliciviridae, the genome of which is represented by single-stranded RNA, and there are several genetic groups. [26] According to the International Committee on Taxonomy of Viruses, the genus Norovirus has one species – “Norwalk virus”, abbreviated “NV”. Serotypes, strains and isolates include:

  • Desert Shield virus [U04469] (Hu / NLV / DSV395 / 1990 / SR)
  • Lordsdale virus [X86557] (Hu / NLV / LD / 1993 / UK)
  • Mexico virus [U22498] (Hu / NLV / MX / 1989 / MX)
  • Norwalk virus [M87661] (Hu / NLV / NV / 1968 / US)
  • Hawaii virus [U07611] (Hu / NLV / HV / 1971 / US)
  • Snow Mountain virus [L23831] (Hu / NLV / SMV / 1976 / US)
  • Southampton virus [L07418] (Hu / NLV / SHV / 1991 / UK)

Noroviruses are the leading cause of acute gastroenteritis worldwide, often manifested in group outbreaks in institutions.Noroviruses are highly infectious, with 10 viral particles already capable of causing an infection. The disease is transmitted through contaminated food or water and from person to person. The transmission mechanism is mainly fecal-oral, but there is a possibility of infection by airborne droplets, when pathogens enter the air with droplets of vomit. Noroviruses are classified into two genogroups: Genogroup I (GI) includes Norfolk virus, Desert Shield virus and South Hampton virus, and Group II (GII) includes Bristol virus, Lordsdale virus, Toronto virus, Mexico virus, Hawaii virus, and Snowy Mountains virus.

Noroviruses can be classified into 5 genogroups (GI, GII, GIII, GIV and GV), which are further subdivided into different clusters or genotypes. For example, gene group II, the most prevalent “human” genogroup, still contains 19 genotypes. Genogroups I, II, and IV cause damage in humans, while genogroup III infects cattle. Genogroup V has recently been found in mice. [27]

Noroviruses of genogroup II, genotype 4 (abbreviated as GII4) are the cause of most outbreaks of gastroenteritis in adults and often travel across the planet.Recent samples contain a US95 / 96-US strain that is associated with global outbreaks of the mid to late 90s, Farmington Hills virus is associated with outbreaks in Europe and the United States in 2002, and Hunter virus – with outbreaks in Europe, Japan and Australasia in 2004. 2006 saw another global wave of norovirus infection. [28] In December 2007, an outbreak was reported at a country club in northern California, where about 80-100 people were infected.Two new variants of GII.4 were responsible for about 80% of these Norovirus-related outbreaks. They were named 2006a and 2006b, and recent reports suggest a link between blood type and susceptibility to norovirus infection. [29] [30] [31]

Scientists at the University of Washington Medical School in St. Louis, in their study published in the journal PLoS Pathogens (July 18, 2008), suggest that the MDA-5 protein may be the primary immune sensor that detects the presence of noroviruses in the body. [32] Interestingly, some people share variations in the MDA-5 gene, making them more susceptible to norovirus infection. [33]

Virus structure

The genome of norovirus is a single-stranded (+) RNA of approximately 7.5 kb, containing 3 open reading frames encoding a non-structural polypeptide that undergoes autoproteolysis to form 5 active proteins, the main structural protein (VP1) within 58 ~ 60 kDa and minor capsid protein (VP2). [34] When viewed through an electron microscope, viral particles exhibit an amorphous surface structure, the size of viral particles is between 27-38 nm. [35]


  1. Taxonomy of viruses on the website of the International Committee on Taxonomy of Viruses (ICTV).
  2. ICTVdB Family 00.012. Caliciviridae
  3. 1 2 Lindesmith L, Moe C, Marionneau S, et al (2003).”Human susceptibility and resistance to Norwalk virus infection.” Nat. Med. 9 (5): 548-53. DOI: 10.1038 / nm860. PMID 12692541.
  4. Norovirus: Technical Fact Sheet. National Center for Infectious Diseases, CDC. Archived from the original on March 24, 2012.
  5. Widdowson MA, Sulka A, Bulens SN, et al (2005). Norovirus and foodborne disease, United States, 1991-2000. Emerging Infect.Dis. 11 (1): 95-102. PMID 15705329.
  6. 1 2 Goodgame R (2006). Norovirus gastroenteritis. Curr Gastroenterol Rep 8 (5): 401-8. DOI: 10.1007 / s11894-006-0026-4. PMID 16968608.
  7. Lindesmith L, Moe C, Lependu J, Frelinger JA, Treanor J, Baric RS (2005). Cellular and humoral immunity following Snow Mountain virus challenge. J. Virol. 79 (5): 2900-9. DOI: 10.1128 / JVI.79.5.2900-2909.2005. PMID 15709009.
  8. 90,500 Hutson, AM; Atmar RL, Graham DY, Estes MK. (July 2003). Norwalk virus infection and disease is associated with ABO histo-blood group type. Journal of Infectious Diseases 188 (1): 176-7.

  9. Noda M, Fukuda S, Nishio O (2007). “Statistical analysis of attack rate in norovirus foodborne outbreaks.” Int J Food Microbiol 122 : 216 DOI: 10.1016 / j.ijfoodmicro.2007.11.073. PMID 18177970.
  10. Koopmans M, Duizer E (2004). Foodborne viruses: an emerging problem. Int. J. Food Microbiol. 90 (1): 23–41. DOI: 10.1016 / S0168-1605 (03) 00169-7. PMID 14672828.
  11. Jimenez L, Chiang M (2006). “Virucidal activity of a quaternary ammonium compound disinfectant against feline calicivirus: a surrogate for norovirus.” Am J Infect Control 34 (5): 269-73. DOI: 10.1016 / j.ajic.2005.11.009. PMID 16765204.
  12. Vinjé J, Green J, Lewis DC, Gallimore CI, Brown DW, Koopmans MP (2000). “Genetic polymorphism across regions of the three open reading frames of” Norwalk-like viruses “”. Arch. Virol. 145 (2): 223-41. PMID 10752550.
  13. 90,500 ↑ 90,086 Kapikian AZ (1996). “Overview of viral gastroenteritis”. Arch.Virol. Suppl. 12 : 7-19. PMID


    90,500 ICTVdB Management (2006). Norovirus. In: ICTVdB – The Universal Virus Database, version 4. Büchen-Osmond, C. (Ed), Columbia University, New York, USA

  14. Appleton H (1987). “Small round viruses: classification and role in food-borne infections”. Ciba Found. Symp. 128 : 108-25. PMID 3036438.
  15. 90,500 90,085 ↑ 90,086 Children in the Zerkalny camp were infected with norovirus

  16. Marshall JA, Bruggink LD (2006).Laboratory diagnosis of norovirus. Clin. Lab. 52 (11-12): 571-81. PMID 17175887.
  17. Wilhelmi de Cal I, Revilla A, del Alamo JM, Román E, Moreno S, Sánchez-Fauquier A (2007). “Evaluation of two commercial enzyme immunoassays for the detection of norovirus in faecal samples from hospitalized children with sporadic acute gastroenteritis.” Clin. Microbiol. Infect. 13 (3): 341-3. DOI: 10.1111 / j.1469-0691.2006.01594.x. PMID 17391396.
  18. Chadwick PR, Beards G, Brown D, Caul EO, Cheesbrough J, Clarke I, Curry A, O’Brien S, Quigley K, Sellwood J, Westmoreland D (2000). “Management of hospital outbreaks of gastro-enteritis due to small roundstructured viruses”. J. Hosp. Infect. 45 (1): 1-10. DOI: 10.1053 / jhin.2000.0662. PMID 10833336.
  19. http://www.ligocyte.com/downloads/Noro.pdf Norovirus candidate vaccine from Ligocyte
  20. Hedberg CW, Osterholm MT (1993).Outbreaks of food-borne and waterborne viral gastroenteritis. Clin. Microbiol. Rev. 6 (3): 199-210. PMID 8395330.
  21. Parashar UD, Monroe SS (2001). “” Norwalk-like viruses “as a cause of foodborne disease outbreaks”. Rev. Med. Virol. 11 (4): 243-52. DOI: 10.1002 / rmv.321. PMID 11479930.
  22. Norwalk Virus Infection and Disease Is Associated with ABO Histo-Blood Group Type, The Journal of Infectious Diseases . Retrieved 5 February 2007.
  23. Binding of Norwalk Virus-Like Particles to ABH Histo-Blood Group Antigens Is Blocked by Antisera from Infected Human Volunteers or Experimentally Vaccinated Mice, Journal of Virology . Retrieved 5 February 2007.
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  25. Department of Health and Aging Norovirus laboratory case definition
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  28. Huang P, Farkas T, Marionneau S, Zhong W, Ruvoën-Clouet N, Morrow AL, Altaye M, Pickering LK, Newburg DS, LePendu J, Jiang X (2003). “Noroviruses bind to human ABO, Lewis, and secretor histo-blood group antigens: identification of 4 distinct strain-specific patterns.” J. Infect. Dis. 188 (1): 19–31. DOI: 10.1086 / 375742. PMID 12825167.
  29. Huang P, Farkas T, Zhong W, Tan M, Thornton S, Morrow AL, Jiang X (2005). Norovirus and histo-blood group antigens: demonstration of a wide spectrum of strain specificities and classification of two major binding groups among multiple binding patterns. J. Virol. 79 (11): 6714-22. DOI: 10.1128 / JVI.79.11.6714-6722.2005. PMID 15890909.
  30. Rockx BH, Vennema H, Hoebe CJ, Duizer E, Koopmans MP (2005). Association of histo-blood group antigens and susceptibility to norovirus infections. J. Infect. Dis. 191 (5): 749–54. DOI: 10.1086 / 427779. PMID 15688291
  31. McCartney SA, Thackray LB, Gitlin L, Gilfillan S, Virgin Iv HW, Colonna M (July 18 2008). “MDA-5 recognition of a murine norovirus.” PLoS Pathog . PMID 18636103.
  32. Researchers Discover Primary Sensor That Detects Stomach Viruses Newswise, Retrieved on July 20, 2008.