Norovirus - enough to make you sick!

Affecting as many as one million UK people annually, norovirus is a scourge of the late autumn and winter months. It can occur all year round, but its seasonal proliferation has led to it being labelled as the ‘winter vomiting bug’. Fortunately, despite its unpleasantness, it is a condition that can almost always be managed through self-care. (1, 2)

What is norovirus?

Norovirus is a general term for a number of different viruses that can be responsible for gastroenteritis (inflammation of the stomach and intestines), the main symptoms of which are sudden onset nausea (feeling sick), projectile vomiting (being sick with force) and diarrhoea. Other symptoms can include mild fever, stomach ache and aching in the arms and legs. Norovirus is highly contagious and often occurs in ‘outbreaks’ in which several people in a particular area or institution, such as schools, workplaces, care homes, hospitals, cruise ships or restaurants, are infected around the same time. (1, 2)

What can I do if I contract norovirus?

Norovirus is, on the whole, self-limiting. This means it clears up of its own accord without treatment. It doesn’t usually take longer than three days for the infection to run its course. Whilst you’re ill, these tips should help you to deal with the symptoms and to make sure you stay well-nourished and hydrated. (2)

• Drink plenty of water as vomiting and diarrhoea can cause dehydration. Juice or soup can be taken as well as water; however, don’t give juice or fizzy drinks to children as it can make diarrhoea more severe. Babies should be fed as normal, via breast or bottle.

• Fever and body aches can be alleviated with paracetamol.

• Stay indoors and rest as much as possible to allow your body to conserve the energy it needs to recover.

• If you think you are able to eat, stick to plain foods (such as bread, pasta, rice, potato).

• Look out for dark urine and dry mouth – these are signs of dehydration. Signs in babies and young children include a sunken soft spot on the head (babies only), sunken eyes, reduced tear production, urinating less frequently and, as with adults, dark urine and dry mouth. Rehydration sachets to be mixed with water can be bought over the counter at pharmacies and can be used at all ages.

• Over the counter medication to help with nausea, vomiting and diarrhoea, such as loperamide and bismuth subsalicylate, can be taken by adults. However, if you take any other medication, be sure to check with the pharmacist or read the leaflet within the package to make sure these products are safe to take alongside. (2)

Do I need to see the GP?

Don’t go to your GP surgery if you have norovirus, as this can assist its spread to other people. Additionally, as previously mentioned, there is no treatment for norovirus. If you need advice, you can call NHS Direct on 111 or speak to your GP over the phone. (2)

There are certain complications which can arise with norovirus. If you experience any of the following, call your GP or 111 as soon as possible:

• Symptoms have not eased after three days

• Blood in diarrhoea

• Severe dehydration (dizziness, losing consciousness, greatly reduced or no urination)

• Your child has had at least six episodes of diarrhoea or three episodes of vomiting in the last 24 hours

• Your child isn’t as responsive as usual, has a fever or a pallid appearance

You should also call for medical advice if you have a serious health issue such as kidney disease, and you contract norovirus. (2)

Reducing the spread of norovirus

Norovirus is highly contagious and it would be impossible to completely stop the spread. Nevertheless, the following steps can help to protect you and others around you during an outbreak.

• Wash your hands regularly with soap and water. This is especially important after using the toilet and before preparing or eating food.

• Regularly clean surfaces with a bleach-based disinfectant.

• Wash clothes, towels and bedding on a hot wash.

• Don’t share towels.

• Flush the toilet straight after an episode of vomiting or diarrhoea and disinfect the area.

• Wash fruit and veg before preparation and ensure food is thoroughly cooked before eating.

• Don’t return to school or work or make hospital visits before 48 hours have passed since your last symptom. (2)

References

1. NHS. Norovirus [cited 23rd April 2018]. Available from: https://www.nhs.uk/conditions/norovirus/

2. NHS Choices. Norovirus [cited 7 November 2017]. Available from: https://www.nhs.uk/conditions/norovirus/

   Author: Gabby Gallagher MPharm

   Medically reviewed by: Superintendent pharmacist Margaret Hudson BSc(Hons)MRPharmS 10/11/17