Norovirus infection medical therapy

Supportive care is the mainstay of therapy for norovirus infection. Treatment includes oral/IV fluid administration to replace fluids lost from vomiting and diarrhea and correcting electrolyte disturbances. Anti-motility and anti-emetic agents may be administered for symptomatic relief among adults only (controversial efficacy). Antimicrobial agents, including antiviral agents, are generally not recommended to treat norovirus infection.

• Supportive care is the mainstay of therapy for norovirus infection.
• Antibiotic agents are not recommended since norovirus infection is caused by a virus not a bacterial agent.
• Antiviral agents are generally not recommended among patients who are not immunocompromised.
• Hospitalized patients should be isolated to prevent further transmission. Healthcare professionals must wear personal protective equipment and practice hand hygiene when exposed to infected patients.^[1] To learn more about preventive measures, click here.

• Rehydration therapy is the most important therapeutic strategy to treat patients with norovirus infection.^[2][3][4]

• Rehydration is indicated to replace fluids lost from vomiting and diarrhea and correcting electrolyte disturbances.
• Oral rehydration fluids is indicated among patients who can tolerate oral intake, otherwise IV rehydration is indicated.
• Over the counter oral rehydration solutions (ORS) are optimal options for oral rehydration and are usually available for both adults and children.
• Oral rehydration solutions may be home-made by mixing the following:

• Drinking water: 1 liter
• Salt: 0.5 teaspoon
• Sugar: 6 teaspoons

• Rehydration must be gradual until signs of dehydration (e.g. dry mouth, oliguria) are resolved. Drinking ORS must be slow (1 sip every 5 minutes).
• Children often require 1 liter of ORS, whereas adults often require 3 liters of ORS.
• Energy drinks with high concentrations of electrolytes (e.g. sports drinks) may be offered to adults, but not children.
• Fluids high in sugar content (e.g. soda) are not recommended because they may worsen the dehydration.

• Anti-motility and anti-emetic agents may be administered for symptomatic relief in adults (controversial efficacy, may mask infectivity of patients). However, these agents are contraindicated among pediatric patients due to high risk of associated adverse effects.
• Anti-diarrheal agents are not recommended.^[5]

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