Norovirus Infection Management

Primary Treatment Approach

The illness is typically self-limiting, lasting 12-72 hours in immunocompetent individuals 1

Immunocompromised patients are at risk for prolonged infection lasting months to years, with potential for severe malnutrition, villous atrophy, and continuous viral shedding 2
A considerable mortality rate of up to 25% has been reported in allogeneic stem cell transplant patients 2

Handwashing with soap and running water for a minimum of 20 seconds is essential, as alcohol-based hand sanitizers have limited efficacy against norovirus 1, 3
Alcohol-based sanitizers (≥70% ethanol) may be used as an adjunct between proper handwashings but should never substitute for soap and water 1, 3, 4
Ill staff must be excluded until 48-72 hours after symptom resolution 1, 3
In institutional settings, isolate ill individuals until 24-48 hours after symptom resolution 1, 3
After initial cleaning, disinfect contaminated surfaces using chlorine bleach solution at 1,000-5,000 ppm (1:50 to 1:10 dilution of household bleach) or EPA-approved disinfectants 1, 3

Real-time PCR is the diagnostic method of choice (sensitivity 94%, specificity 92%) 2
Collect stool specimens within 72 hours of symptom onset for optimal diagnostic yield 1, 3