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Norovirus Outbreak In The UK: Symptoms, Prevention And Everything You Need To Know

Amidst the COVID-19 pandemic, another highly infectious virus, Norovirus, also known as the vomiting bug, has been reported in the United Kingdom. Public Health England (PHE) recently issued a warning after finding a jump in norovirus cases during routine surveillance.

Since the end of May, 154 cases of norovirus have been recorded in England, and PHE said that this is a three-fold increase in cases over the same time period during the previous five years. The heightened concern regarding this virus outbreak is that it is increasingly being reported in educational settings, particularly in nursery and childcare facilities in the country [1].

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What Is Norovirus?

Also called the winter vomiting bug, norovirus is a highly contagious virus that causes vomiting and diarrhoea, says the Centers for Disease Control and Prevention (CDC). Noroviruses (NoV) are a genetically diverse group of single-stranded positive-sense RNA, non-enveloped viruses belonging to the family Caliciviridae.

People with norovirus illness can shed billions of virus particles around them. Only a few of them are necessary to make other people sick - exactly 18 virus particles [2].

This stomach can be very unpleasant but usually goes away in about two days. People of all ages can get infected and sick with norovirus. The CDC adds that an individual can get norovirus illness many times in your life because there are many different types of noroviruses [3].

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And, being infected with one type of norovirus may not protect you against other types; however, it is possible to develop immunity to specific types, and it is not known exactly how long immunity lasts.

What Are The Symptoms Of Norovirus Infection?

Norovirus is the most common cause of vomiting and diarrhoea and foodborne illness. The symptoms of norovirus infection are as follows [4]:

  • Diarrhoea
  • Vomiting
  • Nausea
  • Stomach pain
  • Fever
  • Chills
  • Headache
  • Body aches
  • Norovirus causes inflammation of the stomach or intestines (acute gastroenteritis), and a person usually develops symptoms 12 to 48 hours after being exposed to the virus. The constant diarrhoea and vomiting can lead to dehydration, especially in young children, older adults, and people with other illnesses.

    Note: Children who are dehydrated may cry with few or no tears and be unusually sleepy or irritated [5].

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How Does Norovirus Spread?

The virus is usually spread by the faecal and oral routes. Noroviruses are transmitted directly from person to person (62-84 per cent of all reported outbreaks) and indirectly via contaminated water and food.

The CDC highlights that the norovirus spreads very easily and quickly in different ways, such as the following [6]:

  • Eating food or drinking liquids that are contaminated with norovirus
  • By coming in direct contact with an infected person
  • By touching contaminated surfaces and then putting those unwashed hands in the mouth
  • The other ways an affected/recovered person can spread the virus are as follows:

    • You can continue to spread the virus for two weeks or longer after symptoms fade.
    • The virus can survive outside your body for several days.
    • The virus has a short incubation period; that is, you can spread it around before realising you are sick.
    • You can have the virus but not have any symptoms; however, you are capable of spreading it around.
    • How Is Norovirus Infection Diagnosed?

      In most cases, a doctor can diagnose norovirus based on the person's symptoms. It can also be detected in a stool sample (will be ordered for people with an underlying health issue or weakened immune system).

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How Is Norovirus Infection Treated?

There is no specific medicine for the treatment of norovirus. Most people will recover from norovirus without needing any treatment. However, older adults, small children, and people with underlying medical conditions can be more susceptible to dehydration and may therefore require medical treatment or hospitalisation [7].

Experts suggest that people with viral infection should drink plenty of water and other liquids to replace fluid lost from vomiting and diarrhoea and prevent dehydration [8]. Rest is also very important while recovering.

Infants who are recovering from norovirus should continue breastfeeding or formula feeding while being rehydrated. For children and adults, the following foods are some healthy and good choices while recovering:

  • Soup
  • Rice
  • Plain noodles
  • Pasta
  • Eggs
  • Potatoes
  • Bread
  • Fresh fruit
  • Yoghurt
  • Cooked vegetables
  • Lean proteins like chicken and fish
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Norovirus In Babies/Infants/Children

As the CDC points out, babies and toddlers are particularly vulnerable to norovirus infection and are more likely to have severe complications. Norovirus spreads quickly among children. Norovirus symptoms in babies, infants and children are as follows [9]:

  • Irritability or fussiness
  • Sleepiness
  • Vomiting
  • Diarrhoea
  • For infants, dehydration can cause complications and, in some cases, death. Call your paediatrician if your child is under six months old and has vomiting or diarrhoea, isn't producing tears, has a fever, has bloody diarrhoea, has had symptoms lasting two days, has an underlying health problem and produces little to no urine.

    How To Prevent The Spread Of Norovirus?

    According to the CDC, the following measures can help prevent the onset of the norovirus infection:

    • Practising proper hand hygiene (washing with water and soap or using alcohol-based hand sanitiser)
    • Washing hands after using the toilet or changing diapers, before eating, preparing, or handling food
    • Washing hands before giving yourself or someone else medicine
    • Can Vaccination Be Given If Your Baby Has A Cold or Cough?

      Is Norovirus Dangerous? Can It Be Fatal?

      Norovirus is found in the faces and vomit of people who have been infected with the virus. People with the infection can release billions of norovirus particles, and only a few of these particles can make an individual fall sick. So, is norovirus dangerous? Yes. It can cause death in people who are older or immunocompromised or in women who are pregnant.

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      However, getting norovirus when you are pregnant should not harm your baby. However, if you have diarrhoea and vomiting while pregnant, it's a good idea to contact your doctor right away.

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Is Norovirus Infection Common?

Norovirus is the most common cause of acute gastroenteritis. According to the CDC, about one out of every five cases of acute gastroenteritis that leads to diarrhoea and vomiting is caused by norovirus.

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About 200 million cases are seen among children under five years old, leading to an estimated 50,000 child deaths annually, mostly in developing countries, and is a problem in both low- and high-income countries [10].

Norovirus illnesses and outbreaks are usually more common in cooler (winter) months.

On A Final Note...

Norovirus illness is not related to the flu. However, it is important to maintain proper hand hygiene to prevent catching the norovirus.

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