Norovirus

Norovirus is the most common cause of infectious gastroenteritis (diarrhoea and vomiting) in England and Wales.It is estimated that norovirus affects between 600,000 and a million people in the UK each year. There is usually a peak of norovirus infection during the winter months and it has been called the “winter vomiting disease”.

The main symptoms are:

• nausea and vomiting (often sudden and severe)
• diarrhoea
• stomach cramps

Some people may also have:

• a fever (a high temperature)
• headache
• muscle aches
• tiredness

Although unpleasant, it is rarely dangerous. Most people start feeling ill within a day or two of catching it. Usually symptoms last for one to two days and most people make a full and speedy recovery. There are no long-term effects from norovirus infection.

Norovirus infection affects people of all ages. The very young and elderly should take extra care if infected, as dehydration is more common in these age groups and may need hospital treatment. People do not become immune to Norovirus and may have it many times in their lifetime.

In hospital any patient who becomes ill with diarrhoea or diarrhoea and vomiting will have a sample of diarrhoea sent to a laboratory for testing. It usually takes one to three working days to get the results.

Norovirus is very infectious. It can spread very easily and quickly from one person to another. The infection can be spread from the moment a person first feels ill, until two days after they feel better.

Someone with a norovirus infection remains infectious for up to 48hours after the symptoms have ended.

Infection can spread easily in areas where there are large numbers of peoples such as hospitals, nursing homes, schools and cruise ships. In hospitals it can affect patients, staff and visitors.

The virus is passed on in an infected person’s vomit or diarrhoea. So it can be caught in a number of ways:

• By being with an infected person. This can happen if you are looking after someone who is ill. So patients, nurses, carers and parents are particularly at risk. You can also catch it by sharing, for example, food or cutlery.
• By eating contaminated food. You can catch the infection by eating or drinking something with the virus in it.
• By touching surfaces or objects that have the virus on them. You can get the virus on your hands (and not see it) by touching, for instance, a cup or toilet used by an infected person. Then, by touching your mouth, the virus can spread into your body. 

When there are high levels of this infection in the community, it is very difficult to prevent patients, staff and visitors bringing the infection into hospital. The virus spreads quickly and easily and not all infections can be prevented. Norovirus can disturb the normal working of the hospital and causes distress to those infected and their friends and families. Particular attention to good hygiene measures should be observed during outbreaks. 

• Patients with norovirus are isolated. This is to prevent other patients, visitors or staff becoming infected. A patient may be looked after in a single room.
• If a number of patients are ill at the same time, they maybe looked after together in one part of the ward.
• If a large number of patients are affected the ward may even be closed to new patients until the infection has cleared up.
• If a patient has norovirus it may be necessary to delay some planned investigations or operations until they are feeling better.
• Alcohol hand gel has limited effect on norovirus therefore hands must be washed with soap and water.
• Staff and visitors should wash their hands with soap and water before and after being with a patient with norovirus infection or their surroundings.
• Cleaning of ward areas and the toilets is increased. This will help remove the virus from the environment and decrease the risk of infection in others.
• If a patient or visitor has a bout of diarrhoea or vomiting anywhere in the hospital please mention this to the staff in charge, as we will give the toilets an extra clean.
• Visiting may be restricted. Visitors to a ward where there are cases of norovirus, are at risk of catching the infection. Norovirus is very infectious and may spread despite measures. Children, frail or elderly should avoid visiting if possible. 
• Visitors are asked not to visit if they or other members of their household have had diarrhoea and/or vomiting within the past 48 hours. They should delay coming into hospital until they are better.
• If possible, the patient will not be moved to another ward, hospital or clinic until the infection has cleared up. 

There is no specific treatment for norovirus. The illness generally gets better on its own after two days. Antibiotics do not work because they kill bacteria not viruses. It is important to drink plenty of fluids to prevent dehydration. There is no vaccine to prevent the infection. 

A patient with norovirus infection will generally not be discharged from hospital until the diarrhoea has resolved completely. If there is a recurrence of diarrhoea a patient should see their general practitioner.

Infection Prevention & Control Team
5th Floor Central
250 Euston Road
London
NW1 2PG
Telephone: 0203 447 9716

Department of Health Website: https://www.gov.uk/
UK Health Security Agency (UK HSA) Website:https://www.gov.uk/government/organisations/uk-health-security-agency