Viral Gastroenteritis due to Norovirus

What is Norovirus?

Viral gastroenteritis, caused by small round structured viruses (SRSVs) is a frequent cause of diarrhoea and vomiting in the community and the commonest cause of outbreaks of gastroenteritis in hospitals. These viruses are also known as winter vomiting disease, gastric’ flu, and Norovirus.

What are the symptoms of Norovirus?

• The incubation period (time between getting the virus and developing symptoms) is 12 to 48 hours.

• The onset is very sudden, typically without any warning.

• Those affected may experience either vomiting, which can be quite explosive (projectile), and / or diarrhoea (runny, watery bowel action).

• Some people may also feel generally unwell and have abdominal (tummy) pain.

• The illness is self-limiting (it resolves on its own without medication) and generally lasts one to three days.

• There is no specific treatment other than rest and drinking plenty of fluids to prevent dehydration. Antibiotics are of no benefit against viral illnesses such as this. In some cases, some elderly patients may need intravenous (IV) fluids given via a drip to prevent dehydration.

How is Norovirus spread?

Norovirus is a community-acquired illness and is present within the general community throughout the year, often causing outbreaks in schools, colleges, nurseries, hotels, and cruise ships.

Outbreaks can occur in hospitals in a number of ways.

• A patient who is incubating the illness may be admitted to hospital and then become ill.

• It may also be brought into the hospital by visitors / members of the public who have symptoms.

• Additionally, healthcare staff may also incubate the illness and then become ill on duty.

As the onset of the illness is so sudden and there are no warning signs, it is not possible to see if a person has the illness until symptoms develop. Norovirus is very infectious and can spread to other people very quickly.

What precautions are taken in hospital?

Depending upon the number of patients affected on a ward, it may be possible to nurse patients with symptoms in side rooms or together in one bay. There are times however when it is necessary to close the entire ward to new patients until there have been no new cases on the ward for 72 hours.

There are some wards that cannot be closed to new admissions, such as the Critical Care and Cardiac Care Units.

Visitors must be aware that there is a risk of contracting Norovirus if they visit a patient who has symptoms or who is on a ward that has been closed. The advice of the Infection Prevention and Control Team is that members of the public do not visit unless absolutely necessary.

Can I be discharged home with Norovirus?

Patients can be discharged to their own home even if they have Norovirus, as long as they are generally fit for discharge and will be able to manage their symptoms at home.

Patients with Norovirus who are awaiting discharge / transfer to a nursing / residential home or other hospital, or patients who do not have Norovirus but are on a closed ward, cannot be discharged to another facility until they have been symptom free for 48 hours or until the ward has been re-opened. This is to stop the spread of Norovirus to other patients / staff in other healthcare facilities.

Further Information

If you have any questions or concerns, please speak to either the nurse-in-charge of the ward or the matron. If they are unable to help you or you need further information, please contact a member of the Infection Prevention and Control Team on:

• Kent and Canterbury Hospital, Canterbury
  Telephone: 01227 864049

• Queen Elizabeth the Queen Mother (QEQM) Hospital, Margate
  Telephone: 01843 225544 extension 725-3625

• William Harvey Hospital, Ashford
  Telephone: 01233 633331 extension 723-8202 or 723-8198