Aside from diarrhoea and vomiting, other signs of an infection with the norovirus include tummy pain, headaches and aching limbs. — dpa
It starts suddenly: When a stomach bug strikes out of nowhere, noroviruses are often the culprits.
Here, we answer the most important questions about this unpleasant virus.
Whether in care homes, on holiday camps or cruise ships, when one person is infected, it often spreads quickly to many others.
“It’s very easy to get infected because the unique thing about norovirus is that even a small dose – 10 to 100 individual viruses – is enough,” says gastroenterologist and internal medicine specialist Prof Dr Birgit Terjung.
The virus can stick to surfaces, such as tables, door handles or even food, and be transmitted by contact.
“However, it is mainly spread through stool and vomit,” explains the adjunct professor at Hochschule Bonn-Rhein-Sieg in Germany.
When someone vomits, the virus can float in fine aerosols through the air, leading to infection via droplet transmission.
From “the first viruses are in the body” to “I don’t feel well”: The incubation period for norovirus is relatively short, according to Prof Terjung.
Symptoms can start as soon as six hours after contact with the virus, but they may also take up to 50 hours to appear.
Generally, things move much faster than with other viruses, and especially when compared to bacteria.
Those who have experienced norovirus know: “The symptoms come on almost explosively,” says Prof Terjung.
“You have to vomit very frequently and experience severe diarrhoea.
“This is accompanied by a strong feeling of illness: fatigue, headaches, often fever and severe abdominal pain.”
After 48 hours, symptoms usually improve and the discomfort subsides.
If someone is suffering from diarrhoea or vomiting, they will spend a lot of time in the bathroom.
Whether in a shared or family home, hygiene is crucial to prevent others from getting infected.
“If someone vomits into the toilet and another person uses it afterwards without knowing, it can easily lead to infection,” says Prof Terjung.
Ideally, the infected person should clean the toilet themselves after use.
“If someone else has to clean it, they should ideally wear a mask,” she advises.
This helps protect against infectious aerosols.
“Wear gloves and wash your hands thoroughly with soap and water afterwards, including your arms. If available, use disinfectant as well.”
It’s best to have a disinfectant in the cleaning cupboard that works against viruses.
For cleaning, wearing an apron is also recommended to prevent viruses from sticking to everyday clothing.
A typical feature of norovirus infection is that the body loses a lot of fluids.
“The danger is that if you are ill for several days, you can become dehydrated because you lose a lot of fluids through vomiting and especially through liquid diarrhoea,” says Prof Terjung.
As soon as possible, you should start replenishing fluids by drinking.
However, to avoid overwhelming the body, don’t drink half a litre at once.
Instead, start with small sips.
ALSO READ: How to keep your child hydrated if he is throwing up
“At the beginning, the stomach is still very irritated.
“This means that whenever something enters, no matter what it is, the stomach reacts with cramps and you feel like vomiting again.”
Young children and older adults are particularly at risk of severe dehydration.
In some cases, they may need to be hospitalised to receive fluids via an intravenous (IV) drip.
Signs of critical dehydration include: “If the tongue is completely dry, rough and deeply cracked when you look at it.
“Patients themselves often say: My mouth is so dry,” explains Prof Terjung.
Other warning signs include severe headaches and drowsiness.
The skin fold test can also provide a clue: “If you pinch the skin on the forearm and it stays in a fold when you let go, that’s a typical sign of severe dehydration,” says the doctor.
ALSO READ: How can you tell if you're dehydrated?
The best options are water and teas, but other drinks are not off-limits.
“I wouldn’t recommend cloudy apple juice because it has a slight laxative effect,” says Prof Terjung.
“A little cola, on the other hand, is fine – people often crave something sweet.”
However, relying solely on cola during a norovirus infection is not advisable due to its high sugar content.
Since a stomach bug flushes many minerals out of the body, it’s important to replenish them.
This can be done with electrolyte solutions from the pharmacy or a World Health Organization-recommended solution for diarrhoeal illnesses.
To make it, mix:
- Four teaspoons of sugar
- Three-quarters of a teaspoon of table salt
- 250ml of orange juice
- One litre of mineral water.
Clear soups are another good way to restore essential salts.
As for food, you can slowly reintroduce it.
“It should be something that doesn’t sit heavily in the stomach: porridge, crackers or toast.
“It shouldn’t be too fatty, as that can slow down the stomach,” she advises.
If someone has been free of fever, diarrhoea and vomiting for 48 hours, they are generally no longer contagious, according to Prof Terjung.
However, thorough hygiene around the toilet should still be maintained.
“It’s possible to shed the virus in stool for up to two weeks,” she says.
This is especially true for immunosuppressed individuals, such as those undergoing chemotherapy, who may continue to shed the virus for longer. – By Ricarda Dieckmann/dpa
