Written by Serrin Gantt, M.D.
January 12, 2016
Thursday I tended to my mother who had what I presumed was norovirus. In the middle of the night she had developed diarrhea and later the next day vomiting. She had a low grade temperature of 100F and very little energy. I kept a safe distance but did empty her vomit pot (AKA emesis basin). CDC guidelines were followed in that I washed my hands very thoroughly before leaving the house and then again when I got home. Norovirus can live on surfaces-door handles, light switches, etc for 2+ weeks. I have since learned that it can be readily aerosolized and thereby transmitted by being in proximity to someone vomiting or a flushed toilet (as happens when emptying a vomit pot).
By the next morning I had altered bowel habits. Perhaps being in denial, I made the assumption it was my diet of bean soup and dried figs the night before and brazenly consumed my morning coffee and wholegrain cereal with blueberries, a decision that turned out to be wasteful as 4 hours later it all came up.
The good thing about norovirus and most other causes of gastroenteritis is that symptoms abate after 24-36 hours. However, those symptoms, especially for the elderly, can be debilitating due to dehydration. Signs of dehydration include feeling dizzy on standing, decreased or absent urination, a dry mouth. My stepfather who is 87 caught the virus the next day. He was unable to keep liquids down and his pulse rose and he felt dizzy. I was concerned that he might fall in route to the bathroom or faint. There is no antibiotic treatment for norovirus as it is a virus. The primary treatment is rehydration; sometimes intravenous fluids are necessary. Thankfully, in the case of my stepfather, he was able to keep sips of ginger-ale and water down and is now slowly recovering.
What is a helpful shopping list for norovirus? Water, ginger-ale or oral rehydration solutions (ORS) such as Pedialyte. ORS contain the right ratio of water, sugar and salt to help promote rapid absorption from the gastrointestinal tract. I found pepto-bismal to be soothing to my acidic feeling stomach. Ginger-ale tasted really good after vomiting. Having Depends on hand are invaluable, especially in the elderly as they can save you from soiling linens as well as the risk of a fall when you are running to the toilet in a dehydrated state.
Norovirus is highly contagious. The CDC states that 18 viral particles will render you sick, a pinhead’s worth of virus will fell 1000. The virus is famous for waylaying cruise ship passengers. You are highly infectious the days you’re symptomatic and 2-3 days thereafter. Virus can be shed in your stool up to 2 weeks thereafter. Food preparers are advised to stop working for at least 48 hours after resolution of symptoms. For this reason, I opted to quarantine myself for several days and have now bleach washed the multitude of surfaces in my home and done 4 loads of laundry.
Having it once does not provide immunity. There are many strains of norovirus. Immunity for the same strain of virus apparently does not persist.
Today I am better and the wind felt good on my face as I walked around my neighborhood. I have passively accomplished a New Year’s resolution of colon cleanse and associated weight loss and am grateful to have it behind me.
Leon, Juan (2008). “Chapter 9.” In Vajdy, Michael. Immunity Against Mucosal Pathogens. Springer. p.232. ISBN9781402084126.
http://www.cdc.gov/norovirus/about/overview.html
http://www.wsj.com/articles/what-is-the-best-drink-to-help-ease-nausea-1448299763
Tags: Norovirus