[Norovirus infections]

Abstract

During the last winter season, there was the hitherto largest norovirus gastroenteritis epidemic in Germany. Noroviruses are genetically highly variable, non-enveloped viruses with a single-stranded, positive sense RNA genome. They are the major cause of epidemic non-bacterial gastroenteritis worldwide, and have been identified as the cause of more than 70% of outbreaks and approximately half of all gastroenteritis outbreaks. Noroviruses also are frequently involved in sporadic cases of gastroenteritis. Typically, norovirus-associated enteritis is characterized by the sudden onset of vomiting and watery diarrhoea, frequently accompanied by several unspecific symptoms, e. g. abdominal pain, anorexia, malaise, headache, and low-grade fever. Diarrhoea without emesis as well as asymptomatic infections is also common. With few exceptions, diseases due to noroviruses are self-limited and the illness duration is restricted to a few days. Noroviruses are transmitted primarily from person-to-person by the faecal-oral route, but airborne transmission also occurs. Contamination of food and water represent important sources for human infection. Treatment ofnorovirus gastroenteritis is usually symptomatic and comprises a sufficient fluid and electrolyte substitution. There is no specific antiviral therapy. For prophylaxis, obeying of common hygienic rules in canteen kitchens and community institutions is regarded to be sufficient. Food with high risk of contamination should be cooked thoroughly. Because of the high stability of noroviruses to several environmental conditions, disinfection should be performed applying disinfectants with proven activity against noroviruses.