Norovirus is an RNA virus of the family Caliciviridae, a very contagious group of viruses that cause gastroenteritis illness. Norovirus was the very first virus identified to cause gastroenteritis, and was named after the first recorded outbreak in Norwalk, OH. During that outbreak, in 1968, elementary students at a school in Norwalk began to present with diarrhea, vomiting, and fever. The kids were thought to have “winter vomiting disease.” Practitioners at this time, while unable to isolate the virus yet, took rectal swabs of the infected kids and gave those to “volunteers” at a prison a the Maryland House, they developed the same illness. When they became ill, their rectal swabs were administered to others who also became sick. Through this process, practitioners developed an idea of transmission, onset, incubation and the length of the illness.
Eventually, “Norwalk” or “Norovirus” was visualized using an immunoelectron microscopy. It wass not until more recently that local health departments had the capability to identify Norovirus effectively.
Today, Norovirus is commonly known as the stomach flu – not much more sophisticated that “winter vomiting disease” – even though it is not related to influenza. As in Norwalk, the virus spreads directly from person to person, though infection can spread through conduits like food, drinks, and contaminated surfaces. The most common sources include ready-to-eat foods prepared by infected employees, fresh produce, and any food items contaminated with feces or vomit from an infected individual. There are a number of factors that help to make norovirus so contagious, such as the very small inoculum required to infect a person at less than 100 viral particles (think tip of a pencil), the lengthy time at which an infected person continues to shed the us, and Norovirus’ incredible ability to survive environmentally – some viruses die within seconds of leaving the human body, but Norovirus has a long life outside the body. In addition, Norovirus can shed from a person for a considerable period of time when the person is no longer symptomatic, making disease spread control more difficult.
Infected individuals usually experience symptoms within 24 to 48 hours of exposure. Symptoms may then last up to 60 hours and alleviate on their own, though sometimes further treatment is necessary. Some studies, however, have shown that Norovirus in the very young (less than 2 years old) can last twice as long as that in adults, with an average illness of near four days. In some cases, neonatal exposure can lead to death. In addition, elderly person over 85 years of age have be identified as much more likely to die from exposure to Norovirus, while those over 65 can experience significant complications. Those with immunocompromised conditions are also at heightened risk of serious complications and death.
Symptoms begin quickly and include stomach cramps, fever, watery diarrhea, chills, headache, fatigue, and muscle soreness. While most of these symptoms are not life-threatening, victims must be aware of dehydration. Diarrhea and vomiting result in dramatic fluid loss, which quickly becomes dangerous, especially for young children and the elderly. Continuing to boost fluid and nutrient intake are critical to ensuring a full recovery. During this time, it’s important to avoid sugary drinks, alcohol, and caffeinated beverages, since this can worsen dehydration. Water and sports drinks are your best options for staying hydrated. In severe cases, our food poisoning lawyers have noted many cases in which IV fluids were necessary to ensure that the individual with Norovirus was hydrated to prevent further, more significant, health risks such as tachycardia, kidney failure, or stroke.
Norovirus is highly contagious and can survive on items an infected person has handled for days or even weeks, so it’s important to be aware of your surroundings, the food you handle, and the presence of any infected persons. Hand washing, using alcohol based lotions, properly preparing food, and consciously avoiding contact with potentially contaminated objects will greatly reduce the likelihood of contracting a norovirus. These items may include cell phones, door handles, keys, books, or any other household item.
To prevent the spread of norovirus, it’s important to:
Since norovirus spreads from person to person, outbreaks are not uncommon within long-term care facilities and other crowded places with residents (such as universities). Strict compliance with good hygiene practices hinders the spread of the virus and can greatly decrease the risk of an outbreak.
As far as treatment, no medical regimen has been identified, and antibiotics are not effective. The recommended treatments are generally linked to maintaining hydration.
Even though norovirus is known by many other names, such as the “stomach flu,” it’s important to remember that it is not related to the flu, which is a respiratory illness. Norovirus is more akin to food poisoning than the influenza virus.
The CDC reveals that 49 percent of all foodborne illness outbreaks in the United States result from the norovirus. World-wide, as many as 90% of non-bacterial gastroenteritis is believed to be from Norovirus. Other common causes of foodborne illness include bacteria, chemicals, and parasites. This stresses the crucial importance of adherence to proper hygiene, such as washing hands and washing foods before meal preparation.
Since no antiviral drug can treat the norovirus, good hygiene is key to minimizing infection. If you’ve recently been stricken with the norovirus, avoid food preparation for at least two to three days after symptoms subside, as you could still spread the norovirus to someone else.
Encouraging infected persons to avoid crowded areas and contact with other individuals will decrease the likelihood of spreading the illness. Be sure to wash your clothing or linens after the symptoms subside, since the germs can survive on contaminated surfaces.
Very recently, the Centers for Disease Control and Prevention (CDC) reported that a new strain of norovirus has been discovered and that the United States experiences more norovirus outbreaks than most other countries, making it all the more important to consult a seasoned norovirus lawyer if you’ve become ill with the viruses. At Ron Simon & Associates, we’re passionate about your health and well-being. Our norovirus attorneys have over two decades of experience with providing news and information about food poisoning outbreaks and litigation across the nation. The National Trial Lawyers Association has named Ron one of the Top 100 Trial Lawyers in the United States, distinguishing him as a lawyer with a proven track record of trial success.
We’ve helped our clients recover over $700,000,000. Ron’s articles on outbreaks and litigation found on Food Poisoning News have been viewed by readers in over 180 countries. If you have any questions about the norovirus and a potential foodborne poisoning case on your hands, contact one of our associates today.
 The Caliciviridae family of small, nonenveloped, positive-stranded RNA viruses is now comprised of five genera, including Norovirus, Sapovirus, Lagovirus, Nebovirus, and Vesivirus. Green KY. 2013. Caliciviridae: the noroviruses, p 582–608. In Knipe DM, Howley PM, Cohen JI, Griffin DE, Lamb RA, Martin MA, Racaniello VR, Roizman B. (ed), Fields virology, 6th ed, vol 1Lippincott Williams & Wilkins, Philadelphia, PA
 See Elizabeth Robilotti, et. al., “Norovirus,” Clinical Microbiology Reviews, 2015 January: 28(1), 134-164.
 Dolin R, Blacklow NR, DuPont H, Formal S, Buscho RF, Kasel JA, Chames RP, Hornick R, Chanock RM. 1971. Transmission of acute infectious nonbacterial gastroenteritis to volunteers by oral administration of stool filtrates. J Infect Dis 123:307–312. doi:10.1093/infdis/123.3.307.
 Kapikian AZ, Wyatt RG, Dolin R, Thornhill TS, Kalica AR, Chanock RM. 1972. Visualization by immune electron microscopy of a 27-nm particle associated with acute infectious nonbacterial gastroenteritis. J Virol 10:1075–1081.
 Murata T, Katsushima N, Mizuta K, Muraki Y, Hongo S, Matsuzaki Y. 2007. Prolonged norovirus shedding in infants <or=6 months of age with gastroenteritis. Pediatr Infect Dis J 26:46–49; Turcios-Ruiz RM, Axelrod P, St John K, Bullitt E, Donahue J, Robinson N, Friss HE. 2008. Outbreak of necrotizing enterocolitis caused by norovirus in a neonatal intensive care unit. J Pediatr 153:339–344
 Turcios-Ruiz RM, Axelrod P, St John K, Bullitt E, Donahue J, Robinson N, Friss HE. 2008. Outbreak of necrotizing enterocolitis caused by norovirus in a neonatal intensive care unit. J Pediatr 153:339–344.
 van Asten L, van den Wijngaard C, van Pelt W, van de Kassteele J, Meijer A, van der Hoek W, Kretzschmar M, Koopmans M. 2012. Mortality attributable to 9 common infections: significant effect of influenza A, respiratory syncytial virus, influenza B, norovirus, and parainfluenza in elderly persons. J Infect Dis 206:628–639; Harris JP, Edmunds WJ, Pebody R, Brown DW, Lopman BA. 2008. Deaths from norovirus among the elderly, England and Wales. Emerg Infect Dis 14:1546–155
 Doshi M, Woodwell S, Kelleher K, Mangan K, Axelrod P. 2013. An outbreak of norovirus infection in a bone marrow transplant unit. Am J Infect Control 41:820–823; chwartz S, Vergoulidou M, Schreier E, Loddenkemper C, Reinwald M, Schmidt-Hieber M, Flegel WA, Thiel E, Schneider T. 2011. Norovirus gastroenteritis causes severe and lethal complications after chemotherapy and hematopoietic stem cell transplantation. Blood 117:5850–5856; Roddie C, Paul JP, Benjamin R, Gallimore CI, Xerry J, Gray JJ, Peggs KS, Morris EC, Thomson KJ, Ward KN. 2009. Allogeneic hematopoietic stem cell transplantation and norovirus gastroenteritis: a previously unrecognized cause of morbidity. Clin Infect Dis 49:1061–1068.