Norovirus Treatment & Management

Updated: May 08, 2023
  • Author: Zartash Zafar Khan, MD, FACP; Chief Editor: Michael Stuart Bronze, MD  more...
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Medical Care

Oral fluid and electrolyte replacement generally is adequate for the treatment of norovirus infections.

In cases of severe volume depletion, intravenous fluid and electrolyte resuscitation may be necessary.

Symptomatic relief can be achieved using antiemetics for nausea and vomiting and analgesics for myalgias and headache.

Antiperistaltic agents generally should be avoided in cases of infectious diarrhea but could be considered in patients with severe diarrhea.



In all epidemic outbreaks (2 or more people who shared a common meal), the local and/or state health department should be contacted for investigation of potential sources.



Treatment includes the following:

  • Electrolyte replacement liquids

  • Regular diet as tolerated



Activity may be performed as tolerated.



In cases of norovirus outbreaks, several measures should be taken to prevent further transmission, as follows:

  • Contaminated sources should be identified and eliminated.

  • Strict hand hygiene is necessary. Food handlers should be thoroughly educated on the infectivity of norovirus, and updated hygienic codes should be maintained. [25]  Although virucidal efficacy of alcohol against feline calicivirus is inferior to that of povidone-iodine, it is greatly variable depending on different formulations, concentrations, and contact times. In one study, only a 0.5-1 log10 reduction in virus titer was achieved after exposure to ethanol (62-99.5%) for 30 seconds. Another study showed a 2 and 3 log10 reduction in virus titer when 80% ethanol was used for 30 seconds and 1 minute, respectively. Successful control of a norovirus outbreak using 80% alcohol-based hand rubs was reported in an infirmary. [26]  Hand washing with soap and water is necessary for hands that are visibly soiled. [27]

  • Environmental sanitization and disinfection should be performed.

  • Instruct individuals with viral gastroenteritis to self-quarantine.

Clinical trials are in progress for vaccine development. Currently no vaccines against norovirus are available due to wide genetic and antigenic diversity of noroviruses with multiple co-circulated variants of various genotypes.