Norwalk virus
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Introduction
Named after town, Norwalk Ohio where outbreak of viral gastroenteritis occurred
Epidemiology
- transmitted by fecal oral route
- shellfish and salads are common culprits
- ill food handlers also culprits
- waterbourne outbreaks from municipal supplies, wells, recreational lakes, swimming pools, ice machines
- outbreaks on cruise ships
- second to the common cold as a cause of illness in the USA
- incubation time is > 14 hours
Pathology
Clinical manifestations
- incubation time 24-48 hours
- gastroenteritis, non-inflammatory diarrhea
- nausea, vomiting
- abdominal pain
- fever (50%)
- symptoms may persist for several days
- dehydration may be life-threatening the young, elderly, immunocompromised
Laboratory
- RT-PCR for norovirus RNA
- ELISA lacks sensitivity & specificity
- single-stranded RNA virus
- no envelope
- size: 8 kilobases in size
- see norovirus (no Loincs for Norwalk virus found)
Management
- self-limiting disorder
- treatment is supportive
- dehydration is a concern
- handwashing & surface sanitization are the cornerstones of infection control
More general terms
References
- ↑ Harrison's Principles of Internal Medicine, 13th ed. Isselbacher et al (eds), McGraw-Hill Inc. NY, 1994, pg 469
- ↑ Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 536
- ↑ Clinical Diagnosis & Management by Laboratory Methods, 19th edition, J.B. Henry (ed), W.B. Saunders Co., Philadelphia, PA. 1996, pg 1164-65
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 15, 16. American College of Physicians, Philadelphia 2009, 2012