Norovirus -Norwalk agent

Norovirus -Norwalk agent

1. Norovirus formerly NORWALK agent an update Dr.T.V.Rao MD 2/23/2016 Dr.T.V.Rao MD 1

2. Norovirus Norwalk agent Norovirus, formerly referred to as Norwalk virus, is the most common cause of epidemic nonbacterial gastroenteritis in the world. 2/23/2016 Dr.T.V.Rao MD 2

3. Norovirus group The Norovirus group were first identified as the cause of a primary school outbreak of vomiting/ diarrhea in Norwalk, Ohio during the early 1970's. The group consists of related viruses that share similar symptoms and epidemiology. This virus group causes viral gastroenteritis predominately during the winter in temperate climates 2/23/2016 Dr.T.V.Rao MD 3

4. Structure of norovirus The Noroviruses are small, round, structured, non-enveloped viruses which are 27 to 32 nm in diameter. Their genome consists of a single 7.5 kb positive strand of RNA. The protein coat is composed of a 60 kDa structural protein. The virus is resistant to pH levels between 5 to 10, acid, ether, and is capable of surviving temperatures of 60C for 30 minutes. 2/23/2016 Dr.T.V.Rao MD 4

5. Norwalk Virus Norwalk Virus - an intestinal infection caused by fecal contamination, mainly occurring in countries with poor sanitation, and less frequent in developed countries. The problem is not life-threatening, but causes digestion, stomach problems, and diarrhoea. The virus is named after the place it was first diagnosed in 1972: Norwalk, Ohio. The Norwalk virus is a member of the calicivirus family of viruses 2/23/2016 Dr.T.V.Rao MD 5

6. Norwalk Virus Causes Norwalk virus symptoms and infections are often caused by contact with sewege , or fecal contact. It is contageous and contracted from other people. Pets and animals do not get the Norwalk Virus infections 2/23/2016 Dr.T.V.Rao MD 6

7. Sources which can spread Norwalk infections Contaminated water •Contaminated food that may be irrigated, farmed, treated or washed with contaminated water •Person-to-person anal of fecal contact •Contact with feces •Contact with children's diapers •Contact with sewage 2/23/2016 Dr.T.V.Rao MD 7

8. How are Noroviruses Transmitted? Norwalk and Noroviruses are transmitted primarily by the fecal -oral route. Having direct contact with vomit or feces from an infected person and then transferring the virus to the mouth from the hands primarily spreads the viruses. Secondary person-to-person transmission through sharing food, water, and/or utensils, or contact with the contaminated environment is also possible. Touching a contaminated door knob and/or stair railing and then touching your mouth is a possible method of transmission. In some outbreaks, there is evidence that the virus may be spread by the airborne route. These viruses are very contagious and only a few are needed to cause an illness. 2/23/2016 Dr.T.V.Rao MD 8

9. Transmission of Noroviral infections The disease is transmitted through ingestion of contaminated foods and drinks, or by contact with an infected individual. Shellfish from waters exposed to raw sewage will concentrate virus particles from the water since they are filter feeders. Contaminated water can also introduce the virus to beverages, ice, eggs, fruits, and salad ingredients. Cooked foods may also be contaminated though handling by an infected individual. The virus can also be transmitted through close contact with an infected individual and/or touching contaminated surfaces 2/23/2016 Dr.T.V.Rao MD 9

10. Norwalk Virus Symptoms • Abdominal cramps and bloating •Fatigue and Nausea, and sometimes weight-loss •Diarrhoea •Greasy stools •Red and bloody poop •Foul-smelling stools •Excessive gas • Dehydration •Developing a lactose intolerance 2/23/2016 Dr.T.V.Rao MD 10

11. Other clinical manifestations Low-grade fever Tachycardia Possible hypotension with volume depletion 2/23/2016 Dr.T.V.Rao MD 11

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13. Norwalk Virus diagnostic Tests Specialized laboratories can perform stool testing from an infected person and identify evidence of infection by testing blood for antibody. Laboratory stool test diagnosis is difficult. Diagnosis is often based on the combination of symptoms and the short time of illness. 2/23/2016 Dr.T.V.Rao MD 13

14. Treatment and support of Norwalk infections Infected people usually recover within a week without serious or long-term health effects. Treatment options are limited since norwalk virus symptoms go away on their own. In case of severe diarrhea, doctors suggest drinking more water and fluids to avoid dehydration. 2/23/2016 Dr.T.V.Rao MD 14

15. Norwalk Virus Prevention Washing hands after using the toilet, changing diapers, before eating or preparing food •Use alcohol-based sanitizers when soap is not available •Purify wilderness water 2/23/2016 Dr.T.V.Rao MD 15

16. Safe water makes life safe from norvovirus Be careful of fish or shellfish that may have come from contaminated water •Don't drink water from shallow wells, lakes, rivers, springs, ponds and streams unless you filter it or boil the water •Don't swallow water when swimming in pools, lakes or streams •Use bottled water 2/23/2016 Dr.T.V.Rao MD 16

17. Protecting from norovirus Don't use ice, and avoid raw fruits and vegetables, even those you peel yourself •Practice safer sex •People handling food need to wash their hands after bowel movements •Avoid bad plumbing and keep a well-functioning plumbing system 2/23/2016 Dr.T.V.Rao MD 17

18. New strain In January 2013, the US Centers for Disease Control and Prevention (CDC) reported that a new norovirus strain, GII.4 Sydney, which was first detected in Australia, had spread to the United States. During the last 4 months of 2012 2/23/2016 Dr.T.V.Rao MD 18

19. New strain causes higher mortality In general, GII.4 strains are associated with higher rates of hospitalization and death . 2/23/2016 Dr.T.V.Rao MD 19

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21. Program Created by Dr.T.V.Rao MD for medical and paramedical students for universal health education on infectious diseases Email [email protected] 2/23/2016 Dr.T.V.Rao MD 21