Acute gastroenteritis caused by Norwalk virus

Acute gastroenteritis caused by the Norwalk pathogen is an acute viral infectious disease with a fecal-oral mechanism of transmission of the pathogen, characterized by moderate intoxication and a picture of acute gastroenteritis with a benign course.

ICD-10 code

A08.1. Acute gastroenteropathy due to Norwalk.

Epidemiology of acute gastroenteritis caused by Norwalk virus

The source of the infectious agent is a sick person, contagious for up to 2 days after the cessation of diarrhea; the mechanism of transmission of the pathogen is fecal-oral, realized by food (green salad, oysters, ice cream) and water. The Norwalk virus is active throughout the year without pronounced seasonality, older children and adults are more often affected. Both sporadic cases of the disease and group outbreaks are observed. After the infection, persistent long-term immunity develops.

Acute gastroenteritis caused by the Norwalk virus is widespread. 50-70% of adults living in both developed and developing countries have antibodies to the Norwalk virus, which appear in childhood. In developed countries, about 30% of all diarrhea epidemics of this group are associated with this virus. Norwalk virus has been identified as the etiologic agent of epidemics in boarding schools, summer camps, and schools.

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What causes acute gastroenteritis due to Norwalk virus?

Acute gastroenteritis caused by the Norwalk virus is caused by an RNA-containing unclassified Norwalkvirus, which has a protein structure, a round shape and dimensions of about 27-32 nm, is resistant in the environment, and also to the action of disinfectants.

Pathogenesis of acute gastroenteritis caused by Norwalk virus

When entering the human body, the Norwalk virus disrupts the structure of small intestinal cells, shortening the villi, causing crypt hyperplasia, and infiltrating the proper plate of the intestinal mucosa with polymorphonuclear and mononuclear cells. All this causes moderate steatorrhea, impaired carbohydrate absorption, and decreased activity of some enzymes located in the boundary cell layer. No significant changes are observed in the mucous membrane of the stomach and colon. Adenylate cyclase activity of cells does not change.

Symptoms of acute gastroenteritis caused by the Norwalk virus

The incubation period of acute gastroenteritis caused by the Norwalk virus is from 10 hours to 2-3 days. Acute gastroenteritis caused by the Norwalk virus has an acute onset, in some patients - a short subfebrile temperature, severe weakness, adynamia. The most common symptoms of acute gastroenteritis caused by the Norwalk virus:

• nausea and occasional short-term vomiting;
• pain in the epigastrium and middle abdomen (mild, aching or cramping);
• loose stools without pathological impurities no more than 5-7 times a day for 1-2 days.

Most patients have headaches and myalgias. On examination, the abdomen is slightly distended, and a loud rumbling sound is felt on palpation. The liver and spleen are not enlarged.

Leukocytosis with relative lymphopenia is occasionally detected in the hemogram. Acute gastroenteritis caused by the Norwalk virus is often mild, recovery occurs within 12-72 hours. Complications have not been established.

Diagnosis of acute gastroenteritis caused by Norwalk virus

Diagnosis of acute gastroenteritis caused by the Norwalk virus is based on clinical and epidemiological data, confirmed by laboratory tests (radioimmune tests, ELISA method).

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Treatment of acute gastroenteritis caused by Norwalk virus

Hospitalization is carried out mainly according to epidemiological indications. A full diet is prescribed, including mechanically and chemically gentle food. In the acute period, whole milk and refractory fats are excluded from the diet, and carbohydrate consumption is limited.

Drug treatment of acute gastroenteritis caused by Norwalk virus

Drug treatment of acute gastroenteritis caused by the Norwalk virus is based on oral rehydration, enterosorbents, enzymes, and biopreparations. Antibacterial treatment of acute gastroenteritis caused by the Norwalk virus is not indicated.

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Clinical examination

No outpatient observation is carried out.

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How to prevent acute gastroenteritis caused by Norwalk virus?

There is no specific prophylaxis for acute gastroenteritis caused by the Norwalk virus. Acute gastroenteritis caused by the Norwalk virus can be prevented in the same way as other intestinal infections.

What is the prognosis for acute gastroenteritis caused by Norwalk virus?

Acute gastroenteritis caused by the Norwalk virus has a favorable prognosis. Discharge after complete clinical recovery.