Nobody likes to get sick least of all me. Yet recently, I found myself stuck in bed for three days, too sick to move.
It was a stomach bug, and in my bed-bound misery, I had plenty of time to think about things. What was this bug that hit me from out of the blue?
Most likely, it was a norovirus. According to the Centers for Disease Control and Prevention, these viruses infect more than 20 million Americans each year. One in 15 U.S. adults will suffer a norovirus infection annually. Norovirus is the leading cause of an infection of the stomach and intestines known as gastroenteritis. Many simply call this the stomach flu, though this virus is unrelated to influenza.
The classic symptoms of norovirus are nausea with vomiting, diarrhea and stomach cramps with bloating. Fever, tiredness, muscle aches and chills also are common. The symptoms typically last for one to two days, although, as in my case, it can continue a little longer. While the infection itself is not dangerous and usually resolves without long-term effects, small children, the elderly and people with chronic disease are at higher risk for complications, the most common of which is dehydration.
Fever increases fluid loss, along with diarrhea. Vomiting often prevents fluid intake. The net effect is a loss of body fluid content that raises heart rate, decreases urination and increases the misery of the illness. Rarely, dehydration can progress to the point of low blood pressure and/or kidney problems. For these reasons, it is important to focus on fluid intake during a bout of gastroenteritis.
There are a few basic principles to fluid rehydration. With vomiting and diarrhea, your body loses both water and salt, so fluids containing a little of both can be beneficial. Common examples are sports drinks and preparations like pedialyte (for kids). The best formulation, albeit not quite as palatable, is called WHO (for World Health Organization) formula. It is a packet of salts mixed with water and can be found in many pharmacies. I find it not to be very tasty, though it has been attributed the distinction of having saved more lives worldwide than any other medicine.
The common advice for fluid intake is clear liquids taken a little at a time. It is generally best to avoid sweet drinks like juices particularly apple, pear or prune. These sweeter juices increase water in the stool and can contribute to the diarrhea. Also, dairy drinks like milk are not always the best choice during a bout of gastroenteritis. Viral infections of the intestines tend to damage the lining where lactose (the main sugar in milk) is digested. As a result, folks with a stomach bug often have a transient lactose intolerance (with gas and perhaps diarrhea) for up to one or two weeks during and after the illness.
Norovirus is transmitted with ease through contact with an infected person, by touching contaminated surfaces, and through consumption of contaminated food. The virus is found in fecal material and vomit in the infected person and is easily spread by the hands. Hand washing and frequent decontamination of infected surfaces is essential to preventing spread.
Noroviral infections can occur repeatedly because infection does not produce permanent immunity. The virus frequently mutates and therefore efforts at finding a vaccine have failed. There is no cure for norovirus infection, but medications can help alleviate the symptoms. Hospitalization is rarely necessary, except in cases of significant dehydration.
Dr. Matthew A. Clark is a board-certified physician in internal medicine and pediatrics practicing at the Ute Mountain Health Center in Towaoc.