# Norovirus Gastroenteritis - Category: infectious - Review status: reviewed (every claim checked against a document named on this page) - Sources: CDC Yellow Book 2024 · NICE CG84 Diarrhoea and vomiting caused by gastroenteritis in children under 5 (NCBI Bookshelf NBK63837) - Verified date: 2026-08 ## Verified against - NICE CG84 Diarrhoea and vomiting caused by gastroenteritis in children under 5 (NCBI Bookshelf NBK63837) - WHO. The treatment of diarrhoea: a manual for physicians and other senior health workers, 4th rev. Geneva: WHO; 2005 (IRIS 10665/43209), section 4.3.1 and Table 2 ## Treatment metadata - ORS — oral.liquid ## Complete treatment card ```text NOROVIRUS GASTROENTERITIS Sources: CDC Yellow Book 2024 · NICE CG84 Diarrhoea and vomiting caused by gastroenteritis in children under 5 (NCBI Bookshelf NBK63837) Review status: REVIEWED against NICE CG84 Diarrhoea and vomiting caused by gastroenteritis in children under 5 (NCBI Bookshelf NBK63837), WHO. The treatment of diarrhoea: a manual for physicians and other senior health workers, 4th rev. Geneva: WHO; 2005 (IRIS 10665/43209), section 4.3.1 and Table 2 (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (6) - Sickness, vomiting, cramping belly pain and loose stool, often with muscle aches, headache and chills [abdominal pain · chills · headache · muscle cramps · muscle pain · vomiting] - Some people get mainly loose stool, others mainly nausea and vomiting [nausea · vomiting] - Illness usually runs 1 to 3 days, with or without a prodrome - Ask about living quarters, water source, recent travel, raw or undercooked food and sick contacts - A weakened immune system predicts a longer illness and greater risk of serious harm - Rarely the picture is neurological, with a fit or a confused, drowsy state [seizures] SIGNS - what you find (4) - Belly tenderness is typically mild, diffuse and does not localise [abdominal tenderness] - Marked tenderness or guarding points away from this and needs another cause hunted for [guarding] - Visibly bloody stool does not fit and calls for further workup - Dry mouth, poor skin turgor, fast pulse and a postural blood pressure drop mark dehydration [dehydration · dry mouth] TESTS (6) - Most cases need no test at all - A metabolic panel is worth it in selected patients, to check salts and hydration - Stool culture, C difficile toxin and ova and parasites only if illness drags on or another organism is suspected - RT-PCR on stool or vomit is the reference test; enzyme immunoassay is the one more clinics can actually get - Accuracy swings with how many samples were sent, when the stool was taken and how it was handled - Outbreak pattern: vomiting in over half of cases, incubation 24 to 48 hours, illness lasting 12 to 60 hours, and no bacteria grown from stool IF NOT THIS - what else fits (4) - Other gut infections: rotavirus, cholera, C difficile, Salmonella, Cryptosporidium, enterovirus, E coli, Shigella, Campylobacter, Vibrio - When belly pain leads, weigh surgical and vascular causes: appendicitis, gallbladder, gut obstruction or perforation, diverticulitis, pancreatitis, gut ischaemia, aortic aneurysm - Also weigh pregnancy in the tube, twisted ovary or testis, pelvic infection, kidney infection and urine infection - A heart attack can show up as belly pain and belongs on the list Source StatPearls "Norovirus" - disease-level clinical article Status traced to the source above 1. ORS [1st line] Adult Make the sachet up to the volume printed on the pack - a WHO/UNICEF standard sachet makes 1 litre, and using less water than the label says makes the solution dangerously concentrated. Egypt also sells ready-mixed 240-360 mL packs, which need no dilution. Drink after each loose stool or vomiting episode. Peds 75 mL/kg/dose (75 ml/kg over 4 hours for fluid deficit replacement (WHO Plan B), plus maintenance fluid. This matches every other rehydration entry in the app.) 3kg -> 225 mL/dose 4kg -> 300 mL/dose 5kg -> 375 mL/dose 6kg -> 450 mL/dose 7kg -> 525 mL/dose 8kg -> 600 mL/dose 9kg -> 675 mL/dose 10kg -> 750 mL/dose 11kg -> 825 mL/dose 12kg -> 900 mL/dose 13kg -> 975 mL/dose 14kg -> 1050 mL/dose 15kg -> 1125 mL/dose 16kg -> 1200 mL/dose 17kg -> 1275 mL/dose 18kg -> 1350 mL/dose 19kg -> 1425 mL/dose 20kg -> 1500 mL/dose 21kg -> 1575 mL/dose 22kg -> 1650 mL/dose 23kg -> 1725 mL/dose 24kg -> 1800 mL/dose 25kg -> 1875 mL/dose 26kg -> 1950 mL/dose 27kg -> 2025 mL/dose 28kg -> 2100 mL/dose 29kg -> 2175 mL/dose 30kg -> 2250 mL/dose 31kg -> 2325 mL/dose 32kg -> 2400 mL/dose 33kg -> 2475 mL/dose 34kg -> 2550 mL/dose 35kg -> 2625 mL/dose 36kg -> 2700 mL/dose 37kg -> 2775 mL/dose 38kg -> 2850 mL/dose 39kg -> 2925 mL/dose 40kg -> 3000 mL/dose 41kg -> 3075 mL/dose 42kg -> 3150 mL/dose 43kg -> 3225 mL/dose 44kg -> 3300 mL/dose 45kg -> 3375 mL/dose 46kg -> 3450 mL/dose 47kg -> 3525 mL/dose 48kg -> 3600 mL/dose 49kg -> 3675 mL/dose 50kg -> 3750 mL/dose Source WHO. The treatment of diarrhoea: a manual for physicians and other senior health workers, 4th rev. Geneva: WHO; 2005 (IRIS 10665/43209), section 4.3.1 and Table 2 Why Norovirus is self-limiting; management is purely supportive fluid replacement. Caution Never make the solution up in less water than the pack states. A five-fold concentrated ORS given to a dehydrated patient causes hypernatraemia, and an infant is the one least able to survive it. Use strict hand hygiene with soap and water (alcohol sanitizers are less effective against norovirus). Exclude patient from work/school for 48 hours after symptoms resolve. Do not use antidiarrhoeal medications. Egypt GLUCOHYDRAN 10 SACHET. ARAB DRUG COM... 1.75 EGP REHYDRAN N 10 SACHET CID 4.50 EGP REHYDRO ZINC 10 SACHETS CID 7.00 EGP ORS 20 SACHETS PHAROPHARMA 40.00 EGP ELECTRO MASH SYRUP 200 ML MASH PREMIERE 60.00 EGP FLEXOLYTE ORAL REHYDRATION SOL. 240 ML KEMPETRO FOR CHEMICAL INDUSTRIES 65.00 EGP HERO ORS 200 ML HERO > HERO M... 120.00 EGP SANSO ORS SYRUP 140 ML AUG PHARMA 400.00 EGP Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)