Each week we will aim to bring out a concise email that provides 4-5 key pieces of information addressing a specific issue in clinical therapeutics.
This week: Norovirus Gastroenteritis
Mary Mickael, Clinical Pharmacist, Ward MM
Outbreaks of gastroenteritis commonly occur in residential aged care, affecting both residents and staff. Outbreaks are often caused by noroviruses, which are a group of highly infectious viruses that can cause diarrhoea, stomach pain and vomiting.
- Norovirus is highly infectious and may cause outbreaks in aged care facilities. Those most at risk include the elderly > 65 years, young children < 5 years and immunocompromised people. Outbreaks of gastroenteritis commonly occur in residential aged care, affecting both residents and staff. Symptoms include diarrhoea, stomach pain and vomiting.
- Norovirus is spread by the faecal-oral route and consumption of food, drink or inhaling vomit contaminated with the virus.Common disinfectants do not kill norovirus.
- Strategies to prevent spread include thorough washing and drying hands thoroughly after using the toilet. After an episode of diarrhoea or vomiting, it is important to clean contaminated surfaces immediately using detergent and hot water. Disinfect surfaces using a bleach-based product diluted according to the manufacturer’s instructions. Visits to an affected facility should be limited during outbreaks.
- Management of novovirus infection includes encouragement of drinking water and fluids or oral rehydration solutions (ORS) to avoid dehydration.
- Opioid antidiarrhoeals should not be used in severe or bloody diarrhoea, where there is a possibility of invasive organisms, or in patients with severe inflammatory bowel disease or intestinal obstruction.
- Diarrhoea resulting in dehydration and electrolyte disturbances may increase the risk of adverse effects with some drugs (e.g. ACE inhibitors, digoxin, lithium, metformin, NSAIDs, ATRAs “sartans”, and warfarin).
Please consider these issues when preparing or interpreting RMMR reports or education sessions. Contributions of content or suggested topics are welcome and should be sent directly to firstname.lastname@example.org.