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| __NOTOC__
| | #REDIRECT [[Norovirus outbreak resident survival guide]] |
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| {{WikiDoc CMG}}; {{AE}} {{TS}}
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| ==Definition==
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| [[Norovirus]] is one of the extremely [[contagious]] viruses leading to 50% of the [[gastroenteritis]] outbreaks worldwide.<ref name="pmid19084472">{{cite journal| author=Patel MM, Hall AJ, Vinjé J, Parashar UD| title=Noroviruses: a comprehensive review. | journal=J Clin Virol | year= 2009 | volume= 44 | issue= 1 | pages= 1-8 | pmid=19084472 | doi=10.1016/j.jcv.2008.10.009 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19084472 }} </ref> | |
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| ==Causes==
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| ===Life Threatening Causes===
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| Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
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| * [[Life threatening cause 1]]
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| * [[Life threatening cause 2]]
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| * [[Life threatening cause 3]]
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| ===Common Causes===
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| * [[Common cause 1]]
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| * [[Common cause 2]]
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| * [[Common cause 3]]
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| * [[Common cause 4]]
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| * [[Common cause 5]]
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| ==Management==
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| Shown below is an algorithm summarizing the approach to [[norovirus]] infection outbreak.
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| {{familytree/start |summary=PE diagnosis Algorithm.}}
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| {{familytree | | | | | | | A01 | | | | | | | | | | | | | | | | | | | | | | | | |A01=<div style="float: left; text-align: left; height: 18em; width: 20em; padding:1em;">'''Characterize the symptoms'''<br>
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| ----
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| ❑ Non bloody [[diarrhea]]<br>❑ [[Vomiting]]<br>❑ [[Nausea]]<br>❑ [[Abdominal cramps]]<br>❑ [[Low grade fever]]<br>❑ Body aches <br>❑ [[Necrotising enterocolitis]] (in [[neonates]])<br>❑ Chronic diarrhea (in [[immunosuppressed]])<br> ❑ [[Irritable bowel syndrome]]</div>}}
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| {{familytree | | | | | | | |!| | | | | | | | | | | | | | | | | | | | | | | | | | }}
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| {{familytree | | | | | | | C01 | | | | | | | | | | | | | | | | | | | | | | | | |C01='''Collect samples'''}}
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| {{familytree | | | | | | | |!| | | | | | | | | | | | | | | | | | | | | | | | | | }}
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| {{familytree | | | |,|-|-|-|+|-|-|-|.| | | | | | | | | | | | | | | | | | | | | | }}
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| {{familytree | | | B01 | | B02 | | B03 | | | | | | | | | | | | | | | | | | | | |B01=<div style="float: left; text-align: left; height: 25em; width: 20em; padding:1em;">
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| ❑ '''Whole [[stool]] sample'''<br>
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| '''Collection:'''<br>
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| : ❑ Within 48 to 72 hrs after onset<br>
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| : ❑ From at least 5 ill patients<br>
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| : ❑ 10-50 ml of whole stool sample in a stool cup is preferred.<br>
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| '''Storage:'''<br>
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| : ❑ If testing done < 3 weeks
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| :: ❑ Refrigerate samples at 39 F<br>
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| : ❑ If testing done > 3 weeks<br>
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| :: ❑ Refrigerate samples at - 4 F<br>
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| '''Transportation:'''<br>
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| : ❑ Bagged, sealed and transported on ice packs in an insulated and waterproof container.</div>|B02=
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| <div style="float: left; text-align: left; height: 20em; width: 20em; padding:1em;">
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| ❑ '''Vomitus sample''' <br>
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| : ❑ Collected, stored and transported in same ways as mentioned above for stool sample.
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| </div>|B03=<div style="float: left; text-align: left; height: 20em; width: 20em; padding:1em;">❑ '''Environmental samples:'''<br>
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| : ❑ Water sample <br>
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| : ❑ Shellfish samples <br>
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| : ❑ Environmental surface swabs<br>
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| (Pursued in consultation with CDC)
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| </div>}}
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| {{familytree | | | |`|-|-|-|+|-|-|-|'| | | | | | | | | | | | | | | | | | | | | | }}
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| {{familytree | | | | | | | |!| | | | | | | | | | | | | | | | | | | | | | | | | | }}
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| {{familytree | | | | | | | D01 | | | | | | | | | | | | | | | | | | | | | | | | |D01=<div style="float: left; text-align: left; height: 8em; width: 20em; padding:1em;"> '''Diagnostic tests''':<br>
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| ----
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| ❑ [[Enzyme immunoassays]]<br>
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| ❑ [[Reverse transcription-polymerase chain reaction]]<br>
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| ❑ [[Geno-typing]]</div>}}
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| {{familytree | | | | |,|-|-|^|-|-|.| | | | | | | | | | | | | | | | | | | | | | | }}
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| {{familytree | | | | |!| | | | | |!| | | | | | | | | | | | | | | | | | | | | | | }}
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| {{familytree | | | | E01 | | | | E02 | | | | | | | | | | | | | | | | | | | | | |E01='''[[Norovirus]]''' '''positive'''|E02='''[[Norovirus]]''' '''negative'''}}
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| {{familytree | | | | |!| | | | | |!| | | | | | | | | | | | | | | | | | | | | | | }}
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| {{familytree | | | | F01 | | | | F02 | | | | | | | | | | | | | | | | | | | | | | F01=<div style="float: left; text-align: left; height: 5em; width: 15em; padding:1em;">❑ Take measures to prevent and control outbreak (see below)<br>❑ Treat [[acute gastroenteritis]]</div>|F02=<div style="float: left; text-align: left; height: 2em; width: 15em; padding:1em;">❑ Treat as [[Acute diarrhea resident survival guide|acute diarrhea]]</div>}}
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| {{familytree | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | }}
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| {{familytree | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | }}
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| {{familytree | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | }}
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| {{familytree | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | }}
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| {{familytree | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | }}
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| {{familytree/end}}
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| ==Do's==
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| * Settings prone to outbreaks:<br>
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| ❑ Health care settings<br>❑ Restraunts<br>❑ Cruise ships<br>❑ Schools and other institutional settings
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| ==References==
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