An informative editorial in The Lancet Infectious Diseases: The inexorable progress of norovirus. The conclusion:
There is no specific treatment for norovirus gastroenteritis. Research on possible treatments is not helped by the fact that the virus cannot yet be grown in cell culture. Management should focus on maintaining fluid and electrolyte balance. Results of a volunteer challenge trial of a vaccine against norovirus, developed by Ligocyte Pharmaceuticals, were reported in 2011. Vaccination significantly reduced the frequency of norovirus gastroenteritis from 69% in placebo recipients to 37% in vaccine recipients.
Because human immunity against norovirus seems not to be longlasting, and because of antigenic drift, it is likely that in routine practice frequent revaccination with formulations reflecting the prevalent viral strains would be necessary.
Sound sanitary practices are the only protection against norovirus. UK and US guidelines recommend rapid cleaning up of vomit and surrounding areas, cleaning of hard surfaces with detergent followed by a bleach solution, and washing of soft furnishings and fabrics as recommended by the manufacturer. Infected people should be isolated and avoid visiting health-care facilities if at all possible.
Hand hygiene is key. Hands should be washed with soap and running water for at least 20 s. The efficacy of alcohol-based hand sanitisers is controversial, but they may be useful between handwashing.
Arguably among the best adapted of human pathogens, although vaccination may one day have a role in slowing the march of norovirus, there is as yet no substitute for the basics of forewarning from epidemiological surveillance and diligent infection control.
