Norovirus symptoms without vomiting
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Norovirus Symptoms Without Vomiting: Key Clinical Features
Common Norovirus Symptoms Beyond Vomiting
Norovirus is widely recognized for causing vomiting and diarrhea, but it can also present with other symptoms, even in the absence of vomiting. Fever, fatigue, loss of appetite, nausea, abdominal pain, and dehydration are frequently reported in norovirus infections, regardless of whether vomiting occurs 456. These symptoms can be significant, especially in vulnerable populations such as young children and the elderly 46.
Diarrhea and Other Gastrointestinal Symptoms
Diarrhea is a primary symptom of norovirus infection and can occur independently of vomiting. Studies show that a substantial proportion of norovirus cases experience diarrhea without vomiting, indicating that vomiting is not a necessary symptom for diagnosis 13. In some outbreaks, only about half of those who vomited also had diarrhea, and vice versa, highlighting the variability in symptom presentation .
Additional Symptoms: Fever, Abdominal Pain, and Dehydration
Fever and abdominal pain are also common in norovirus cases, with or without vomiting. In pediatric cases, fever was present in about 69% and abdominal pain in 31% of symptomatic children, regardless of vomiting status . Dehydration is a risk, especially when diarrhea is persistent, and can be more severe in young children and older adults 46.
Nausea and Loss of Appetite
Nausea and loss of appetite are frequently associated with norovirus infection, even when vomiting does not occur. These symptoms are part of the body’s broader sickness response to viral infection and can contribute to the overall feeling of illness .
Norovirus Without Vomiting: Implications for Diagnosis and Control
The presence of norovirus symptoms without vomiting can lead to underdiagnosis if vomiting is used as a primary criterion for case identification. Studies suggest that relying solely on vomiting or diarrhea for surveillance may underestimate the true burden of norovirus disease, as many symptomatic cases may present with only one of these symptoms or with other non-specific symptoms .
Conclusion
Norovirus infection can cause a range of symptoms beyond vomiting, including diarrhea, fever, abdominal pain, nausea, loss of appetite, and dehydration. Vomiting is common but not universal, and many individuals experience significant illness without it. Recognizing the full spectrum of norovirus symptoms is important for accurate diagnosis, effective outbreak control, and better understanding of the disease’s impact 13456.
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