Fast Five Quiz: Common Food Poisoning Pathogens

Richard H. Sinert, DO

Disclosures

November 12, 2018

Oral fluid and electrolyte replacement is generally adequate for the treatment of norovirus infections. In cases of severe volume depletion, intravenous fluid and electrolyte resuscitation may be necessary. Symptomatic relief can be achieved using antiemetics for nausea and vomiting and analgesics for myalgias and headache. Antiperistaltic agents should generally be avoided in cases of infectious diarrhea but could be considered in patients with severe diarrhea.

Norovirus illness can be acquired at any time during the year, but it is most common in winter in the United States.

Abdominal examination reveals the absence of focal tenderness and peritoneal signs. Vital signs include low-grade fever, tachycardia, and possible hypotension with volume depletion.

Detection methods include:

  • Immune electron microscopy: immune serum is used to aggregate virus in stool samples to aid detection

  • Antigen immunoassay: has high sensitivity but low specificity because of reactivity with antigenic variants and homologous viruses

  • Nucleic acid amplification: this technique is highly sensitive and specific. The sensitivity of real-time polymerase chain reaction (PCR) is more than 1000 times greater than that of standard enzyme-linked immunosorbent assays and approximately 10-fold greater than reverse transcription-PCR in detection of norovirus capsid proteins in stool and food samples

For more on norovirus infection, read here.

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