Does severe norovirus infection need emergency care?

Question

Hello, Doctor,

A norovirus outbreak has hit our cruise ship, and my husband (age 72) is severely ill. We are stuck in our cabin. He has explosive diarrhea every 30 minutes and is vomiting frequently. The ship's doctor gave him Ondansetron and Loperamide, but they are not helping much.

He has a history of heart failure and usually takes Furosemide every day. Still, he has not been able to take any of his heart medications for the past two days because he vomits up everything he tries to swallow. His heart rate is fast (112 beats per minute) and irregular. He becomes so dizzy when he tries to stand up that he almost faints.

The bathroom is messy, and he is too weak to clean himself. The ship’s staff said over 200 passengers are sick, and the medical center is overwhelmed. We are scheduled to dock in two days, but I am afraid he will not survive until then. He has barely urinated today, and the little he produced was dark brown.

Should we demand a helicopter evacuation?
What else can we do if the medicines they gave him are not working?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Your husband’s condition needs urgent medical care. It is very concerning that he cannot keep down any medicines, including his heart medicines. The frequent diarrhea, fast heart rate, dizziness when standing, weakness, and very low urine output all strongly suggest that he is severely dehydrated.

He needs fluids and medicines given through a vein (intravenously) to stop the diarrhea and vomiting and to treat the dehydration. His blood pressure must be checked often, and he must be treated quickly if it is low. It is also very important to check his blood with laboratory tests. These should include a complete blood count, blood salts (electrolytes), and tests to check his kidney function. Any salt imbalances or kidney problems must be treated quickly.

As he cannot take his heart medicines by mouth, he is at higher risk for serious heart problems. His heart medicines need to be restarted as soon as possible, even if that means giving them intravenously instead of by mouth. He must be watched closely to keep the right balance of fluids in his body, not too much and not too little.

If there is a doctor on board, your husband should be assessed right away for intravenous fluids and medicines and treated as described above. If there is any delay in getting proper treatment on the ship, you should insist that he be transferred to a hospital immediately, without waiting until the ship docks.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.