How to manage norovirus infection in elderly people?

Question

Hello doctor,

My 82-year-old mom has norovirus and is getting worse quickly. She has been vomiting and having diarrhea for 18 hours straight and can not keep anything down, not even her medications. She is on Warfarin and has missed two doses. She is getting very weak, confused, and struggling to reach the bathroom, already falling twice. Her fever is 100.8°F. She usually lives alone, but I am staying with her now. I tried giving her anti-nausea medicine, but she threw it up immediately. Her lips are dry, and her skin stays up when pinched.

When is this dangerous for the elderly? Should I take her to the emergency room? What should I do about her missed medications? How long does norovirus usually last for someone her age?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Norovirus is a highly contagious but self-limiting infection that usually resolves within 10 days. The main concern is dehydration, which can become serious if fluids are not replaced. Signs of severe dehydration include low energy or unusual tiredness, pale and sunken eyes, cold hands or feet, fast breathing and heart rate, irritability, drowsiness, confusion, dark yellow urine or reduced urination, and loss of skin elasticity.

To manage the condition, it is important to give oral rehydration solution (ORS) and plenty of fluids while avoiding sugary drinks. Anti-nausea medication like Ondansetron can help control vomiting, and Imodium (Loperamide hydrochloride) may be used for diarrhea. Antispasmodics like Cyclopam can relieve stomach cramps, while easy-to-digest foods such as rice, soups, toast, and fruits are recommended. Yogurt can also help restore gut bacteria. As the patient has underlying heart issues and is missing medications due to vomiting, it is best to take her to the emergency room. If possible, anti-nausea medication should be administered to help her keep down essential medications. If she remains unable to take her medicines or her condition worsens, urgent medical attention is necessary. The likely cause is a norovirus infection, and a serum electrolyte test is recommended to assess dehydration and electrolyte imbalances.

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

Thank you.