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Medical Author:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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After an individual has contracted norovirus, it first attaches to cells in the gastrointestinal tract. The virus enters the cells, triggering the gastrointestinal tract to cause vomiting and preventing good fluid adsorption, which results in diarrhea. Because the virus is very difficult to cultivate, it has not been precisely determined exactly how the virus causes disease. However, studies done to date suggest that the capsid (external coat) helps attach virus to cells, avoid the body's immune defenses, and targets people with specific blood groups (especially group O). At least five genogroups (genetically related groups GI, GII, GIII, GIV, GV) of norovirus, with at least 31 genetic clusters (genetic subgroups) have been identified. One genogroup, GII subgroup 4, is responsible for about 80% of recent (2002-2008) outbreaks. The virus is spread by droplets in the air, and if the droplets land on food or other objects, the virus can be transmitted to the mouth when touched by the hands.

Unfortunately, the virus has been referred to by many names (for example, Norwalk virus, Norwalk-like virus or NLV, SRSV, meaning small round structured viruses, Snow Mountain virus). Many of these names often arise from the area or region where an outbreak occurs, like Toronto virus, Hawaii virus, or Bristol virus. Common names like "winter vomiting virus" or "stomach flu" are also used. "Stomach flu" is not related to any type of influenza; the term was likely coined because of the frequent watery diarrhea norovirus produces which is like the frequent clear or "watery" nasal discharge of the flu. This loose terminology can be confusing but it is understandable because by the time the norovirus is identified as the causative agent, usually the brief outbreak is ending or is over.

Drawings and electron microscopy pictures of the norovirus can be seen by going to the last two Internet sites listed below.

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Vomiting and Nausea Vomiting and nausea are common complaints that accompany many conditions and diseases. A few common causes of vomiting and nausea include food poisoning, viruse...learn more >>

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