What is the initial management of norovirus gastroenteritis?

• A. Antibiotics
• B. Hydration and supportive care
• C. Antivirals
• D. Probiotics

Answer: (B)

Hydration and supportive care are the initial management for norovirus gastroenteritis. This viral illness causes rapid fluid loss, so the priority is to prevent and treat dehydration rather than use antibiotics or antivirals, which don’t help here. Start with oral rehydration solutions to replace losses; if vomiting prevents taking fluids or dehydration is present, provide IV fluids with appropriate electrolytes. Once rehydration is achieved, advance to regular foods as tolerated rather than sticking to a restrictive diet. Use antiemetics like ondansetron to reduce vomiting and facilitate rehydration, and provide fever/pain relief as needed. Probiotics have inconsistent evidence and are not essential in the initial management. In adults, antidiarrheal medications can be considered only after rehydration and when appropriate, but they’re usually avoided in children and in cases where invasive infection is suspected. Also emphasize infection control—hand hygiene, cleaning of surfaces, and staying home until at least 48 hours after symptoms stop—to limit spread.