Dawaa Reference

infectious

Norovirus Gastroenteritis

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources2 sources

CDC Yellow Book 2024 · NICE CG84 Diarrhoea and vomiting caused by gastroenteritis in children under 5 (NCBI Bookshelf NBK63837)

Verified against2 documents
  • NICE CG84 Diarrhoea and vomiting caused by gastroenteritis in children under 5 (NCBI Bookshelf NBK63837)
  • WHO. The treatment of diarrhoea: a manual for physicians and other senior health workers, 4th rev. Geneva: WHO; 2005 (IRIS 10665/43209), section 4.3.1 and Table 2

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (6)

  • Sickness, vomiting, cramping belly pain and loose stool, often with muscle aches, headache and chills [abdominal pain · chills · headache · muscle cramps · muscle pain · vomiting]
  • Some people get mainly loose stool, others mainly nausea and vomiting [nausea · vomiting]
  • Illness usually runs 1 to 3 days, with or without a prodrome
  • Ask about living quarters, water source, recent travel, raw or undercooked food and sick contacts
  • A weakened immune system predicts a longer illness and greater risk of serious harm
  • Rarely the picture is neurological, with a fit or a confused, drowsy state [seizures]

Signs — what you find (4)

  • Belly tenderness is typically mild, diffuse and does not localise [abdominal tenderness]
  • Marked tenderness or guarding points away from this and needs another cause hunted for [guarding]
  • Visibly bloody stool does not fit and calls for further workup
  • Dry mouth, poor skin turgor, fast pulse and a postural blood pressure drop mark dehydration [dehydration · dry mouth]

Tests (6)

  • Most cases need no test at all
  • A metabolic panel is worth it in selected patients, to check salts and hydration
  • Stool culture, C difficile toxin and ova and parasites only if illness drags on or another organism is suspected
  • RT-PCR on stool or vomit is the reference test; enzyme immunoassay is the one more clinics can actually get
  • Accuracy swings with how many samples were sent, when the stool was taken and how it was handled
  • Outbreak pattern: vomiting in over half of cases, incubation 24 to 48 hours, illness lasting 12 to 60 hours, and no bacteria grown from stool

If not this — what else fits (4)

  • Other gut infections: rotavirus, cholera, C difficile, Salmonella, Cryptosporidium, enterovirus, E coli, Shigella, Campylobacter, Vibrio
  • When belly pain leads, weigh surgical and vascular causes: appendicitis, gallbladder, gut obstruction or perforation, diverticulitis, pancreatitis, gut ischaemia, aortic aneurysm
  • Also weigh pregnancy in the tube, twisted ovary or testis, pelvic infection, kidney infection and urine infection
  • A heart attack can show up as belly pain and belongs on the list

SourceStatPearls "Norovirus" - disease-level clinical article

Presentation findings are traced to the source above.

1

ORS

1st line

Formoral.liquid

Adult dose and duration

Make the sachet up to the volume printed on the pack - a WHO/UNICEF standard sachet makes 1 litre, and using less water than the label says makes the solution dangerously concentrated. Egypt also sells ready-mixed 240-360 mL packs, which need no dilution. Drink after each loose stool or vomiting episode.

Paediatric dose

75 mL/kg/dose

(75 ml/kg over 4 hours for fluid deficit replacement (WHO Plan B), plus maintenance fluid. This matches every other rehydration entry in the app.)

Dose by weight
3kg225 mL/dose
4kg300 mL/dose
5kg375 mL/dose
6kg450 mL/dose
7kg525 mL/dose
8kg600 mL/dose
9kg675 mL/dose
10kg750 mL/dose
11kg825 mL/dose
12kg900 mL/dose
13kg975 mL/dose
14kg1050 mL/dose
15kg1125 mL/dose
16kg1200 mL/dose
17kg1275 mL/dose
18kg1350 mL/dose
19kg1425 mL/dose
20kg1500 mL/dose
21kg1575 mL/dose
22kg1650 mL/dose
23kg1725 mL/dose
24kg1800 mL/dose
25kg1875 mL/dose
26kg1950 mL/dose
27kg2025 mL/dose
28kg2100 mL/dose
29kg2175 mL/dose
30kg2250 mL/dose
31kg2325 mL/dose
32kg2400 mL/dose
33kg2475 mL/dose
34kg2550 mL/dose
35kg2625 mL/dose
36kg2700 mL/dose
37kg2775 mL/dose
38kg2850 mL/dose
39kg2925 mL/dose
40kg3000 mL/dose
41kg3075 mL/dose
42kg3150 mL/dose
43kg3225 mL/dose
44kg3300 mL/dose
45kg3375 mL/dose
46kg3450 mL/dose
47kg3525 mL/dose
48kg3600 mL/dose
49kg3675 mL/dose
50kg3750 mL/dose
Dose source

WHO. The treatment of diarrhoea: a manual for physicians and other senior health workers, 4th rev. Geneva: WHO; 2005 (IRIS 10665/43209), section 4.3.1 and Table 2

Why

Norovirus is self-limiting; management is purely supportive fluid replacement.

Cautions
  • Never make the solution up in less water than the pack states. A five-fold concentrated ORS given to a dehydrated patient causes hypernatraemia, and an infant is the one least able to survive it.
  • Use strict hand hygiene with soap and water (alcohol sanitizers are less effective against norovirus).
  • Exclude patient from work/school for 48 hours after symptoms resolve.
  • Do not use antidiarrhoeal medications.
Egyptian brands
Egyptian brandManufacturerIndicative price
GLUCOHYDRAN 10 SACHET.ARAB DRUG COMPANY (ADCO)1.75 EGP
REHYDRAN N 10 SACHETCID4.50 EGP
REHYDRO ZINC 10 SACHETSCID7.00 EGP
ORS 20 SACHETSPHAROPHARMA40.00 EGP
ELECTRO MASH SYRUP 200 MLMASH PREMIERE60.00 EGP
FLEXOLYTE ORAL REHYDRATION SOL. 240 MLKEMPETRO FOR CHEMICAL INDUSTRIES65.00 EGP
HERO ORS 200 MLHERO > HERO MEA TRADING120.00 EGP
SANSO ORS SYRUP 140 MLAUG PHARMA400.00 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.