QOD 11 3 09

QOD 11 3 09

Which one of the following therapies is generally recommended for the treatment of severe norovirus gastroenteritis?
		A.	Interferon.
		B.	Parenteral hyperimmune human immune globulin.
		C.	Rehydration with intravenous fluids alone.
		D.	Ribavirin. The treatment for norovirus gastroenteritis, like that for other diarrheal illnesses, is oral rehydration with fluids and electrolytes, if the patient is alert and able to drink, or with intravenous fluids, if vomiting and dehydration are severe. Antimotility and antisecretory agents can be useful in adults to decrease diarrhea in situations in which a person's performance is critical. Although no antiviral agents have yet been developed, the x-ray crystallographic structures of the viral polymerase and proteases are known, as is the binding site of histo-blood group antigens in particles, and these provide potential targets for the development of drugs. Interferons and ribavirin effectively inhibit replication of Norwalk virus in replicon-bearing cells, and their potential therapeutic value needs to be further evaluated. Among patients receiving immunosuppressive therapy, recognition of norovirus infection could optimize case management with respect to long-term therapy for the primary disease. Administration of hyperimmune human immune globulin parenterally or orally has been suggested, but this therapy has never been studied in a clinical trial. Answer: C