Screen Shot 2013-02-12 at 10.27.08 AMNorovirus is a nasty one. It’s the leading cause of epidemics of vomiting/diarrhea and causes over 20 million cases of gastrointestinal disease (“stomach flu” with vomiting, diarrhea, abdominal pain, fever and achiness) in the US each year. Our experience with Norovirus historically is worse in years with “novel” or new strains of infection. Unfortunately there’s an new strain circulating around the globe. “Sydney 2012” was discovered in Australia last March and just last month the CDC officially announced it’s causing the majority of Norovirus infections. Over 1.2 million people in the United Kingdom have had it and the FDA reports this strain may potentially cause more hospitalizations. Time will tell if we have more Norovirus this year, too.

When new strains arrive, we tend to see a 50% increase in the number of cases of “stomach flu.” Norovirus is remarkably potent and contagious. It often isn’t killed by hand sanitizer (see #3 below). You touch the virus and touch your mouth and you could get it. We can get Norovirus multiple times in our lives because our immunity wanes after infection and new viral strains develop which cause unique disease. We get Norovirus from contaminated food, contaminated surfaces we touch, and from other people who vomit or have diarrhea and spread the virus. This is the cause of the stomach bug that you often associate with cruise ship outbreaks or daycare outbreaks when everyone starts vomiting one afternoon…

Around the holidays a stomach bug swept through our home. It did so for many of my patients, too. During the first week of January, I had a day in clinic where approximately 75% of the families I saw in clinic mentioned someone in their home had been vomiting over the past week. Unusual. I can’t tell you what virus it was (I didn’t test any child’s stool or vomit in the lab), but my bet is on Norovirus…

Facts About Norovirus

  • Norovirus is an unpleasant but generally well-tolerated illness. Most children and adults do fine getting over Norovirus without medicine or visits to the doctor but it’s known to be more dangerous for infants and the elderly. It is the leading cause of outbreaks of the “stomach flu” each year. It tends to cause 1-3 days of sudden-onset vomiting, diarrhea, stomach upset, and/or fever and achiness. The biggest risk is severe dehydration.
  • Vomiting and diarrhea typically come on suddenly so it seems like “food poisoning.” In truth, about 1/2 of “food poisoning” is caused by Norovirus contamination but we can get it from food prepared by someone with the virus, contaminated food or surfaces we touch. Outbreaks occur in enclosed places like cruise ships, daycare, and nursing homes where people live in close quarters. Most common foods where Norovirus comes into our bodies is raw oysters, leafy greens, and fresh fruit. A reminder even when we’re tired we should always wash that lettuce that says it’s been “triple cleaned.”
  • You’re most contagious with Norovirus on the day you’re vomiting and/or having diarrhea or stomach upset and for the subsequent 3 days. The virus is in your vomit, your diarrhea, and can live on surfaces that you touch with contaminated hands for days. The virus can stay in your and your baby’s stool for up to 2 weeks after you’re sick. You can even get Norovirus from particles that get aerosolized into the air from vomit when it hits the table or floor.

What To Do About The “Stomach Flu”

  1. Hydration: The biggest health risk from Norovirus is dehydration. Your biggest goal is stay hydrated for the 1-2 days of vomiting and diarrhea. When you and your children are ill, take slow sips of fluids throughout the day to keep your fluids up. Don’t give them a sippy cup or water bottle full at first–often a big amount of liquid at once will come right back up! Think spoonfuls.
  2. No Perfection Prevention: You can’t prevent the “stomach flu” or Norovirus with a vaccine or antibiotic. Your best defense is hand-washing and sanitizing when exposed to the virus. Wash your hands before eating.
  3. Wash With Soap And Water: Use soap and water after using the toilet, changing a diaper, cleaning up after your children’s vomit or when they have accidents. There is some data that Norovirus isn’t killed off by hand-sanitizer. You have to wash your hands with water and soap to be the most safe. Here’s a list of cleaning sanitizer products that kill Norovirus.
  4. Don’t Prepare Food: One of the biggest ways that Norovirus is transmitted is through contaminated food. Don’t prepare food while you’re ill or for 3 days after you’ve had the “stomach flu.”
  5. Sanitize your home: Use an affordable bleach water solution after vomiting and diarrhea strikes. It’s easy to make with bleach from the grocery store. Mix between 5-25 tablespoons of bleach in 1 gallon of water. Use this bleach water solution (it’s cheapest) for cleaning the bathroom, counters, and toys. Don’t hesitate to mix it up and re-clean the day after you or your child is improved as their stool will likely still contain some of the very contagious virus particles. Wash all clothes in long washing cycle and then use a dryer to further kill potential virus that remains.
  6. When To See The Doctor: If your child is having severe pain that causes them to double-over or yell out in pain, it likely isn’t Norovirus.  If your child isn’t making good tears, isn’t making a wet diaper every 6 hours or not peeing. If your child reports feeling dizzy when you stand up, call your child’s clinician for advice or a possible visit to rule-out dehydration.