What parents need to know about norovirus (the stomach bug)

Norovirus is the leading cause of vomiting and diarrhea among people of all ages in the United States. It’s sometimes called the stomach flu or stomach bug, but norovirus (NOR-uh-vy-ris) isn’t related to the flu, which is caused by the influenza virus.

Norovirus is very contagious, and with cases confirmed in our area, it’s important for parents to know the signs and symptoms, as well as how to prevent infection.

What are the signs and symptoms of a norovirus infection?

About a day or two after contact with norovirus, a person may develop symptoms such as:

• Diarrhea
• Vomiting
• Nausea
• Stomach pain

Other symptoms include fever, chills, headache, or muscle aches. Sometimes norovirus causes no symptoms, but infected people can still pass the virus to others.

A child with a norovirus infection who is experiencing a lot of diarrhea and vomiting is at risk for dehydration and may feel lightheaded or dizzy. Children who are dehydrated may cry with few or no tears and be unusually sleepy or fussy.

How does norovirus spread?

Norovirus spreads easily, and can be spread both before a person has symptoms and even weeks after they feel better. Outbreaks are more common in places where many people gather, like at childcare centers and schools and on cruise ships.

Norovirus infections happen when people accidentally get tiny particles of feces (poop) or vomit from an infected person in their mouths. This can happen if they have direct contact with someone who is infected with norovirus, such as by caring for them or sharing food or eating utensils with them.

These particles can also land on objects or surfaces if a person doesn’t wash their hands well after using the bathroom or changing a diaper. Kids can get the virus if they put their fingers in their mouths after touching something that has been contaminated.

People can also eat food or drink liquids that are contaminated with norovirus (then, it’s known as food poisoning), and even by breathing in the virus if they’re close enough to an infected person who vomits.

How is norovirus treated?

Most people with norovirus illness get better within 1 to 3 days. Antibiotics only work against bacteria, so doctors don’t use them to treat norovirus. While there is no specific medicine to treat people with norovirus illness, you can take steps to help your child recover at home and prevent dehydration. These include:

• Making sure your child gets plenty of rest.
• Giving lots of fluids to help your child stay hydrated, such as water or sports drinks.
• Giving your child oral rehydration fluids that you can get over the counter at the pharmacy or grocery store, such as Pedialyte, Enfalyte, or a store brand. You also can give frozen electrolyte pops or broth.
• Not giving your child any medications unless recommended by their health care provider.
• Making sure your child washes their hands thoroughly and often to prevent the virus from spreading.
• Offering small amounts of food after vomiting has stopped. A child who isn’t throwing up can eat a regular diet if they feel up to it, but it may take time. Avoid greasy or fried foods until they feel better.

When can children return to day care or school?

Kids with a norovirus infection should not go to school or childcare/day care until their vomiting and diarrhea has stopped for 24 hours. They also should not go in swimming pools until they’re well again. Children in diapers should stay out of pools until their diarrhea has stopped for 7 days.

How can norovirus infections be prevented?

You can help protect yourself and others from norovirus by washing your hands thoroughly with soap and water. If someone in your household has the stomach bug, please follow these prevention tips:

1. Wash your hands thoroughly (for at least 20 seconds) with soap and water, especially after using the toilet or changing diapers, always before eating, preparing, or handling food, and before giving yourself or someone else medicine. Know that when it comes to norovirus, hand sanitizers don’t work as well to remove the germs as soap and water.
2. Keep sick infants and children out of areas where food is being handled and prepared.
3. Do not prepare food for others while you are sick and for at least two days after symptoms stop.
4. Wear rubber gloves and a face mask when cleaning up vomit or poop or handling soiled clothes.
5. Clean and disinfect surfaces with a bleach-based household cleaner as directed on the product label.
6. Clean soiled clothing using the washing machine’s longest cycle and hot water settings and the dryer’s high heat setting.

When should parents call their child’s pediatrician?

The most important things to watch for will be signs of dehydration. Call your doctor if your child:

• Goes more than a few hours without drinking anything
• Shows other signs of dehydration, such as a dry mouth, few tears when crying, urinates less than 3 times a day, or has no wet diaper in 4–6 hours
• Continues to have diarrhea or vomiting after a few days
• Develops a high fever
• Vomits blood, or has bloody diarrhea or severe belly pain