There has been a spike in cases of norovirus (stomach flu) in the past couple months. The Midwest is at 20% positivity as of a few weeks ago (per the CDC). HANDWASHING IS VERY IMPORTANT. Hand sanitizers do not work as well to prevent it.

OVERVIEW OF NOROVIRUS

Norovirus infection can cause severe vomiting and diarrhea that start suddenly. Noroviruses are highly contagious. They commonly spread through food or water that is contaminated during preparation or through contaminated surfaces. Noroviruses can also spread through close contact with a person who has norovirus infection.

Diarrhea, stomach pain, and vomiting typically begin 12 to 48 hours after exposure. Norovirus infection symptoms usually last one to three days. Most people recover completely without treatment. However, for some people — especially young children, older adults, and people with other medical conditions — vomiting and diarrhea can be severely dehydrating and require medical attention.

Norovirus infection occurs most frequently in closed and crowded environments. Examples include hospitals, nursing homes, childcare centers, schools, and cruise ships.

SYMPTOMS

Signs and symptoms of norovirus infection may start suddenly and include:

·     Nausea

·     Vomiting

·     Stomach pain or cramps

·     Watery or loose diarrhea

·     Feeling ill

·     Low-grade fever

·     Muscle pain

Signs and symptoms usually begin 12 to 48 hours after your first exposure to a norovirus and last one to three days. You can continue to shed virus in your stool for several weeks after recovery. This shedding can last weeks to months if you have another medical condition.

Some people with norovirus infection may show no signs or symptoms. However, they are still contagious and can spread the virus to others.

WHEN TO SEE A DOCTOR

Seek medical attention if you develop diarrhea that does not go away within several days. Call your health care provider if you experience severe vomiting, bloody stools, stomach pain, or dehydration.

CAUSES

Noroviruses are highly contagious. This means the norovirus infection can easily spread to others. The virus is shed in both stool and vomit. You can spread the virus from the time you first have symptoms of illness until several days after you recover. Noroviruses can stay on surfaces and objects for days or weeks.

You can get norovirus infection by:

·     Eating contaminated food;

·     Drinking contaminated water;

·     Touching your hand to your mouth after your hand has been in contact with a contaminated surface or object;

·     Being in close contact with a person who has norovirus infection.

Noroviruses are difficult to kill because they can withstand hot and cold temperatures and many disinfectants.

RISK FACTORS

Risk factors for becoming infected with a norovirus include:

·     Eating in a place where food has been handled by someone with norovirus infection or the food has been in contact with contaminated water or surfaces;

·     Attending preschool or a childcare center;

·     Living in close quarters, such as in nursing homes;

·     Staying in hotels, resorts, cruise ships, or other destinations with many people in close quarters;

·     Having contact with someone who has norovirus infection.

COMPLICATIONS

For most people, norovirus infection usually clears up within a few days and is not life-threatening. But in some people — especially young children, older adults, and people with weakened immune systems or other medical conditions or who are pregnant — norovirus infection can be severe. Norovirus infection can cause severe dehydration and even death.

Warning signs of dehydration include:

·     Fatigue

·     Dry mouth and throat

·     Listlessness

·     Dizziness

·     Decreased urine output

Children who are dehydrated might cry with few or no tears. They might be unusually sleepy or fussy.

PREVENTION

Norovirus infection is highly contagious. There are many types of noroviruses. Anyone can get norovirus infection more than once.

To prevent norovirus infection:

·     Wash your hands thoroughly with soap and water for at least 20 seconds, especially after using the toilet or changing a diaper and before you prepare food and eat or drink. Alcohol-based hand sanitizers are not as effective against noroviruses as using soap and water.

·     Avoid contaminated food and water, including food that could have been prepared by someone who was sick.

·     Wash fruits and vegetables before eating.

·     Cook seafood thoroughly.

·     Disinfect surfaces that might have been contaminated. Wear gloves and use a chlorine bleach solution or a disinfectant that is effective against noroviruses.

·     Use caution when traveling. If you’re traveling to areas with a high risk of norovirus infection, consider eating only cooked foods, drinking only hot or carbonated beverages, and avoiding food sold by street vendors.

To help prevent norovirus infection spread, please follow these guidelines during illness and for two to three days after your symptoms end:

·     Avoid contact with others as much as possible.

·     Wash your hands thoroughly with soap and water.

·     Stay home from work. Children should stay home from school or childcare.

·     Avoid handling food and items to be used by other people. Disinfect contaminated surfaces with a disinfectant effective against noroviruses.

·     Dispose of vomit and stool carefully. Wearing disposable gloves, soak up material with disposable towels. Disturb soiled material as little as possible to avoid spreading noroviruses by air. Place soiled items in plastic bags and place them in the trash. Remove and wash clothes and linens that may be contaminated.

·     Avoid traveling until two to three days after your symptoms are gone.

DIAGNOSIS

Norovirus infection is usually diagnosed based on your symptoms, but noroviruses can be identified from a stool sample. If you have a weakened immune system or have other medical conditions, your health care provider might recommend a stool test to confirm the presence of norovirus.

TREATMENT

There is no specific treatment for norovirus infection. Recovery generally depends on the health of your immune system. In most people, the illness usually resolves within a few days.

It is important to replace lost fluids. Oral rehydration solutions may be used. If you are not able to drink enough fluids to prevent dehydration, you might need to receive fluids through a vein (intravenous).

Your health care provider might recommend over-the-counter anti-diarrheal medication and medication to reduce nausea.

LIFESTYLE AND HOME REMEDIES

If your family includes young children, it is a good idea to have commercially prepared oral rehydration solutions on hand. Adults can drink sports drinks, broths, or oral rehydration solutions. Drinking liquids that contain a lot of sugar, such as soft drinks and some fruit juices, can worsen diarrhea. Avoid beverages with caffeine and alcohol.

Ease back into eating. Try to eat small amounts of food frequently if you experience nausea. Otherwise, gradually begin to eat bland, easy-to-digest foods, such as soda crackers, toast, gelatin, bananas, applesauce, rice, and chicken. Stop eating if your nausea returns. Avoid milk and dairy products, caffeine, alcohol, nicotine, and fatty or highly seasoned foods for a few days.

Remember that norovirus infection is highly contagious. Avoid contact with others as much as possible during illness and for several days after recovery. Wash your hands and disinfect surfaces and objects. Do not prepare food for others until your symptoms are gone.

Submitted from Jean Roedl/Mayo Clinic