Know the signs, the treatment & how to avoid catching it in the first place
In October 1968, a mysterious illness tore through an elementary school in Norwalk, Ohio. It infected half of the students and teachers in two days, and quickly spread to their families.
Then it disappeared. Folks called it “the Norwalk virus.” In the years following, similar outbreaks were reported in Colorado, Vermont, Massachusetts, and Canada, and as far away as Hawaii, Mexico, and Australia.
And in 1977, scientific authorities revealed the true culprits to the world: a mad family of RNA pathogens dubbed “noroviruses.”
Today, norovirus is the leading cause of acute gastroenteritis in the United States, with an estimated 2,500 norovirus outbreaks each year and causing 58% of all foodborne illness in the country. (It is also responsible for more than 90% of all diarrheal disease aboard cruise ships, earning the nautical moniker “cruise ship virus.”)
Incredibly contagious and devilishly diverse, norovirus spreads quickly and easily through the population, while stymying continued attempts to develop a vaccine.
“It rips through families,” says FPG Pediatrician Ronald D. Laracuente, MD. “Someone brings it home from school and then everyone gets it.” And while not deadly, norovirus is deeply uncomfortable and severe cases can lead to hospitalization.
However, doctors discovered one neat and nifty trick to help prevent norovirus infection…
How to Prevent Norovirus Infection
Norovirus is most often spread via fecal-oral transmission. This is science’s way of not sounding gross when they tell you that norovirus spreads by getting little poop particles in your mouth.
The good news is this means norovirus is not typically airborne.
Instead, people most often share their infected poo particles through surface transmission, meaning they have not washed their hands properly after using the bathroom, they then touch something around them—a doorknob, a chair, a serving spoon at a buffet—and the next person unknowingly picks those particles up. And it only takes a few. Again, incredibly contagious.
But there’s a pretty simple solution: wash your hands.
“The most important thing is to wash your hands extremely thoroughly,” says Dr. Laracuente, noting that the classic “Sing-Happy-Birthday-twice-while-scrubbing” rule still applies. And if a sink with soap and water is not available, hand sanitizer will do. So teaching kids to wash hands regularly throughout the day—“And especially before eating,” Dr. Laracuente emphasizes—can greatly reduce risk of transmission.
And while it’s generally a good idea to keep a clean house, this becomes extra important during a norovirus outbreak—and especially if it’s in your house. Sanitize surfaces regularly with bleach or a similarly strong cleanser. Be sure to use proper PPE and ventilation.
Also, just don’t put things in your mouth.
Do I Need to Sanitize Everything?
Lessons Learned from Vomiting Larry
You may think your tyke a tidy puker, an initiate in the Order of the Immaculate Upchuck, but when you have norovirus, there’s no such thing.
A 2013 study, conducted using a cookie-tossing robot named Vomiting Larry, discovered that losing one’s lunch can send pathogen-carrying vomit particles more than 2.5 meters in every direction.
So sanitize everything.
How to Spot Norovirus – Key Symptoms & Signs
With all sorts of bugs floating around at once, it can be hard to tell which is which. But there are a few things to look out for.
Incubation
“Norovirus very characteristically has a short incubation period,” Dr. Laracuente says, with symptoms typically coming on 12-24 hours after exposure.
Expression
Norovirus symptoms come on strong, often causing pretty severe vomiting and diarrhea. This is the worst of it and lasts 48-72 hours.
“This is where you’re at highest risk for dehydration and hospitalization,” says Dr. Laracuente, “because you can lose a lot of fluids during that period.”
Duration
After the worst has passed, expect lingering nausea and gastrointestinal distress for 4-6 days.
How to Treat Norovirus – Hold On Tight & Hydrate
So, your child has norovirus.
Unfortunately, being a virus, there’s not much to do other than wait for the sickness to run its course. Fortunately, being a virus, it shouldn’t take terribly long. In the meantime, over-the-counter medications for nausea and diarrhea can help alleviate symptoms.
Until then, the most important thing for anyone with norovirus is to stay hydrated.
Water, soda, juice, sports drink—whatever the child wants to drink and can keep down is good, says Dr. Laracuente. Aim for small volume but frequent sips.
He offers a Pro Tip: Pedialyte popsicles.
The Trick to Spotting Dehydration
Watching for dehydration while your child is dealing with a norovirus infection can seem tricky, says Dr. Laracuente, but there’s one simple rule to guide parents:
Watch the output.
Measuring how much fluid a child takes in can be complicated, and the requirements are different for every child. But all children should be urinating three times a day. If they are not, says Dr. Laracuente, speak to your healthcare provider.
How Long Is Norovirus Contagious?
Thankfully, just as norovirus comes on strong and fast, it also leaves relatively quickly. Those 2-3 days will be rough, but they’ll pass. In this way, the symptoms of the disease somewhat mirror its course.
However, someone with norovirus can still spread the disease to those around them for up to two weeks after symptoms fade.
So even if symptoms have passed and the person is feeling better, everyone should remain extra vigilant about surface sanitation and hand-washing.
Can You Become Immune to Norovirus?
Yes. And no. But mostly No.
Immediately after a bout with norovirus, a person may retain some brief mucosal immunity that can help prevent them from picking up the illness again right away. Most studies show that this immunity lasts for less than six months.
And like the flu, noroviruses mutate rapidly and frequently, making a lasting vaccine near impossible to make.
Your best bet is to keep washing your hands.
Need A Pediatrician?
To learn more about Pediatric Services at First Physicians Group, including locations in Lakewood Ranch, Sarasota, Osprey and Venice, click here.
To schedule an appointment with Dr. Laracuente, click here.
Written by Sarasota Memorial copywriter Philip Lederer, MA, who crafts a variety of external communications for the healthcare system. SMH’s in-house wordsmith, Lederer earned his Master’s degree in Public Administration and Political Philosophy from Morehead State University, KY, and couldn’t find a place to work in his “ignore-a-virus” joke.